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Medical Examiner’s Handbook 2024 Edition

NOTE: The January 2024 edition of the Medical Examiner’s Handbook replaces all previous handbook editions. Medical examiners should not rely on previously published editions of the handbook, including any drafts available on FMCSA’s Medical Review Board website, as a source of Agency guidance. In addition, section of the handbook relating to obstructive sleep apnea rescinds and replaces the January 2015 FMCSA Bulletin to Medical Examiners and Training Organizations Regarding Obstructive Sleep Apnea (FMCSA-MED-Sleep Apnea-FAQ001).



Medical Examiner’s Handbook 2024 Edition

Cover Page of Medical Examiner's Handbook 2024 Edition, with decorative photos of truck drivers, trucks, medical professionals, and patient having blood pressure checked.

























The Medical Examiner’s Handbook 2024 Edition provides information about regulatory requirements and guidance to medical examiners listed on FMCSA’s National Registry of Certified Medical Examiners who perform physical qualification examinations of interstate commercial motor vehicle drivers. The goal of the handbook is to provide recommendations and guidance to assist medical examiners in applying the physical qualification standards, basic information related to testing, and matters to consider when making a physical qualification determination in conjunction with established best medical practices. The handbook also includes updates to the Medical Advisory Criteria published in Appendix A to 49 CFR part 391.

Contact Info:  FMCSA Medical Programs Division,

Note: This guidance document does not have the force and effect of law and is not meant to bind the public in any way. It is intended only to provide information and clarity regarding existing requirements under the law or agency policies.

Regulatory Topic: Driver Physical Qualification Examination and Standards
Effective Date: Tuesday, January 23, 2024
Issued Date: Monday, January 22, 2024