Under 49 CFR 391.45(b), a driver must be medically examined and certified if the driver has not been examined and certified as qualified during the preceding 24 months. A medical examiner may certify a driver for a shorter period. Appendix A to 49 CFR Part 391 provides medical advisory criteria under which a driver with hypertension may be certified for 1 year, 6 months or a one-time 3-month period, depending on the stage of the condition.
Section 391.45 sets a 12-month interval for several groups:
1. Drivers authorized to operate only within an exempt intracity zone under 49 CFR 391.62
2. Drivers with diabetes mellitus treated with insulin who were certified under the standards in 49 CFR 391.46
3. Drivers who do not meet the vision standard in the worse eye and were certified under the standards in 49 CFR 391.44
Under 391.45(g), a driver whose ability to perform normal duties has been impaired by a physical or mental injury or disease must also be examined and certified again. Under 391.45(h), on or after June 23, 2025, a person found by a medical examiner not to be physically qualified under 49 CFR 391.43(g)(3) must also be examined and certified again. Under 391.43(g)(3), all medical examiner's certificates previously issued to that person are not valid and no longer satisfy 391.41(a).
Motor carriers keep the medical certification in the driver qualification file under 49 CFR 391.51. The examination itself must be performed by a medical examiner listed on the FMCSA National Registry of Certified Medical Examiners.
Sources: 49 CFR 391.45, 49 CFR 391.43, 49 CFR 391.51, Appendix A to 49 CFR Part 391
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