CDL Medical Card and DOT Physical: What You Need to Know
TL;DR
Most CDL drivers need a DOT physical from a medical examiner on the FMCSA National Registry, and the certificate is good for up to 24 months. If you let your medical certification lapse, your state can mark your record not-certified and downgrade your CDL, per 49 CFR 383.73.
Who needs a DOT medical certificate
49 CFR 391.41 says a person subject to that part must not operate a commercial motor vehicle unless medically certified as physically qualified to do so. Most CDL drivers who cross state lines fall under it. Whether you need the certificate depends on the type of driving you do, which is what the self-certification categories below are for. If you are not sure which category you fit, ask your state licensing agency or your employer's safety department.
Who can give the exam
Per 49 CFR 391.43, the exam must be done by a medical examiner listed on the FMCSA National Registry of Certified Medical Examiners. A regular family doctor who is not on the registry cannot certify you for this purpose. The one exception in that section is vision: a licensed ophthalmologist or optometrist can do the vision part. Certified VA examiners may examine veteran drivers only. When you pass, the examiner completes the Medical Examiner's Certificate, Form MCSA-5876. The examiner also reports the result electronically to FMCSA. You can search the National Registry on the FMCSA website to find a listed examiner near you. Exam prices are set by the clinic.
How long it lasts
49 CFR 391.45 sets the standard interval: a driver who has not been examined and certified within the preceding 24 months must be examined again. FMCSA describes the certificate as valid for up to 24 months. The examiner can issue a shorter certificate when a condition needs monitoring, high blood pressure being the example FMCSA gives. Read the expiration date on your certificate rather than assuming two years.
The four self-certification categories
When you apply for or renew a CDL or CLP, 49 CFR 383.71(b)(1) has you certify the type of driving you do or expect to do. There are four options.
- Non-excepted interstate: you drive across state lines and must meet the federal medical standards in 49 CFR Part 391, including holding a medical certificate.
- Excepted interstate: you drive across state lines but only in the kinds of excepted transportation named in the regulation, so no medical certificate is required.
- Non-excepted intrastate: you drive only within your state and are subject to that state's driver qualification rules.
- Excepted intrastate: you drive only within your state and only in transportation that is excepted from state qualification requirements.
What happens if it lapses
If you are a non-excepted driver and your medical certification is missing or expires, 49 CFR 383.73(o)(4) requires your state to mark your driver record as not-certified and begin a CLP or CDL downgrade under its procedures. The downgrade must be completed and recorded within 60 days of the record becoming not-certified. A downgrade removes your commercial driving privilege from your license, so you cannot legally drive a CMV until you are certified again. Since June 23, 2025, 49 CFR 391.41(a)(2) lets CDL and CLP holders whose current certificate is on file with their state stop carrying a paper copy, though anyone with a medical variance must still carry that documentation. Procedures and timing for updating your record vary by state, so confirm with your state licensing agency.