Posted on January 28, 2024.

Who Federal Medical Standards Apply To

Drivers of Class A, Class B, and commercial Class C vehicles must meet medical requirements established by the federal government and Department of Motor Vehicles (DMV). This applies to:

• All Class A, Class B, and commercial Class C driver license (DL) holders.
• All commercial drivers who drive interstate.
• Firefighters who operate fire equipment, any class C vehicle, or any other vehicle in their capacity as a firefighter.If the firefighter has a physical or mental condition which would otherwise disqualify them from driving a commercial vehicle, a license may be issued as long as they do not transport passengers when driving commercially or materials requiring placards/markings. Show Citation 11
  
• Drivers hauling hazardous agricultural material (HAM). Show Citation 22

Purpose

Operating commercial vehicles, commercial Class C vehicles, noncommercial Class A and Class B vehicles, fire vehicles and equipment, and vehicles hauling HAM is more physically and mentally demanding than operating other types of vehicles, which creates an increased risk to public safety. Additionally, challenging driving conditions make it difficult for drivers to adequately provide for any special medical, diet, exercise, or rest needs associated with a medical condition or physical impairment.

For these reasons, CDLs are generally denied to drivers who do not meet the federal medical standards. However, in accordance with statute and court decisions, each case must be considered individually to determine if the driver compensates adequately for any medical condition or physical impairment and if any restrictions apply (see Exceptions and Review Process below).

Medical Certificates and Reports

Drivers who are required to meet medical standards must certify that they meet the requirements when they apply for their license and every two years thereafter.

Commercial Drivers

Commercial drivers must submit a completed Medical Examination Report (MER) Form (MCSA 5875) and Medical Examiner’s Certificate (MEC) (MCSA 5876) (see “Medical Examination Report” in Commercial Driver Licenses).

The MER (MCSA 5875) must be completed and signed by a health care professional who is licensed, certified, or registered in accordance with applicable state laws and regulations to practice medicine and perform physical examinations in the United States (U.S.). Health care professionals are doctors of medicine, doctors of osteopathy, physicians assistants, and advanced practice nurses, or doctors of chiropractic who are clinically competent to perform the examination. An optometrist (O.D.) may perform the vision portion of the exam. Drivers who wish to perform interstate commerce must have their exam completed by a medical professional on the National Registry of Certified Medical Examiners and the certification number must be present on the form.

For 15 days after being issued a MEC (MCSA 5876), commercial drivers must have a copy of the MEC, signed by a health care professional, in their possession when operating any commercial motor vehicle. Show Citation 33 After 15 days have passed, the driver no longer needs to carry it on their person. DMV is authorized to issue the Medical Certificate (form DL 51B), pursuant to CCR 28.19.

Noncommercial Class A and B Drivers, Firefighters, and Drivers Hauling HAM

Noncommercial Class A and B drivers must complete a Physician’s Health Report (DL 546A) to certify that they meet the required medical standards. This form must be completed by a physician as it includes details concerning drivers’ vision and any physical impairments they may have.

Firefighters and drivers hauling HAM must complete a Health Questionnaire (DL 546). This form is completed by the applicant, but does not require a physician’s signature to verify driver information.

Medical Standards

The Federal Motor Carrier Safety Regulations (FMCSR) establish the criteria to determine when a person is physically qualified to drive a commercial vehicle (see 391.41 FMCSR). The following guidelines are provided as they apply to various medical conditions.

California Standards

CVC §12804.9 requires that DMV determine whether the applicant is mentally and physically fit to operate a motor vehicle, and permits us to consider the standards required by federal regulations in establishing California medical requirements for commercial driver licenses. It also provides that any physical defect of the applicant which, in the opinion of DMV, is compensated for to ensure safe driving ability, will not prevent the issuance of the license. CVC §12809 authorizes DMV to refuse to issue a CDL to any person not meeting the medical requirements.

California Regulations

Title 13, Article 2.1, 28.18 and 28.19, of the California Code of Regulations (CCR) provides the minimum physical and medical requirements for Class A, B, or commercial Class C drivers’ licenses. These are the same standards required of motor carrier drivers by the Federal Highway Administration of the Department of Transportation.

