C.F.R. » Title 49 » CHAPTER III—FEDERAL MOTOR CARRIER SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION › SUBCHAPTER B—FEDERAL MOTOR CARRIER SAFETY REGULATIONS › PART 391—QUALIFICATIONS OF DRIVERS AND LONGER COMBINATION VEHICLE (LCV) DRIVER INSTRUCTORS › Subpart E—Physical Qualifications and Examinations

49 C.F.R. § 391.43

Medical examination; certificate of physical examination

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(a) Except as provided by paragraph (b) of this section, the medical examination must be performed by a medical examiner listed on the National Registry of Certified Medical Examiners under subpart D of part 390 of this chapter.

(b) Exceptions:

(1) A licensed ophthalmologist or licensed optometrist may perform the part of the medical examination that involves visual acuity, field of vision, and the ability to recognize colors as specified in § 391.41(b)(10).

(2) A certified VA medical examiner must only perform medical examinations of veteran operators.

(c) Medical examiners shall:

(1) Be knowledgeable of the specific physical and mental demands associated with operating a commercial motor vehicle and the requirements of this subpart, including the medical advisory criteria prepared by the FMCSA as guidelines to aid the medical examiner in making the qualification determination; and

(2) Be proficient in the use of and use the medical protocols necessary to adequately perform the medical examination required by this section.

(d) Any driver authorized to operate a commercial motor vehicle within an exempt intracity zone pursuant to § 391.62 of this part shall furnish the examining medical examiner with a copy of the medical findings that led to the issuance of the first certificate of medical examination which allowed the driver to operate a commercial motor vehicle wholly within an exempt intracity zone.

(e) [Reserved]

(f) The medical examination shall be performed, and its results shall be recorded on the Medical Examination Report Form, MCSA-5875, set out in this paragraph (f):

(g) Upon completion of the medical examination required by this subpart:

(1) The medical examiner must date and sign the Medical Examination Report and provide his or her full name, office address, and telephone number on the Report.

(2)(i) Before June 23, 2025, if the medical examiner finds that the person examined is physically qualified to operate a commercial motor vehicle in accordance with § 391.41(b), he or she must complete a certificate in the form prescribed in paragraph (h) of this section and furnish the original to the person who was examined. The examiner must provide a copy to a prospective or current employing motor carrier who requests it.

(ii) On or after June 23, 2025, if the medical examiner identifies that the person examined will not be operating a commercial motor vehicle that requires a commercial driver's license or a commercial learner's permit and finds that the driver is physically qualified to operate a commercial motor vehicle in accordance with § 391.41(b), he or she must complete a certificate in the form prescribed in paragraph (h) of this section and furnish the original to the person who was examined. The examiner must provide a copy to a prospective or current employing motor carrier who requests it.

(3) On or after June 23, 2025, if the medical examiner finds that the person examined is not physically qualified to operate a commercial motor vehicle in accordance with § 391.41(b), he or she must inform the person examined that he or she is not physically qualified, and that this information will be reported to FMCSA. All medical examiner's certificates previously issued to the person are not valid and no longer satisfy the requirements of § 391.41(a).

(4) Beginning December 22, 2015, if the medical examiner finds that the determination of whether the person examined is physically qualified to operate a commercial motor vehicle in accordance with § 391.41(b) should be delayed to receive additional information or to conduct further examination in order for the medical examiner to make such determination, he or she must inform the person examined that the additional information must be provided or the further examination completed within 45 days, and that the pending status of the examination will be reported to FMCSA.

(5)(i)(A) Once every calendar month, beginning May 21, 2014 and ending on June 22, 2018, the medical examiner must electronically transmit to FMCSA, via a secure Web account on the National Registry, a completed CMV Driver Medical Examination Results Form, MCSA-5850. The Form must include all information specified for each medical examination conducted during the previous month for any driver who is required to be examined by a medical examiner listed on the National Registry of Certified Medical Examiners.

(B) Beginning June 22, 2018 by midnight (local time) of the next calendar day after the medical examiner completes a medical examination for any driver who is required to be examined by a medical examiner listed on the National Registry of Certified Medical Examiners, the medical examiner must electronically transmit to FMCSA, via a secure FMCSA-designated website, a completed CMV Driver Medical Examination Results Form, MCSA-5850. The Form must include all information specified for each medical examination conducted for each driver who is required to be examined by a medical examiner listed on the National Registry of Certified Medical Examiners in accordance with the provisions of this subpart E, and should also include information for each driver who is required by a State to be examined by a medical examiner listed on the National Registry of Certified Medical Examiners in accordance with the provisions of this subpart and any variances from those provisions adopted by such State.

(ii) Beginning on June 22, 2015, if the medical examiner does not perform a medical examination of any driver who is required to be examined by a medical examiner listed on the National Registry of Certified Medical Examiners during any calendar month, the medical examiner must report that fact to FMCSA, via a secure FMCSA-designated website, by the close of business on the last day of such month.

