Federal law requires certain commercial motor vehicle (CMV) drivers to pass a medical examination and hold a valid medical examiner’s certificate. Operating a CMV with an expired medical certificate is a serious violation of federal regulations and can put drivers, carriers, and the public at risk.
The Federal Motor Carrier Safety Administration (FMCSA) enforces these requirements under 49 CFR § 391.45, which outlines who must be medically examined and how often certification must occur.
Why Medical Certification Is Required
Medical certification ensures that drivers are physically and mentally capable of safely operating a commercial motor vehicle. Driving a CMV demands alertness, strong vision, coordination, and the ability to respond to emergencies.
The FMCSA requires periodic medical exams to confirm that drivers continue to meet these safety standards. When a medical examiner’s certificate expires, there is no proof that the driver remains physically qualified.
Learn more about FMCSA medical requirements on fmcsa.dot.gov.
Drivers Who Must Be Medically Examined and Certified
Under 49 CFR § 391.45, the following categories of drivers must maintain valid medical certification:
Drivers Without a Current Medical Certification
Any driver who has not been medically examined and certified cannot operate a commercial motor vehicle. Past certification does not protect a driver once it expires.
Drivers Not Examined Within the Last 24 Months
Most CMV drivers must be medically examined at least once every 24 months. If the last medical exam is older than 24 months, the driver is unqualified to drive until a new certification is issued.
Drivers Operating Only in an Exempt Intracity Zone
Drivers operating exclusively within an exempt intracity zone must renew certification every 12 months due to special geographic exemptions.
Drivers With Insulin-Treated Diabetes Mellitus
Drivers managing diabetes with insulin must complete a medical exam and receive certification at least annually. Expired certification immediately disqualifies them.
Drivers With Certain Vision Limitations
Drivers relying on a vision exemption must renew their certification every 12 months. Expired certification means the driver no longer meets federal qualification standards.
Drivers With Physical or Mental Impairments
Drivers whose ability to perform normal duties is affected by an injury or disease must be re-examined. Operating a CMV without re-certification is a violation.
Drivers Found Not Physically Qualified (Effective June 23, 2025)
Beginning June 23, 2025, drivers deemed not physically qualified under updated medical evaluation standards cannot operate a CMV until they meet the revised requirements.
Why an Expired Medical Certificate Is a Serious Violation
An expired medical examiner’s certificate eliminates proof that a driver is physically and mentally fit. FMCSA treats this violation seriously because driver health directly impacts road safety. Consequences include:
- Citations and fines
- Out-of-service orders for drivers
- Negative safety scores for carriers
More details on FMCSA enforcement are available on fmcsa.dot.gov.
How FMCSA Identifies This Violation
FMCSA inspectors identify expired medical certificates during roadside inspections and compliance reviews. Inspectors verify certification dates against regulatory requirements. Any driver with an expired certificate is considered unqualified, regardless of current health status.
How Carriers Can Prevent This Violation
Motor carriers can proactively prevent violations by:
- Tracking medical certification expiration dates
- Scheduling exams well in advance
- Maintaining clear records and reminder systems
- Regularly reviewing driver files for upcoming expirations
Proactive compliance protects drivers, carriers, and the public while supporting safer commercial vehicle operations.
For official FMCSA guidance on driver medical qualifications, visit FMCSA Medical Requirements.
Key Takeaway
Maintaining a current medical examiner’s certificate is not optional. It’s a federal requirement that safeguards drivers, carriers, and everyone on the road. Motor carriers should prioritize timely renewals to avoid violations and ensure safe CMV operations.