If a driver fails or is not recertified for a DOT Medical Certificate?

What are the rules, if a driver fails or is not recertified for a DOT Medical Certificate, due to the particular type of medicine he is on?

A Medical Examiner’s Certificate, which is also known as a DOT Medical Card, is required for every Commercial Motor Vehicle (CMV) driver. The card is issued by a DOT Medical Examiner after a “DOT physical examination.” A driver is asked to fill out a form called a “Medical Examination Report for Commercial Driver Fitness Determination,” also known as the “long form” which details the driver’s medical history and lists all current medications. To show that the driver is “fit” or medically qualified to drive, the card is required to be carried by all CMV drivers (and CDL drivers until at least January 30, 2015). This information will become part of a driver’s motor vehicle record (MVR) when the CDL driver “self-certifies” or updates the information at his Department of Motor Vehicles (DMV). Carriers and organizations should retain a copy of the card for the driver’s qualification file (QF). For most drivers, this card is valid for a period of two years. Before the expiration date of the card, the driver should recertify with another DOT examination.

If there is a change in a driver’s health status, the driver may be medically unqualified to drive and the card would become invalid. Here are a few actual situations concerning a driver’s health status:

Example 1:
A CMV driver had a “sleep study” at a sleep clinic and left for a two week trip. When he was 351 miles from home, he was informed that he was diagnosed with sleep apnea. He informed his dispatch of the results of the sleep study. The driver was told to secure and clean out the truck, then load his personal belongings on a Greyhound bus and return home. The driver was off work for four weeks waiting for a sleep study appointment, then getting his CPAP machine. He was on the CPAP for 7 days before a DOT Examiner certified and released him to return to work as a CMV truck driver.

Example 2:
A CMV driver had a mild cold. He did not see a doctor or take any medication or over-the-counter cold medication, as he felt he did not need it and the mild cold did not impair his driving. As such, his medical card was in effect and no other action was required.

Example 3:
A CMV driver with a chronic medical condition was issued medication with the warning on the bottle saying “DO NOT OPERATE HEAVY EQUIPMENT.” When the driver began taking the medication, he was not medically qualified to operate his truck and the medical card became invalid. The driver should see a medical examiner for a new card, if his medical condition improves and that particular medication is not needed.

Example 4:

A CMV driver was helping a friend on the weekend do a roofing job. His ladder slipped as he started to climb, he was knocked out and taken to the hospital. In his state, “a loss of consciousness” means “loss of all driving privileges” for six months. The driver should see a DOT Examiner for an examination after the mandatory six month period.

If a driver experiences a change in his health status, he may be medically unqualified to operate a CMV. He should consult with appropriate medical professionals before resuming to drive a CMV.


A DOT medical card (Part 391) violation falls under the Driver Fitness SMS BASIC Category in CSA. Violations in the Driver Fitness BASIC are the cause of 9% of DOT Interventions/ Investigations according to Patti Gillette of the Colorado Motor Carriers Association. There are 30 Driver Fitness violations that can affect your CSA scores according to the Table of Driver Fitness BASIC Violations.

A driver cited for failure to carry a medical card (Part 391.41) adds 3 points to the CSA score (1 point times a CSA Time Weight of three = three points). Violation of 391.41A No Medical Card in Possession continues to be a top violation year after year. Best Practice: keep a photocopy of the card in the truck.

A driver with a history of driving without a valid medical card (no card in possession or an expired card in possession) may be placed Out Of Service (OOS), which would add another six CSA points (2 points times a CSA Time Weight of three = 6 points), as of April 1, 2012, according to the North American Standard Out-of-Service Criteria (OOSC).

CSA points follow carriers for 24 months, but fall off over time:

Time Weights (Carriers)
0-6 months old = 3
6-12 months old = 2
12-24 months old = 1


CMV drivers need to carry or keep a copy of a valid DOT medical certificate with them when driving (CDL drivers until at least January 30, 2015), and recertify their certification before their current DOT Medical Certificate expires. CDL drivers need to make their medical certification a part of their CDL driving record.


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