Yes, under 49 CFR  § 382.305 question 8, the driver must be in DOT random for each employer they are employed with.

Last Updated : May 20, 2015

Section 391.43(g) requires the Medical Examiner to give a copy of the medical certificate to the driver and the motor carrier(employer), if the driver passes the medical examination.

Last Updated : April 1, 2014

Q. If the driver admits to regular alcohol use, and based on responses on the driver history, further questioning or additional tools such as CAGE, AUDIT or TWEAK assessments, may the examiner require further evaluation prior to signing the medical certificate?

A. Yes. Except where absolute criteria exist, the final determination as to whether the driver meets the FMCSA medical standards is to be made by the medical examiner. The examiner should use whatever tools or additional assessments they feel are necessary. Under 391.43, Instructions to the Medical Examiner -Laboratory and "Other Testing," support is provided to the examiner if they believe that "Other test(s) may be indicated based upon the medical history or findings of the physical examination."

Further supporting the need for additional evaluation is the medical advisory criteria for 391.41(b) 13 which notes that "if an individual shows signs of having an alcohol-use problem, he or she should be referred to a specialist. After counseling and/or treatment, he or she may be considered for certification."
While not regulation, the medical advisory criteria are provided by the FMCSA to assist the Medical Examiner determine if a person is physically qualified to operate a CMV. The Medical Examiner may or may not choose to use these guidelines. These guidelines are based on expert review and considered practice standards. The examiner should document the reason(s) for not following the guidelines.

Last Updated : April 1, 2014

No. The Medical Examiner is required to provide a copy of the Medical Examiner’s Certificate (49 Code of Federal Regulations (CFR) 391.43(g)) to the motor carrier that employs the driver. A release form is not required. The motor carrier is required to keep a copy of the certificate in the driver qualification file. (49 CFR 391.51(b)(7))

Last Updated : April 1, 2014

In general, all CMV drivers driving in interstate commerce within the United States must obtain medical certification from a Medical Examiner. CMV drivers from Canada and Mexico can be medically qualified in their countries.

Last Updated : April 1, 2014

Under 49 United States Code 31315 and 31136(e), the FMCSA may grant an exemption from the FMCSRs if the agency determines it is in the public interest and would likely achieve a level of safety equivalent to, or greater than, the level that would be achieved by complying with the safety regulation. Section 381.300 through 381.330 of the FMCSRs describes procedures applicants must follow to apply for exemptions and can be viewed at 49 CFR 381.330. FMCSA currently has exemption programs for vision and insulin-treated diabetes mellitus, and offers a certificate program for drivers with limb impairments. FMCSA also has a special certification program for drivers with missing and/or impaired limbs (49 CFR 391.41(b)(1).

Last Updated : April 1, 2014

The guidelines recommend disqualifying a CMV driver with a diagnosis of Narcolepsy, regardless of treatment because of the likelihood of excessive daytime somnolence.

Last Updated : April 1, 2014

Depending on the amount, protein in the urine (Proteinuria) may indicate significant renal disease. The Medical Examiner may certify, time limit, or disqualify a commercial driver with Proteinuria. The decision is based on whether the examiner believes that Proteinuria may adversely affect safe driving regardless of the examiner’s decision. The driver should be referred for follow-up.

Last Updated : April 1, 2014

When a Medical Examiner grants medical certification, he/she certifies the driver to perform any job duty required of a commercial driver, not just the driver's current job duties.

Last Updated : April 1, 2014

Yes, the motor carrier (employer) is required to keep a copy of the medical card (certificate) on file and the driver is required to keep the medical certificate (and supporting documents as required) with him while driving.

Last Updated : April 1, 2014

The FMCSRs do not address this issue.

Last Updated : April 1, 2014

Section 391.41(b)(10) do not apply to a driver who was a participant in good standing on March 31, 1996, in a waiver study program concerning the operation of CMVs by drivers with visual impairment in one eye; provided: (1) The driver is physically examined every year, including examination by an ophthalmologist or optometrist attesting to the fact that the driver: (i) Is otherwise qualified under 391.41; and (ii) Continues to measure at least 20/40 (Snellen) in the better eye. (2) The driver provides a copy of the ophthalmologist or optometrist report to the Medical Examiner at the time of the annual medical examination. (3) The driver provides a copy of the annual medical certification to the employer for retention in the driver's qualification file and retains a copy of the certification on his/her person while driving for presentation to an authorized federal, state or local law enforcement official. The grandfathering provision is no longer available.

