The Anatomy of a DOT Medical Card

The DOT Medical Certification is a critical requirement. Without it, you’re parked. But have you ever thought about what’s actually behind it?

What Is It?

The Medical Examiner’s Certificate (MEC), or "med card," proves that you’re physically fit to safely drive a commercial motor vehicle (CMV).

A DOT medical certification is required by the FMCSA for most drivers operating:

• Vehicles over 10,000 lbs
• Hazmat loads
• Special Transportation Services vehicles
• Passenger vehicles (9+ passengers with pay, 16+ without pay)

What Happens if Your DOT Card Expires?

If your DOT medical certification expires, the FMCSA requires states to automatically downgrade your CDL, meaning you lose your commercial driving privileges. As of June 23, 2025, drivers no longer submit medical certificates to the state. Instead, certified medical examiners upload results to the National Registry, and the FMCSA transmits the information to state licensing agencies. The state uses your Motor Vehicle Record (MVR) to verify your medical status, and if you're not current, the downgrade can happen fast.

What Does the Card Say?

Here’s what your card actually lists:

• Whether you meet the medical standards — with or without glasses, hearing aids, or restrictions
• Expiration date — usually 2 years if everything checks out, sometimes 1 year or less if you’ve got conditions being monitored
• Medical examiner’s info — must be on the FMCSA National Registry

What’s In the DOT Physical?

It’s a serious safety check because driving an 80,000lb truck down the highway demands sharp senses and good health. Here’s what they look for:

• Vision: Must have 20/40 vision or better in each eye (with or without correction), a field of vision of at least 70° in each eye, and the ability to recognize red, green, and amber.
• Hearing: Must be able to hear a forced whisper from 5 feet or less, with or without a hearing aid.
• Blood Pressure: Must be below 140/90 for a full 2-year certification; higher readings may shorten certification or disqualify until controlled.
• Heart & Lung Health: Must not have conditions that cause fainting, shortness of breath, or chest pain while driving.
• Neurological Health: Must not have uncontrolled seizures, significant head injuries, or disorders that impair consciousness or coordination.
• Musculoskeletal Fitness: Must have the strength, range of motion, and control needed to operate a truck safely.
• Diabetes: Must have stable blood sugar levels and no severe low blood sugar episodes while driving; insulin users must submit an Insulin-Treated Diabetes Assessment Form.
• Urinalysis: Screening checks for protein, blood, and sugar to identify possible conditions like diabetes or kidney disease.
• Medications & Medical History: Must disclose all current medications and any medical conditions that might interfere with safe driving.

A Few Tips

• Don’t wait till the last minute — get your physical done well before your card expires
• Know your restrictions — if you need glasses or hearing aids to pass, use them while driving
• Stay on top of your health — if your blood pressure or diabetes is borderline, work with your doctor early

That little card says a lot about your ability to safely do one of the toughest jobs out there. Take it seriously, take care of your health, and stay ahead of the game. Because nobody wants to hear “you’re out of service” just because you forgot to renew your med card.