The basics
- Up to 24 months. A medical certification lasts at most 24 months. The examiner can certify for a shorter period when a condition needs monitoring, for example 1 year for a driver treated for high blood pressure. §391.45
- National Registry examiners only. The exam must be done by a medical examiner listed on FMCSA's National Registry of Certified Medical Examiners. §391.43
- Expired means parked. When the certification expires, the driver may not drive a commercial vehicle until a new one is on record.
CDL drivers: the record is now electronic
| Driver | Proof of medical certification |
|---|---|
| CDL or CLP holder | The examiner sends the results to FMCSA's National Registry, which passes them to the state licensing agency; they appear on the driver's CDLIS driving record. That record is the official proof. The examiner no longer has to issue a paper card, but drivers can ask for a copy. |
| Non-CDL commercial driver (for example, a 10,001–26,000 lb truck in interstate commerce) | Nothing changed: the examiner issues the paper certificate and the driver carries it. |
| Driver who needs a medical variance | Results are sent to the state only after FMCSA issues the variance (a skill performance evaluation certificate or a medical exemption). The driver carries the variance. |
Avoid a surprise downgrade
The electronic transfer fails when the examiner's entry doesn't match the license exactly: last name, date of birth, licensing state or license number. A driver who passed can still get a CDL downgrade letter. FMCSA's advice:
- Book the exam well before the current certification expires, so there is time to fix errors.
- Give the examiner a copy of the license and check that the details are entered exactly as printed.
- Ask for a paper copy of the certificate anyway; it helps when sorting out a failed transfer.
- If the record shows "not certified": call the examiner first, then the state licensing agency, then FMCSA's National Registry help desk.
The carrier's part
Keep proof of each driver's medical certification in the driver qualification file. For CDL drivers that is the state driving record showing the medical status; for other drivers, a copy of the certificate and a note that the examiner was on the National Registry. Track each expiration date: at CVSA's 2026 Roadcheck, "no medical card" was the most common driver violation, and using a driver who is not medically qualified fails a new entrant safety audit. §391.51(b)(6), (b)(8)
No expired cards on the road
IFTAX tracks every driver's medical certification date next to their CDL, driving record and Clearinghouse query, and reminds you weeks before anything expires.
Sources: 49 CFR 391.43, 391.45, 391.51; FMCSA National Registry II driver FAQ (May 2025). General information, not medical or legal advice. IFTAX is not affiliated with FMCSA or any government agency.