A person is physically qualified to drive a commercial motor vehicle if that person:
	1. Has no loss of a foot, leg, hand, or arm, or has been granted an SPE certificate*
	2. Has no impairment of a hand or finger that interferes with prehension or power grasping; has no impairment of an arm, foot, or leg that interferes with the ability to perform normal tasks associated with operating a commercial motor vehicle; has no other significant limb defects or limitations that interfere with the ability to perform normal tasks associated with operating a commercial motor vehicle; or has been granted an SPE certificate*
	Summary of advisory criteria: the SPE Certificate Program may allow those persons with amputation or impairment to qualify under the Federal Motor Carrier Safety Regulations by use of prosthetic devices or equipment modifications. If the examiner finds the person otherwise medically qualified, they must check on the medical certificate that the driver is qualified only if accompanied by an SPE certificate. Information on the SPE can be found at http://www.fmcsa.dot.gov/rules-regulations/topics/medical/spepackage.htm.
	3. Has no established medical history or clinical diagnosis of diabetes mellitus currently requiring insulin for control
	Summary of advisory criteria: the FMCSA has consistently stated that a person with diabetes who uses insulin for control does not meet the minimum physical requirements of the Federal Motor Carrier Safety Regulations. If the condition can be controlled by the use of oral medication and diet, then a person may be qualified under the present rule. Drivers who do not meet the federal diabetes standard may call 202-366-1790 for an application for a diabetes exemption.
	4. Has no current clinical diagnosis of myocardial infarction, angina pectoris, coronary insufficiency, thrombosis, or any other cardiovascular disease of a variety known to be accompanied by syncope, dyspnea, collapse, or congestive cardiac failure
	Summary of advisory criteria: the examiner must determine if the nature and severity of a person's cardiovascular condition will likely cause the symptoms of cardiovascular insufficiency mentioned above. After an occurrence of cardiovascular insufficiency (e.g., myocardial infarction, thrombosis), before a driver is certified, he or she must have a normal resting and stress electrocardiography, no residual complications, no physical limitations, and should be taking no medication likely to interfere with safe driving. Coronary artery bypass surgery and pacemaker implantation are not necessarily disqualifying, but implantable cardioverter defibrillators are because of the risk of syncope.
	5. Has no established medical history or clinical diagnosis of a respiratory dysfunction likely to interfere with the ability to control and drive a commercial motor vehicle safely
	Summary of advisory criteria: slight impairment in respiratory function under emergency conditions may be detrimental to safe driving. Conditions that may interfere with oxygen exchange and may result in incapacitation include emphysema, chronic asthma, carcinoma, tuberculosis, chronic bronchitis, and sleep apnea. If the medical examiner detects a respiratory dysfunction that in any way is likely to interfere with the driver's ability to safely control and drive a commercial motor vehicle, the driver must be referred to a specialist for further evaluation and therapy. Anticoagulation therapy for deep venous thrombosis and/or pulmonary thromboembolism is not unqualifying once optimal dose is achieved, provided lower extremity venous examinations remain normal and the treating physician gives a favorable recommendation.
	6. Has no current clinical diagnosis of high blood pressure likely to interfere with the ability to operate a commercial motor vehicle safely
	Summary of advisory criteria: hypertension alone is unlikely to cause sudden collapse; however, the likelihood increases when target organ damage, particularly cerebral vascular disease, is present (see Table 3).
	Annual recertification is recommended if the medical examiner does not know the severity of hypertension before treatment. An elevated blood pressure finding should be confirmed by at least two subsequent measurements on different days.
	7. Has no established medical history or clinical diagnosis of a rheumatic, arthritic, orthopedic, muscular, neuromuscular, or vascular disease that interferes with the ability to control and operate a commercial motor vehicle
	Summary of advisory criteria: diseases that have acute episodes of transient muscle weakness, poor muscular coordination, abnormal sensations, decreased muscle tone, visual disturbances, and pain may be suddenly incapacitating and interfere with safe driving. Those with more insidious onset may not suddenly incapacitate a person but may restrict his or her movements and eventually interfere with the ability to safely operate a motor vehicle. The physician, when examining a person, should consider the following: (1) the nature and severity of the person's condition; (2) the degree of limitation present; (3) the likelihood of progressive limitation; and (4) the likelihood of sudden incapacitation. If severe functional impairment exists, the driver does not qualify. In cases in which more frequent monitoring is required, a certificate for a shorter period of time may be issued.
