Weekly digest
No account needed

CDL & medical · Updated Oct 2026

CDL medical card: how the DOT physical works

Interstate commercial drivers must be medically certified under 49 CFR 391. Since June 23, 2025, results for CLP and CDL holders travel electronically from FMCSA to the state, which changes what you carry and what your carrier checks.

How a DOT medical certification reaches your driver recordFrom the exam with a National Registry examiner, to the electronic report to FMCSA, to your CDLIS driver record, to the card's expiry and renewal.ExamWith an examineron the NationalRegistryReported to FMCSABy midnight localtime the nextcalendar dayPosts to yourdriver recordCDLIS record;carriers checkyour MVRValid up to 24monthsShorter if theexaminer sets itRenew earlyLeaves time to fixtransmissionerrors
Book your exam a few weeks early so a slow upload doesn't take you off the road. Source: FMCSA National Registry.

Getting certified

  • The exam must be done by a medical examiner listed on FMCSA’s National Registry of Certified Medical Examiners.
  • A medical examiner’s certificate is valid for up to 24 months. The examiner can issue a shorter card when a condition needs monitoring.
  • Examiners report every result to FMCSA by midnight (local time) of the next calendar day, including drivers found not qualified.

What changed in 2025 (National Registry II)

  • In states that have implemented it, CLP and CDL holders no longer submit a paper certificate to the state. The National Registry sends the result electronically and it posts to your CDLIS driver record.
  • That electronic record is the official proof of medical certification. Carriers check your driver record (MVR) instead of the paper card.
  • You no longer need to carry the certificate. If you hold an FMCSA medical variance, you still carry that document while on duty.
  • If your state has not implemented it yet, the examiner still issues a paper certificate and you still submit it to the state.
  • FMCSA suggests getting your exam well before your current card expires, so there is time to fix any transmission errors.

Conditions with their own rules

  • Insulin-treated diabetes: qualified with a stable regimen and the treating clinician’s ITDM Assessment Form (MCSA-5870); certificate up to 12 months.
  • Vision: drivers who do not meet the acuity or field-of-vision standard in one eye may qualify under the alternative vision standard.
How long a medical certificate can lastUp to 24 months for a standard certificate and up to 12 months for insulin-treated diabetes; the examiner can set a shorter period when a condition needs monitoring.Standard certificateUp to 24 monthsInsulin-treated diabetesUp to 12 months06121824MONTHSMax 24 months
You can get up to 24 months, and your examiner can give you less. Source: 49 CFR 391.41.

Sources

  1. FMCSA National Registry: NRII Learning Center  (opens in a new tab)
  2. 49 CFR 391.41: Physical qualifications for drivers  (opens in a new tab)
  3. 49 CFR 391.45: Persons who must be medically examined and certified  (opens in a new tab)
  4. FMCSA: States that have not implemented NRII  (opens in a new tab)