Medical Certificates and Reports

Drivers who are required to meet medical standards must certify that they meet the requirements when they apply for their license and every two years thereafter.

Commercial Drivers

Commercial drivers must submit a completed Medical Examination Report (MER) Form (MCSA 5875) and Medical Examiner’s Certificate (MEC) (MCSA 5876) (see “Medical Examination Report” in Commercial Driver Licenses).

The MER (MCSA 5875) must be completed and signed by a health care professional who is licensed, certified, or registered in accordance with applicable state laws and regulations to practice medicine and perform physical examinations in the United States (U.S.). Health care professionals are doctors of medicine, doctors of osteopathy, physicians assistants, and advanced practice nurses, or doctors of chiropractic who are clinically competent to perform the examination. An optometrist (O.D.) may perform the vision portion of the exam. Drivers who wish to perform interstate commerce must have their exam completed by a medical professional on the National Registry of Certified Medical Examiners and the certification number must be present on the form.

For 15 days after being issued a MEC (MCSA 5876), commercial drivers must have a copy of the MEC, signed by a health care professional, in their possession when operating any commercial motor vehicle. Show Citation 33 After 15 days have passed, the driver no longer needs to carry it on their person. DMV is authorized to issue the Medical Certificate (form DL 51B), pursuant to CCR 28.19.

Noncommercial Class A and B Drivers, Firefighters, and Drivers Hauling HAM

Noncommercial Class A and B drivers must complete a Physician’s Health Report (DL 546A) to certify that they meet the required medical standards. This form must be completed by a physician as it includes details concerning drivers’ vision and any physical impairments they may have.

Firefighters and drivers hauling HAM must complete a Health Questionnaire (DL 546). This form is completed by the applicant, but does not require a physician’s signature to verify driver information.

Medical Examination Report Review

DMV reviews the medical report for completeness, legibility, and compliance withmedical standards.

If the driver does not meet the medical standards or does not adequately compensate for a loss or impairment, the driver may be scheduled for a reexamination or issued an Order of Refusal. In certain instances, we may also issue the following outcomes:

• Medically qualified with conditions: When evidence proves the driver may not be medically qualified to drive a commercial motor vehicle, but the condition appears correctable, the driver will be contacted for further information or a reexamination will be scheduled.
• Medically qualified with restrictions: Applicants with conditions that are waivable under federal standards (vision, hearing, and loss or impairment of limb), or previously licensed commercial drivers with other conditions, may be eligible for a CDL with appropriate restrictions. If the applicant adequately demonstrates compensation, a CDL may be approved with the following restrictions:No passengers when driving commercially or transporting material requiring placards/markings. Show Citation 44
  May not drive in interstate commerce.
  
• Medically disqualified for CDL only: When evidence proves the driver is not qualified to drive a commercial motor vehicle, but does qualify for a Class C noncommercial driver license, the driver will be issued only a Class C license.
• Medically disqualified for any class driver license: When a medical report indicates the driver does not qualify to drive any motor vehicle safely, revocation of the entire driving privilege is required.

Drive Test

DMV will conduct a drive test to determine whether the driver compensates for a condition that is waivable under federal standards (if the driver has not previously demonstrated compensation). If the driver compensates for the condition, DMV will issue a restricted license.

Exceptions

In certain circumstances, DMV may make exceptions to the medical standards for a commercial driver license.

Original Application

On original CDL applications, DMV may make rare exceptions to the medical requirements when the driver is able to demonstrate a history of adequate compensation. The commercial drive test will determine if the driver adequately compensates for any loss or impairment of a limb, vision, or hearing. If a CDL is issued, it will be restricted to driving intrastate only (within California), and without passengers or HazMat.

Factors DMV considers to determine if the medical condition will affect driving include (but are not limited to) the following:

• History and length of medical condition.
• Scope of commercial driving.
• Hours of operation.
• Driving record history.
• Scope of employment.
• Side effects of condition.
• Geographic location.
• Type of vehicle.

Commercial License Renewal

If the driver has been driving safely with the disqualifying medical condition, DMV may make exceptions from federal standards to allow the driver, when renewing a Class A or B license, to operate a commercial vehicle. However, the license must be restricted to driving intrastate only and without passengers or hazardous materials.