(h) The medical examiner's certificate shall be completed in accordance with the following Form MCSA-5876, Medical Examiner's Certificate:

(i) Each original (paper or electronic) completed Medical Examination Report and a copy or electronic version of each medical examiner's certificate must be retained on file at the office of the medical examiner for at least 3 years from the date of examination. The medical examiner must make all records and information in these files available to an authorized representative of FMCSA or an authorized Federal, State, or local enforcement agency representative, within 48 hours after the request is made.

[35 FR 6460, Apr. 22, 1970] Editorial Note:For Federal Register citations affecting § 391.43, see the List of CFR Sections Affected, which appears in the Finding Aids section of the printed volume and at www.govinfo.gov.
Notes of Decisions
Cited in 51 cases (11 in the last 5 years), 1987–2026 · leading case: Hollywood Trucking, Inc. v. Watters, 895 N.E.2d 3 (Ill. App. Ct. 2008).
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Hollywood Trucking, Inc. v. Watters, 895 N.E.2d 3 (Ill. App. Ct. 2008). · cites it 6× “49 C.F.R. § 391.43 (2005). "The medical examiner must be aware of the rigorous physical, mental, and emotional demands placed on the driver of a commercial motor vehicle.”
Est. of Szleszinski v. Labor & Indus. Review Comm'n, 2007 WI 106 (Wis. 2007). · cites it 10× “" 49 C.F.R. § 391.43 (f). [12] If the medical examiner concludes a driver is physically qualified, he or she must provide the driver and his or her employer with a copy of a certificate that so indicates.”
Everett v. 357 Corp., 21 Am. Disabilities Cas. (BNA) 1362 (Mass. 2009). · cites it 3× “See 49 C.F.R. § 391.43 (1996). To obtain a DOT certificate, DOT regulations explicitly state that a driver have “no mental .”
Brian Hejda v. Bell Container Corp., 160 A.3d 741 (N.J. Super. Ct. App. Div. 2017). · cites it 3× “" 49 C.F.R. § 391.43 (a) requires that the physical examination "be performed by a medical examiner listed on the National Registry of Certified Medical Examiners.”
Equal Emp. Opportunity Comm'n v. Texas Bus Lines, 923 F. Supp. 965 (S.D. Tex. 1996). · cites it 5× “Among the numerous safety regulations set forth in Title 49 of the Code of Federal Regulations, part 391 requires all driver applicants to pass a physical examination to be conducted by a licensed health care professional meeting the standards of 49 C.F.R. § 391.43 , and obtain…”
John Goodpaster v. Schwan's Home Serv., Inc. & Todd Swanson, Individually & in His Corp. Capacity, 849 N.W.2d 1 (Iowa 2014). · cites it 2× “See 49 C.F.R. § 391.43 (“Instructions for Performing and Recording Physical Examinations”).”
State v. Orueta, 164 P.3d 267 (Or. 2007). · cites it 4× “49 CFR § 391.43 (f). An applicant is medically qualified to drive a commercial vehicle if, among other things, the applicant "has no current clinical diagnosis of alcoholism.”
Charles Harris v. P.A.M. Transp., Inc. P.A.M. Transp. Servs., Inc., 339 F.3d 635 (8th Cir. 2003). “” 49 C.F.R. § 391.43 (f). And, most importantly in this case, DOT regulations provide appeal procedures 5 for instances of “disagreement between the physician for the driver and the physician for the motor carrier concerning the driver’s qualifications.”
Robert Parker v. Crete Carrier Corp., 839 F.3d 717 (8th Cir. 2016). · cites it 2× “49 C.F.R. §§ 391.43 (a), 391.45(b)(1). Drivers cannot operate commercial motor vehicles unless an examiner certifies them as physically qualified to do so.”
Joe Allman v. Walmart, Inc., 967 F.3d 566 (6th Cir. 2020). “” 49 C.F.R. § 391.43 (a). Against this regulatory backdrop, Walmart promulgated a sleep-apnea program for its commercial truck drivers in 2013.”
United States v. Maldonado, 356 F.3d 130 (1st Cir. 2004). “In all events, Maldonado pays little attention to Flint’s actions.”
Butler v. Washington Metro. Area Transit Auth., 275 F. Supp. 3d 70 (D.D.C. 2017). “” 49 C.F.R. § 391.43 (a). The FMCSA regulations also establish standards applicable to the medical conditions underlying this dispute—sleep apnea and diabetes.”
Show all 51 citing cases →
— 49 C.F.R. § 391.43(a) — 2 cases
Dep't of Civil Rights Ex Rel Lanphar v. A & C Carriers, 403 N.W.2d 586 (Mich. Ct. App. 1987).
Love v. Prime, Inc., 312 P.3d 562 (Or. Ct. App. 2013).
— 49 C.F.R. § 391.43(c) — 1 case
Dep't of Civil Rights Ex Rel Lanphar v. A & C Carriers, 403 N.W.2d 586 (Mich. Ct. App. 1987).
— 49 C.F.R. § 391.43(g)(5) — 1 case
Metro. Transit Auth. of Harris Cnty., Texas v. John Carter (Tex. App. 2021).
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