DOT Physical and Medical Card: Who Needs One, What to Expect, and How Long It Lasts

Reviewed by Austin Park, founder of ICR Filings · Updated October 31, 2026

To legally drive a commercial motor vehicle, you must be medically certified as physically qualified. That is what people mean by a DOT physical, and the certificate that results is the medical card. Here is what the federal rules require.

Who needs one

The rule in 49 CFR 391.41 covers people subject to the driver qualification rules, which generally means drivers of commercial motor vehicles in interstate commerce. That is not limited to CDL holders. A vehicle of 10,001 lbs or more can count, as our 10,001 lb guide explains. Owner-operators need one too. Covered farm vehicles are a notable exception.

Finding an examiner

The exam must be done by a medical examiner on FMCSA's National Registry of Certified Medical Examiners. A doctor who is not listed cannot certify you, however qualified. FMCSA's site has a search for listed examiners.

Some of the vision portion can be done by a licensed ophthalmologist or optometrist. Certified VA examiners can only examine veteran operators.

What the exam checks

Results are recorded on Form MCSA-5875. The standards in 49 CFR 391.41(b) include:

• Vision: at least 20/40 in each eye, with or without corrective lenses, plus field of vision and color recognition. A separate standard in 391.44 covers drivers who cannot meet this.
• Hearing: perceiving a forced whisper at 5 feet or more in the better ear, with or without a hearing aid, or passing an audiometric test.
• Blood pressure and heart: no current diagnosis likely to interfere with safe driving.
• Diabetes: insulin-treated diabetes is allowed if you meet 391.46.
• Limbs: no loss or impairment that interferes with driving, unless you have a skill performance evaluation certificate.
• Other conditions: respiratory, neurological and psychiatric conditions likely to interfere with safe driving, and epilepsy or anything else likely to cause loss of consciousness.
• Drugs: no use of Schedule I drugs, amphetamines, narcotics or other habit-forming drugs, subject to the exceptions in the rule.

How long it lasts

You also need a new exam if an injury or illness impairs your ability to do your normal duties, even if your certificate has not expired. If you were found not qualified, you must be examined and certified again.

The June 2025 change

The examiner now reports results to FMCSA electronically, by midnight local time the next calendar day after the exam. From June 23, 2025, CDL and CLP holders with a current certificate no longer need to carry it. Non-CDL drivers still get a certificate and must have the original or a copy when on duty. If the electronic record and a paper copy conflict, the electronic record controls.

Official sources

• FMCSA: Driver physical qualification
• 49 CFR 391.41: physical qualifications for drivers
• 49 CFR 391.43: medical examination and certificate
• 49 CFR 391.45: who must be medically examined, and how often

This guide is general information, not legal advice. Rules and fees change, so confirm with the official source before you file.

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