The most crucial part of truck driving is, well, the truck driver. A fit, deft and agile driver is the foremost requirement of any trucking company, because of all the physical exertion involved. With regard to this, Federal Motor Carrier Safety Administration (FMCSA) has been proactive in setting medical requirements and standards that all commercial motor vehicle drivers must meet.

FMCSA medical regulations constitute the Medical Program Division. This Division has a mission committed to improving the safety standards of American roadways via legislating and implementing medical regulations, guidelines and policies that will warrant that commercial motor vehicle drivers engaged in interstate commerce are physically qualified for the same.

FMCSA Portal provides detailed information about all the medical requirements that ought to be met, what exemptions can be made, who is an FMCSA Certified Medical Examiner, and any other information a driver may seek.

Medical Fitness for Duty

Driving a passenger vehicle is easy - fewer blind spots, easy maneuverability, automatic steering, and painless parking. On the other hand, driving a commercial motor vehicle is entirely different. It is physically strenuous, the truck driver needs to be aware of blind spots and much more careful of other vehicles on the road.

The FMCSA Regulations are designed for interstate truck drivers. The intrastate drivers are subject to regulations of their respective states which have been adapted from the federal regulations. There are minor differences between the regulations of each state.

Medical Exam

The Department of Transportation (DOT) mandates a physical exam for truck drivers which is to be conducted by a licensed medical examiner listed on the FMCSA National Registry.

Safe driving is not the only reason why truck drivers must qualify the medical exam. They also have to perform pre and post trip safety inspections, secure the load, and make sure it doesn’t shift.

The FMCSA Portal states that this DOT physical exam is valid for up to 24 months. However, there is an exception that if the truck driver has a health condition that needs to be monitored, then the FMCSA certified medical examiner can issue a certificate for less than 24 months.

Important FMCSA Regulations

The Qualifications find mention in the Code of Federal Regulations Title 49 Subtitle B Chapter III Subchapter B Part 391. It has been titled " Qualification of Drivers and Longer Combination Vehicle (LCV) Driver Instructors."

Three important regulations from this are:

i. 49 CFR 391.41 - Physical Qualifications for Drivers

This part states that a person can operate a commercial motor vehicle only if he or she is medically certified for meeting the physical qualifications, subject to CDL/CLP exemptions. There are 13 qualifications mentioned explicitly in this part, which are as follows:

  • Has no loss of a foot, a leg, a hand, or an arm
  • Has no impairment of hand or finger and arm, foot, or leg which interferes with power grasping or the ability to perform normal tasks associated with operating a CMV, respectively
  • Has no established medical history or clinical diagnosis of diabetes mellitus
  • Has no current clinical diagnosis of certain cardiovascular diseases
  • Has no established medical history or clinical diagnosis of a respiratory dysfunction that can affect driving
  • Has no current clinical diagnosis of high blood pressure that can affect work
  • Has no established medical history or clinical diagnosis of rheumatic, arthritic, orthopedic, muscular, neuromuscular, or vascular disease that can affect work
  • Has no established medical history or clinical diagnosis of epilepsy or any other condition that can cause loss of consciousness
  • Has no mental, nervous, organic, or functional disease or psychiatric disorder that can affect operating the CMV
  • Meets the distant visual acuity given in the CFR or meets the requirements in § 391.44
  • Meets the given hearing ability requirements
  • Does not use certain drugs or substances
  • Has no current clinical diagnosis of alcoholism
ii. 49 CFR 391.43 - Medical Examination; certificate of physical examination

This section has eight paras. The first two paras (a) and (b) talk briefly about the FMCSA certified medical examiner.

(a) The medical examination must be performed by a medical examiner listed on the National Registry of Certified Medical Examiners

(b) there are two exceptions to the above rule:

  • A licensed ophthalmologist or licensed optometrist may perform the part of the medical examination that involves visual acuity, the field of vision, and the ability to recognize colors
  • A certified VA medical examiner must only perform medical examinations of veteran operators.
iii. 49 CFR 391.46 - Physical qualification standards for an individual with diabetes mellitus treated with insulin for control

If such an individual meets the physical qualification standards or has an exemption or skill performance evaluation certificate, he/she is physically qualified to operate a commercial motor vehicle. Prior to the examination as per FMCSA regulations, the individual must be evaluated by his or her "treating clinician." Such individuals must self-monitor their blood glucose according to the treatment plan specified by their treating clinician.


FMCSA has Exemption programs through which individuals may apply for exemption from seizure, vision, and/or hearing standards. The Federal Motor Carrier Safety Administration requires the submission of some specific information for review, such as medical exams and employment history, with regard to the Federal Vision Exemption Program and requests for hearing and seizure exemptions. A final decision is made within 180 days of receiving a completed application.

It must be noted that FMCSA's exemption programs are only for drivers who seek to operate commercial motor vehicles in interstate commerce, as FMCSA does not have statutory authority to grant waivers/exemptions to drivers who operate intrastate.

FMCSA Certified Medical Examiner

" Federal Motor Carrier Safety Regulations define Medical Examiner as a person who is licensed, certified and/or registered in accordance with applicable State laws and regulations to perform physical examinations. The term includes but is not limited to doctors of medicine, doctors of osteopathy, physician assistants, advanced practice nurses and doctors of chiropractic."

The Code of Federal Regulations states that the medical examiners shall be knowledgeable of the specific and mental demands associated with operating a commercial motor vehicle as per FMCSA guidelines. The FMCSA certified medical examiner should be proficient in the use of necessary medical protocols.

An Imperative

The trucking system cannot function properly if its human resource is not fit for duty. Human capital is just as essential as any other equipment, if not more. The FMCSA regulations are thorough and detailed in informing truck drivers about which exams they need to take, which qualifications they need to meet and why all of this is important for road safety.

A truck driver who is in good shape can keep the flow of logistics moving uninterrupted, while making sure that safety standards are met.

A healthy driver means a healthy system.