FMCSA Basics: Driver Regulations

The Federal Motor Carrier Safety Administration regulates interstate trucking and bus transportation. The agency’s regulations and methodologies are ever always in flux, with changes proposed as recently as January 15, 2016. The medical qualifications and regulations for drivers are no exception, though general requirements have remained relatively consistent.

Here’s what you need to know about general requirements and recent changes in the regulations.


For the legal, in-depth version of driver requirements, view Rule 391 on the FMCSA website. In short, CMV drivers are required to:

• Be at least 21 years old
• Be able to read and speak the English language well enough to dothe job
• Be able to safely operate the motor vehicle he/she will be driving
• Be physically qualified to operate the vehicle
• Have a currently valid commercial motor vehicle operator’s license issued by his/her state of residence
• Not be disqualified to operate a motor vehicle
• Have successfully completed a road test or its equivalent
• Follow the Hours of Service (HOS) regulations
• Have a Driver Qualification File w/Medical Certification

A Driver Qualification (DQ) file consists of:

• An application for employment
• A motor vehicle record (MVR) from states
• Previous employer information
• Road test form and certificate or license or certificate accepted in lieu of road test
• Medical exam certificate, original or a copy, plus any letter granting a waiver of a physical disqualification
• Annual motor vehicle record
• Annual review of driving record
• Annual list of violations
• Entry-level driver training certificate (if applicable)
• Longer combination vehicle driver training certificate (if applicable)

Physical qualifications

To qualify physically, drivers must not have any the following conditions if it is likely to interfere with ability:

• A loss of foot, leg hand or arm
• An impairment of hand or finger which interferes with power grasping
• An impairment of arm, foot, leg
• A history or clinical diagnosis of diabetes that currently requires insulin for control
• A current diagnosis of myocardial infarction, angina pectoris, coronary insufficiency, or thrombosis
• A history or clinical diagnosis of respiratory dysfunction
• A current diagnosis of high blood pressure
• A history or clinical diagnosis of rheumatic, arthritic, orthopedic, muscular, neuromuscular, or vascular disease
• A history or clinical diagnosis of epilepsy or any other condition likely to cause loss of consciousness
• A mental, nervous, organic, or functional disease or psychiatric disorder
• Use of a Schedule I drug, amphetamine, narcotic, or any other habit-forming drug
• A current clinical diagnosis of alcoholism

Drivers must also:

• Have eyesight of at least 20/40 in each eye, or corrected to 20/40 or better
• Have a field of vision of at least 70 degrees horizontally
• Be able to perceive red, green and amber
• Be able to perceive a forced whisper in the better ear at no less than five feet (with or without the use of a hearing aid)

Recent Developments

Linking medical status to CDL status: By January 2014, drivers were required to have presented their medical certification status to their state’s DMV to bind their medical to CDL status.

Approved medical examiners: Starting May 21, 2014, drivers seeking new certification or certification renewal had to be medically certified by examiners approved by the agency.

Altered medical exams: In April, 2015, the FMCSA issued a final rule that changed driver medical exams from December on. The most significant change was an expansion of the medical history form truck drivers must fill out before the exam. In December 2015, the FMCSA granted a 120-day grace period on these medical examination rules.

Medical exemptions:

In May 2015, the FMCSA proposed rules that would release truck drivers with controlled diabetes from having to seek and renew exemptions from the FMCSA.¹  The rule has not been passed yet. In January 2016, The FMCSA exempted 59 truck drivers (many blind in one eye) from the vision requirement and 36 drivers who have insulin-treated diabetes mellitus from the diabetes restriction. ² To apply for an exemption, visit the Driver Exemption Programs page of the FMCSA website or contact the Federal Diabetes and Vision Exemption Program at (703) 448-3094.





Chiro Stop. “FMCSA Rules and Regulations.”

Devaney, Tim. “New regs for Monday: Truck drivers, beer, guns,” The Hill. Jan 8 2016.

Dills, Todd. “Eric Toms’ cancelled CDL privileges,” Overdrive Online. Jan 1 2016–cdl-privileges/ Another medical certification cautionary tale:

Driver Exemption Programs. FMCSA. September 22, 2015.

Fuetsch, Michele. “FMCSA Mulling Over Whether Exemption Process Is Necessary for Diabetic Drivers,” Transport Topics. May 5 2015.



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