Medical certificate and self-certification (interstate / intrastate)

Every CDL applicant tells the state what kind of driving they do. This choice — one of four categories — decides whether you must give the state a medical examiner's certificate. If you must and you let it expire, you can lose your CDL.

Why the state needs your medical status

When you apply for a CLP or CDL, renew, upgrade, add an endorsement, or transfer a CDL from another state, you must tell your State Driver Licensing Agency (SDLA) what type of CMV operation you do or expect to do.

Drivers in some types of commerce must send a current Medical Examiner's Certificate (MEC, form MCSA-5876, often called a "medical card" or "DOT card") and any medical variance (vision, diabetes, or Skills Performance Evaluation waivers) to get a "certified" medical status on their record.

If you must be certified and you fail to keep your MEC up to date, your status becomes "not certified" and the state will downgrade (remove) your CDL privileges. Keep track of the expiration date.

Step 1 — Interstate or intrastate?

Interstate commerce means you drive a CMV:

• from one state to another state or to a foreign country; or
• between two places in the same state, but part of the trip crosses into another state or country; or
• between two places in the same state, but the cargo or passengers are on a journey that started, or will finish, outside the state (in another state or country).

Intrastate commerce means you drive only inside one state and none of the interstate descriptions fit.

Rule: if you do both interstate and intrastate driving, you must choose interstate.

Example: you drive only between Salt Lake City and Ogden, but the freight came by ship from overseas. That trip is interstate commerce, because the cargo's trip began outside the state.

Step 2 — Excepted or non-excepted?

You are excepted interstate only if your only interstate driving is one or more of these activities:

• carrying school children and/or school staff between home and school;
• working as a federal, state or local government employee;
• carrying human remains or sick or injured people;
• driving a fire truck or rescue vehicle in emergencies and related activities;
• carrying propane winter heating fuel in an emergency (for example, a storm damaged a propane system);
• responding to a pipeline emergency (leak or rupture);
• custom harvesting on a farm, or carrying its machinery and supplies, or carrying the harvested crops to storage or market;
• a beekeeper moving bees seasonally;
• a vehicle run by a farmer, not a combination, carrying farm products, machinery or supplies (no placarded hazmat) to or from the farm within 150 air-miles of the farm;
• a private carrier of passengers for non-business purposes;
• carrying migrant workers.

Excepted interstate drivers do not need a federal MEC. If none of these fit, you are non-excepted interstate and must give the SDLA a current MEC (49 CFR 391.45). Most CDL holders who drive interstate are non-excepted.

If you do both excepted and non-excepted interstate driving, choose non-excepted so you are qualified for both.

For intrastate: non-excepted intrastate drivers must meet their state's medical rules; excepted intrastate drivers do work the state has decided needs no medical certificate. If you do both, choose non-excepted intrastate. Ask your SDLA about your state's rules.

Step 3 — The four self-certification statements

On your CDL application you check one box (self-certification). The wording may vary by state:

• Non-excepted interstate (NI): I drive interstate, I must meet federal medical rules (49 CFR Part 391), and I need an MEC.
• Excepted interstate (EI): I drive interstate, but only in excepted operations, so I do not need an MEC.
• Non-excepted intrastate (NA): I drive only within my state, I must meet my state's medical rules, and I need an MEC.
• Excepted intrastate (EA): I drive only within my state, I am not subject to my state's medical rules, and I do not need an MEC.

Getting and keeping your medical card

Your medical exam must be done by an examiner listed on the FMCSA National Registry of Certified Medical Examiners. The examiner reports the result to the registry, and it is added to your driving record electronically.

A medical card is valid for up to 24 months (the examiner may give a shorter period if you need monitoring, for example for blood pressure). Get a new exam and make sure the new MEC reaches the state before the old one expires.

If the FMCSA has given you a medical variance, the state shows it with the V restriction on your CDL and in the CDLIS record.

Put it into practice

Educational questions with explanations. The answer review also works without the interactive quiz.