If the medical condition or physical impairment would affect coordination, strength, vision, hearing, or judgment, a drive test may be required to determine the adequacy of compensation.

Interstate Waivers and Exemptions

Occasionally a driver will contact DMV seeking a federal waiver or exemption. Such drivers may qualify for a federal waiver if they are employed driving in interstate commerce. The federal waiver and exemption program is designed to allow persons with specific conditions listed in FMCSR §391.41 to qualify under the FMCSR. Restrictions may be included on individual waivers when the Regional Federal Highway Administrator determines they are necessary for public safety.

If the driver is found otherwise medically qualified, the examining physician must include the statement “medically unqualified for interstate commerce unless accompanied by a waiver” on the medical certificate.

The driver should send the waiver request to:

U.S. Department of Transportation
1200 New Jersey Avenue, SE
Room W64-224
Washington, DC 20590

Medical Exam Failure

If a driver fails to qualify for a new medical certificate (per CVC §14606(b)), the driver’s employer is required to report it to DMV immediately using one of the following:

• Employer’s Report of Medical Exam Failure/Request for Reexamination (DS 524)
• Health Questionnaire (DL 546)
• Letter from the employer stating that the driver does not qualify

DMV will review the Report of Medical Exam Failure, Health Questionnaire, or letter to determine if the driver’s physical or mental condition may preclude safe operation of a commercial vehicle. The driving record is analyzed for potential problems that may be related to the physical or mental condition (violations, accidents, suspension, revocation).

If the review indicates further investigation is needed, a reexamination may be scheduled.

If the evidence warrants revocation of the driving privilege because of an immediate driving hazard, the CDL will be revoked without first reexamining the driver (per CVC §13953).

Reexamination

A hearing officer may order a reexamination based on information such as medical reports, law enforcement or court referrals, Department of Health Services Confidential Morbidity Reports (CMR), or other contacts.  Show Citation 55

The hearing officer will consider the following factors in the reexamination: 

• A detailed description of the medical condition or physical impairment and any related effects.
• How it affects safe driving, if at all.
• The medical regimen, if any.
• The prognosis of the medical condition or physical impairment.
• The scope of the driving.
• The driving record and how it relates to the medical condition or physical impairment, if at all.
• How compensation for the medical condition or physical impairment (or lack of compensation) was determined.
• Any restrictions and the reasons the restrictions were imposed.

The hearing officer will make a decision following the reexamination to take no action, or, if action is required, find that the driving privilege should be:

• Revoked.
• Restricted to a Class C non-commercial driver license.
• Restricted to intrastate driving only, with no passengers and no hazardous materials requiring placards.
• Restricted to scope or geographical area of employment.
• Placed on probation based on a physical or mental condition.

Hearings

A driver can request a hearing if DMV has:

• Refused to issue a CDL.
• Restricted an already issued Class A or B, or C CDL to a Class C noncommercial license.
• Revoked the driving privilege of a commercial applicant.

When DMV has refused, restricted, or revoked a CDL, the hearing officer must determine if the action is supported by the evidence. If the action is not supported and should be modified, the hearing officer must determine which, if any, restrictions should be imposed.

In determining whether the driver qualifies for a CDL, the hearing officer must consider the evidence received, which may include the following:

- Hours of work.

- Scope of driving.

- Mileage.

- Driving record.

- Health needs.

Hearing Decision

The hearing officer will make a determination regarding whether the driver is competent to drive a particular commercial vehicle in specific circumstances. The hearing officer must consider the facts in each case on an individual basis, balancing the driver’s needs with the requirements of public safety. Possible determinations include:

• Probation: Probation may be appropriate in instances when a driver is currently qualified, but the hearing officer determines that regular medical reports are warranted. The scope of driving will be restricted, and the driver must remain under medical supervision.
• Intrastate exception: If the hearing officer restricts the driver to intrastate driving only, a scope of employment restriction tailored to the individual’s current use may be appropriate. Examples:May operate a Class A or B vehicle only within the scope of employment as a mechanic.
  When operating Class B vehicles, driver is restricted to a three axle dump truck in the municipality of (location).