Last Updated : April 1, 2014

In all cases, clinical judgment is required. The Medical Examiner decides if the driver's diabetes is adequately controlled, which determines certification, length of certification or disqualification. FMCSA guidelines recommend performing annual examination for vision, neurological function and cardiovascular disease, including hypertension. In general, the diabetic driver should have annual re-certification examinations.

Last Updated : April 1, 2014

The Medical Examiner decides to certify, time-limit or disqualify. The decision to certify a driver is determined by whether the examiner believes that the blood in the urine affects the ability of the commercial driver to safely. Regardless of whether the CMV driver is certified, the Medical Examiner should document referral to a specialist or the driver's Primary Care Provider.

Last Updated : April 1, 2014

• Yes, according to 49 CFR 391.43(i), each original (paper or electronic) completed Medical Examination Report Form, MCSA-5875, and Medical Examiner’s Certificate, Form MCSA-5876, must be retained on file at the Medical Examiner’s office for a period of at least 3 years from the date of examination. The Medical Examiner’s employer may maintain all required records on behalf of the Medical Examiner in a centralized medical records department or within its electronic health record system, as long as the Medical Examiner may request and obtain the records and can provide the scanned records upon request to FMCSA or an authorized Federal, State, or local enforcement agency.

Last Updated : June 4, 2019

The decision to qualify a driver to operate a CMV in interstate commerce is the sole responsibility of the Medical Examiner. The driver may discuss the basis for the disqualification with the Medical Examiner and explore options for reconsideration.

Last Updated : April 1, 2014

The Federal Motor Carrier Safety Regulations (FMCSRs) does not include a list of prohibited medications.

The Agency relies on the certifying medical examiner to evaluate and determine whether an underlying medical condition, medication, or combination of medications and substances used by an individual driver will impair his or her ability to safely operate a commercial motor vehicle (CMV).  Medical Examiners may disqualify a driver who takes any medication or combination of medications and substances that may impair or interfere with safe driving practices.  All medications must be assessed to determine the potential risk of adverse side effects, which include but are not limited to:  dizziness, drowsiness, and sleepiness, and the direct impact the potential side effects have on CMV driving and operation safety.

The medical examiner may confer with the treating medical specialist(s) who is familiar with the driver’s health history.  The final decision to certify the driver rests with the certifying medical examiner.

The certifying medical examiner may consider utilizing the optional medication form when communicating with the treating prescribing clinician.

Medication Form for optional/voluntary use by the Certified Medical Examiner.

Last Updated : June 18, 2020

FMCSA regulations prohibit a driver from beginning or continuing to drive if their ability and/or alertness is impaired by: fatigue, illness, or any cause that makes it unsafe to begin (continue) to drive a commercial vehicle.
Even if a driver currently has a valid medical certificate, the driver is prohibited from driving a CMV with any medical condition that would be disqualifying or may interfere with the safe operation of a CMV. Once a disqualifying medical condition is resolved, and before resuming operation of CMVs, a driver is responsible for obtaining re-certification from a Medical Examiner. 391.45

Last Updated : April 1, 2014

Process and Payment for Split Specimen Test: If a driver makes a timely request for a split-specimen test within 72 hours after being notified by the Medical Review Officer (MRO) of a positive DOT drug test, and the driver cannot cover the cost of the split-specimen test, will the split-specimen test proceed without payment?

Yes, the employer must pay the cost of the split-specimen test so that the test proceeds in a timely manner as required by 49 CFR § 40.173  Part 40 provides that an employer may seek reimbursement for full or partial costs of the split-specimen test through company policy or a collective bargaining agreement, but the regulations take no position on who ultimately pays the cost of the test.  See 49 CFR § 40.171 (a) and  § 40.173 (b) (c).

Last Updated : May 20, 2015

Random Testing Selection Period: A motor carrier conducts or administers a DOT random test on a driver that was selected in the fourth quarter of the year, but the test was not verified by the medical review officer (MRO) until the next year. What year does this DOT random test count towards?

The test will count towards the MIS results for the year during which the specimen was collected, and not when the test was verified.

Last Updated : May 20, 2015