Quick answer
A DOT medical card (the medical examiner's certificate) shows you're physically qualified to drive a commercial motor vehicle. You need one if you drive a CMV in non-excepted interstate commerce. It's valid for up to 24 months, or less if the examiner decides. Since June 23, 2025, CDL and CLP results go to your state electronically.
Source: 49 CFR 391.43; 383.73(a)(7) · checked Oct 2026
Running your own authority with a CDL? Your medical card is one piece of your qualification file; the drug and alcohol program is another. Company drivers are covered by their employer's program, and non-CDL drivers aren't in DOT testing. See owner-operator consortium plansWe may earn a referral fee if you sign up through this link. It does not change your price. Disclosure
From the exam room to your driver record
Pick your license type to see how the certificate travels. The steps are a summary of the rules, not a copy of any official form.
1Find an examiner
Book with a medical examiner on FMCSA's National Registry.
2The exam
Health history, vision, hearing, blood pressure and a physical exam against the federal standards.
3Result to FMCSA
The examiner reports the result to FMCSA electronically.
4Your state record
FMCSA sends it to your state, which updates your CDL record. No paper trip to the DMV.
The National Registry is searchable at nationalregistry.fmcsa.dot.gov. Our guide to the FMCSA National Registry explains how to use it, and the DOT physical walks through the exam itself.
DOT medical card requirements: who needs one
Federal medical rules apply to drivers of commercial motor vehicles in interstate commerce. In general, that means a vehicle or combination rated over 10,000 lb, a vehicle carrying placarded hazmat, or one built to carry more than 8 or 15 passengers, depending on whether they pay. A CDL isn't the line here: many non-CDL drivers, such as box truck and hotshot drivers in interstate work, need a medical card too.
The physical standards cover vision, hearing, blood pressure, insulin-treated diabetes, heart and lung conditions, seizures and more. The examiner decides whether you meet them.
Source: 49 CFR 391.41(b)(10); 391.44 · checked Oct 2026
Source: 49 CFR 391.41, 391.43, 391.51 · checked Oct 2026
How long is a DOT physical good for?
Up to 24 months. Every driver must be re-examined at least every 24 months, and some sooner: drivers with insulin-treated diabetes are certified for no more than 12 months, and examiners can issue shorter certificates when a condition needs monitoring. The expiration date on your certificate is the one that counts. Work out yours with the DOT medical card expiration calculator.
Source: 49 CFR 391.45 · checked Oct 2026
If you're watching your blood pressure before an exam, see DOT physical blood pressure.
The four self-certification types
When you apply for or renew a CLP or CDL, you tell your state which kind of driving you do. It decides whether the federal medical card rule applies to you.
| Type | Who it's for | Federal medical card |
|---|---|---|
| Non-excepted interstate | Most truck drivers who cross state lines | Required |
| Excepted interstate | Interstate work in excepted operations, such as some government or emergency driving | Not required by FMCSA |
| Non-excepted intrastate | In-state only, under your state's medical rules | Your state's rules |
| Excepted intrastate | In-state only, in operations your state excepts | Not required |
Source: 49 CFR 383.71(b)(1) · checked Oct 2026
Exemptions and variances
Not meeting one standard isn't always the end of the road. FMCSA has an alternative vision standard, a separate standard for insulin-treated diabetes, a skill performance evaluation for drivers with limb impairments, and exemption programs for some conditions. Each has its own process and paperwork, and the examiner or FMCSA decides.
Source: 49 CFR 391.44, 391.46, 391.49; 381 · checked Oct 2026
Talk to a certified medical examiner, and your own doctor, before you assume a condition rules you out.
What to bring, and if you don't pass
- Your driver's license and glasses, contacts or hearing aids if you use them.
- A list of your medications, with doses and the prescribing doctor.
- Recent records for any condition you're treated for, such as a heart, sleep apnea or diabetes follow-up.
If the examiner finds you not qualified, they must tell you and report it to FMCSA, and any certificate you held before is no longer valid. Ask what would change the outcome: a treated condition, a specialist's report or one of the variance programs above.
Source: 49 CFR 391.43; 383.73(a)(7) · checked Oct 2026
What happens if your medical card expires
For a CDL holder, the state marks you "not certified" within 10 days of the certificate expiring, and that starts the process to downgrade your CDL. Until you're re-certified, you can't drive a CMV that needs the card. For a non-CDL driver, an expired certificate means you're not qualified to drive the CMV until you pass a new exam.
Source: 49 CFR 383.73(o) · checked Oct 2026
Owner-operators carry both roles: you keep your own certificate in your qualification file. If you're starting your own authority, our new authority dispatch begins with a setup check, medical card included.
DOT medical card FAQ
How long is a DOT physical good for?
Up to 24 months. The certified medical examiner can issue a shorter certificate, for example one year, when a condition such as high blood pressure needs monitoring. Your certificate's expiration date is what counts, so book the next exam a few weeks before it.
What is a medical examiner's certificate?
It's the document that shows a certified medical examiner found you physically qualified to drive a commercial motor vehicle under FMCSA's standards; drivers call it the DOT medical card. For CDL and CLP holders, the result now goes to FMCSA and your state electronically; non-CDL drivers still receive a paper certificate.
Who is exempt from a DOT medical card?
Drivers who self-certify as excepted interstate (for example some government, farm or emergency operations), drivers whose state doesn't require one for in-state driving, and drivers of vehicles that aren't commercial motor vehicles, generally 10,000 lb or less, carrying no placarded hazmat and fewer than 9 or 16 passengers depending on pay.
Where do I get a DOT physical?
From a medical examiner listed on FMCSA's National Registry of Certified Medical Examiners. A doctor who isn't on the registry can't issue a valid certificate. Search the registry by location, and bring a list of your medications and any records for conditions you're treated for.
Can my own doctor do my DOT physical?
Only if your doctor is a certified medical examiner listed on FMCSA's National Registry. Many family doctors aren't. Your own doctor can still help: bring their notes on any condition you're treated for to the exam, because the examiner may ask for them.
Do I still need to carry my medical card?
Non-CDL drivers receive a paper certificate and their carrier keeps a copy in the driver qualification file. For CDL and CLP drivers, the certification now reaches the state electronically. Keep a copy of your certificate anyway, and ask your state and carrier what they want to see.