The Federal Motor Carrier Safety Administration (FMCSA) is an organization set up within the United States Department of Transportation. It’s main function is to regulate the trucking industry with a goal to reduce crashes, injuries and fatalities involving large trucks and buses.
As such it is required by federal law for all commercial drivers to get seen at least Bi-annually or sooner by a certified registered medical examiner.
The focus and aim of this exam is to make certain that there are no physical or mental health or drug related issues which can impact attention and focus while on the road (i.e. a missing or impaired hand, foot and leg or a medical condition or other which is deemed to statistically increase the likelihood of a crash or fatality). Their main focus is to keep our roads safe and to ensure safety of all drivers as well as the general public.

The FMCSA has recognized that the landscape of drivers is changing on a continual basis which includes the aging of drivers with newly diagnosed medical conditions. An increasing complexity and awareness that within the driving community there exists newly diagnosed and undiagnosed muscular/orthopedic conditions, Cardiovascular disorders, neurological disorders. Histories of cancers, pulmonary conditions ie: Sleep apnea, emphysema. There is an increasing number of drivers with obesity and diabetes/kidney disease. Many people are taking medications which can potentially impact their ability to stay awake and be mentally alert while on the road. Thus, the examiner is required to perform an extensive physical exam and history in order to determine physical fitness and safety for the driver to continue on the road.

There are a strict set of guidelines which has been set forth by the FMCSA with listed criteria of physical fitness in order to qualify to drive a commercially licensed vehicle. In the past any physician could fill out the physical fitness form and certify a driver; however, as of around May 2014 to present drivers are required to go to a certified medical examiner found only in the national registry. A certified examiner can be found by going to the FMCSA’s website at If the Examiner is not certified then the exam will not count and the driver risks suspension due to failure to renew license. Since the rules are at times complex the FMCSA has issued the ability of only a certified medical examiner within the NRCME (national registry of certified examiners) who are familiar with passing and disqualifying conditions to conduct this exam.
It is useful to note that certain medical conditions are immediately disqualifying; therefore, not recommended to come to the fitness exam unless the driver has successfully obtained a Federal waiver for that condition.

The driver is required by law to fill out the history form accurately to the best of their knowledge without any omissions.
1. Monocular Vision ( vision passing in just one eye ) is automatically disqualified without a waiver. Vision of at least 20/40 is required in each eye in order to pass the exam. Any driver with absence of color vision cannot pass according to the present guidelines.

2. Diabetics on insulin are automatically disqualified unless accompanied by a Federal Diabetes Waiver exemption.

3. It is strongly advised to have blood pressure below 140/90 if possible when taking this exam in order to qualify for a 2 year certificate. Anything above 180 systolic number on top/110 diastolic number on bottom is disqualifying. If the the Blood pressure reading falls between 160-179/100-109 this then the examiner might certify potentially for 3 month period only one time certificate in which case the driver will be re evaluated again after 3 months. If blood pressure has not gone down then driver will not be issued the certificate.

4. Hearing requirement if for a driver to be able to pass the “forced Whisper test” driver would need to perceive a forced whisper in the better ear standing 5 feet away with or without a hearing aid. If cannot hear whisper then would need to take audiology testing and pass without a hearing aid or with a calibrated hearing aid to perceive at least 40dB tested at 500 HZ, 1000 HZ and 2000 HZ.

5. A seizure disorder is disqualifying in general unless there are no seizures off of medications for at least 10 years time.

6. A driver with an implantable cardiac defibrillator can never qualify for a CDL license. Other cardiac dysrhythmias or miscellaneous heart conditions might be able to pass depending on the nature and stability and with proper supporting documents from their cardiologist.

7. Drivers with physical disabilities ie: missing a hand foot arm or leg will be required to apply for Skilled performance evaluation (SPE certificate).

8. For people with lung disease ie: COPD/Emphysema a pulmonary function test ie breathing test will be required or some drivers who are smoking.

9. Drivers with obstructive sleep apnea will be required to bring in their up to date sleep study.

10. Use of any habit forming drugs is automatically disqualifying. Anyone on methadone or opioid therapy anyone with current alcoholism. Marijuana is disqualifying.

11. Certain medications may be disqualifying depending on their ability to affect driving ability ie: A driver may not drive after taking Benadryl and must wait approximately 12 hours.

There are numerous other medical conditions that will not be discussed here.
The intent of this exam is also a good opportunity to emphasize overall preventive health since many drivers deal with stressful shifts with deadlines. They may be driving for longer periods of time without breaks and often resort to eating fast food. Adequate sleep and proper nutrition are emphasized. It is not uncommon for a new medical condition to get diagnosed here. Often times the drivers can implement a healthier lifestyle and they can avoid developing of diabetes, hypertension and obesity. A lot of drivers may not have a primary medical doctor so they might not be aware of certain issues. This can unfortunately lead to a medical condition which can affect their health or cause loss of or suspension of their license due to not able to pass the licensing exam. The exam is once a again a measure of protection to the driver and for safety of our roads . The FMCSA is not looking to kick drivers off of the road. There are plenty of opportunities to address a potentially serious or new medical issue as it comes up so that a driver may qualify to drive again if corrected.

General tips for day of your exam
Refrain from or limit the usual amount of caffeine intake since this can sometimes lead to an elevated blood pressure reading. Other medications like OTC decongestants or Non Steroidal anti inflammatory medications may raise you blood pressure reading as well.

Having amazing blood pressure readings at the pharmacy or by your primary medical doctor does not count on the day of the exam. Only the certified medical examiners blood pressure reading counts towards your license.
Get a good night sleep so that you are focused and calm during the exam.

Try to relax and don’t be stressed out on the day of your exam.

Take all your regularly doctor prescribed medications. If you forgot to take your blood pressure medications and as a result your blood pressure is high you might not be able to pass the exam.

Remember to bring any waivers you may need.

Please bring in all bottles of medications that you are taking and any other medical supporting documentation that you will need in order to pass.

If diabetic please bring in your most recent blood test results from your primary medical doctor.

If you plan to pass with glasses or contact lenses for vision then please do not forget to bring this.
If you need to pass hearing with your hearing aid then do not forget this.