DOT Physical - Driver Exemptions

In certain cases, CDL drivers cannot meet the DOT medical requirements regarding physical impairment, vision, hearing or diabetes, and cannot obtain a medical card. The FMCSA allows you to apply for exemptions that will keep you driving.

All FMCSA exemptions apply only to drivers of CMV's that intend to drive interstate. The FMCSA has no regulatory authority over intrastate driving.

Generally, a DOT physical exemption will only be granted if doing so ensures a level of safety equal to or greater than than the level maintained without the exemption. In other words, the FMCSA will not lower the standards of safety to grant exemptions.

The FMCSA states that a decision will be made for exemption applications within 180 days, and exemptions that meet the criteria will be decided case-by-case.

• Diabetes Exemption Package
• Vision Exam Exemption Package
• Hearing Exam Exemption Package
• Skill Performance Evaluation Certificate Program

You Can Visit the FMCSA Driver Exemption Page here.

Driver Exemptions Programs:

The FMCSA provides exemption programs for drivers who cannot meet the requirements for Diabetes, Vision, Physical Impairments, or Hearing.

Diabetes Exemption Package:

FMCSA regulation 49 341.41 (3) requires that a CMV driver: "Has no established medical history or clinical diagnosis of diabetes mellitus currently requiring insulin for control;".

Diabetes patients who require the regular use of insulin can apply for an exemption using the forms below:

• Diabetes Exemption Application
• Quarterly Endocrinologist Evaluation Form for Already Exempted Drivers
• Annual Diabetes Assessment Package for Already Exempted Drivers

Applicants for diabetes exemptions will be required to submit extensive and complete supporting medical documentation according to the requirements listed below.

Diabetes Exemption Criteria & Requirements:

Diabetes Administrative Criteria:

• Must meet all requirements for commercial drivers.
• Must driver interstate and not for any local/state/county/federal government.
• Must be insulin treated for a minimum of 30 to 60 days.
• Must be without severe hypoglycemic episodes for 1 year and no more than 1 in the past 5 years
• Must meet all other physical qualifications in 49 CFR 391.41(b)(1-13) Qualifications Of Drivers And Longer Combination Vehicle (LCV) Driver Instructors or hold the appropriate exemption/waiver (e.g. Vision).
• Must submit a complete application which documents support from bc/be endocrinologist, and must hold a valid ME Certificate.
• Must have documentation of current diabetes education.

Diabetes Medical Criteria:

• MUST be examined by a BC/BE endocrinologist.
• MUST be On insulin (meet the 30-day/60 day requirement).
• Should have stable control. No severe hypoglycemic reaction that results in seizure or loss of consciousness or requiring assistance of another person or period of impaired cognitive function that occurred without warning: within one year and no more than 1 episode within the last 5 years (of application)
• Does not have the associated medical conditions/complications - e.g. no loss of position sense, cardiac autoneuropathy.
• No large fluctuations in BG levels that may impact safe driving.
• Endo supports the application - the applicant.
• Understands how to individually manage/monitor his/her DM.
• Demonstrated the ability/willingness to properly monitor/manage their diabetes.
• Is able to safely operate CMV in interstate commerce while using insulin.
• Received/participated in a diabetes education program, at least annually to apply for and remain in the program.

Diabetes Vision Criteria:

• Field of vision - must be greater than 70 degrees in each eye.
• Visual acuity - must be 20/40 or better in each eye.
• Diabetic retinopathy/other vision conditions must be stable, e.g. macular edema, glaucoma ; no vision loss, unstable retinopathy, etc.

Vision Exam Exemption Package:

Drivers who cannot pass the vision portion of the DOT physical can apply for an exemption using the forms below:

• General Vision Package
• Florida Residents Only
• Indiana Residents Only

See Also: DOT Eye & Vision Exam Requirements

Vision exemptions are issued for a maximum of 2 years, and are only valid for driving within the United States.

Vision Exemption Criteria & Requirements:

• Must be 21 years old, a United States resident, and want to drive on an interstate basis.
• Must not drive for the local/state/county/government. If they do, they must clearly state that the exemption is for other “part-time” work, or a desire to change jobs.
• Must have a valid license and show that they have driven with the appropriate license during their 3-year period. License must match state of residence.
• Must have 3-years of CMV operation immediately preceding the date of application with the vision deficiency.
• Must drive at least 10 hours per week.
• Must have a safe driving record. Driver cannot be involved in a CMV crash where they are cited and/or contributed to the crash. Additionally, the driver cannot have more than 1 serious violation in a CMV and cannot have more than 2 non-serious moving violations in a CMV. Suspensions are also disqualifying.
• Vision deficiency must be present for a minimum of 3 years.
• Vision must be stable.
• Must meet FMCSA vision standards in the better eye.
• All applicants must meet all other physical qualifications standards in 49 CFR 391.41(b)(1-13) or hold the appropriate exemption/waiver.

Hearing Exam Exemption Package:

In certain cases, drivers who cannot pass the hearing portion of the DOT physical can apply for an exemption using the forms below:

• Application For DOT Physical Hearing Exemption
• DOT Physical Hearing Exemption Medical Release Form

See Also: DOT Hearing & Ear Test

Skill Performance Evaluation Certificate Program:

The SPE certification allows drivers with missing or impaired limbs to drive CMVs across state lines if they have been fitted with (and are wearing) the right prosthetic device, and the driver can demonstrate the ability to drive the truck safely by completing on-and off-road activities.

Drivers with physical impairments which affect their ability to safely operate CMVs according to their medical examiners, or with missing limbs (e.g., a hand or finger, an arm, foot or leg), are required to obtain SPE certificates.

• New Driver SPE Application Package
• Skill Performance Evaluation Certificate Renewal Package
• SPE Service Centers & About the SPE Program

You Can Visit the FMCSA Driver Exemption Page here.

It is important to note that these exemptions apply ONLY to drivers who will be involved in interstate commerce. You are not eligible if your travel will not take you outside of your home state.