	8. Has no established medical history or clinical diagnosis of epilepsy or any other condition likely to cause loss of consciousness, or any loss of ability to control a commercial motor vehicle
	Summary of advisory criteria: the following drivers cannot be qualified: (1) a driver with a medical history of epilepsy; (2) a driver with a current clinical diagnosis of epilepsy; or (3) a driver who is taking antiseizure medication.
	If the person has a sudden episode of a nonepileptic seizure or loss of consciousness of unknown cause that did not require antiseizure medication, the decision as to whether that person's condition will likely cause the loss of consciousness or loss of ability to control a commercial motor vehicle is made on an individual basis by the medical examiner in consultation with the treating physician. A six-month waiting period from the episode and a complete neurologic evaluation is recommended before certification is considered. If the examination is normal and antiseizure medication is not required, then the driver may be qualified. With a seizure or episode of loss of consciousness from a known medical condition, certification should be deferred until the driver has fully recovered from that condition, has no existing residual complications, and is not taking antiseizure medication.
	Drivers with a history of epilepsy or seizures must be off antiseizure medication and seizure-free for 10 years to be qualified to operate a commercial motor vehicle in interstate commerce. Drivers with a history of a single unprovoked seizure may be qualified if they are seizure-free and off antiseizure medication for five years or longer.
	9. Has no mental, nervous, organic, or functional disease or psychiatric disorder likely to interfere with the ability to drive a commercial motor vehicle safely
	Summary of advisory criteria: conditions that may affect memory, reasoning, attention, and judgment or cause drowsiness, dizziness, confusion, weakness, or paralysis may lead to incoordination, inattention, loss of functional control, and susceptibility to crashes while driving. These conditions and symptoms should be thoroughly evaluated when determining a person's overall fitness to drive. Disorders of a periodically incapacitating nature, even in the early stages of development, may warrant disqualification. The degree to which a person is able to appreciate, evaluate, and adequately respond to environmental strain and emotional stress is critical when assessing a person's mental alertness and flexibility to cope with the stresses of commercial motor vehicle driving. Disqualification may be warranted in persons who are highly susceptible to frequent states of emotional instability (e.g., schizophrenia, affective psychoses, paranoia, anxiety, depressive neurosis). Careful consideration should be given to the adverse effects and interactions of medications in the overall certification determination.
	10. Has a distant visual acuity of at least 20/40 (Snellen) in each eye with or without corrective lenses, or visual acuity separately corrected to 20/40 (Snellen) or better with corrective lenses; distant binocular acuity of at least 20/40 (Snellen) in both eyes with or without corrective lenses; field of vision of at least 70 degrees in the horizontal meridian in each eye; and the ability to recognize the colors of traffic control signals and devices showing standard red, green, and amber
	Summary of advisory criteria: the minimum standard is met if the person is able to recognize and distinguish among traffic control signals and devices showing standard red, green, and amber. Contact lenses are permissible if the driver has good tolerance and is well adapted to their use. Use of a contact lens in one eye for distant visual acuity and another lens in the other eye for near vision is not acceptable, nor are telescopic lenses acceptable.
	If a person meets the criteria by the use of glasses or contact lenses, the following statement shall appear on the medical examiner's certificate: “Qualified only if wearing corrective lenses.” Commercial motor vehicle drivers who do not meet the federal vision standards may be eligible for an exemption from the vision standard. Information is available at http://www.fmcsa.dot.gov/rules-regulations/topics/medical/exemptions.htm.
	11. First perceives a forced whispered voice in the better ear at not less than five feet with or without the use of a hearing aid or, if tested by use of an audiometric device, does not have an average hearing loss in the better ear greater than 40 decibels at 500 Hz, 1,000 Hz, and 2,000 Hz with or without a hearing aid when the audiometric device is calibrated to the American National Standard (formerly American Standard Association)
	Summary of advisory criteria: for the whispered voice test, the person should stand at least five feet from the examiner with the ear being tested turned toward the examiner and the other ear covered. Using the breath that remains after a normal expiration, the examiner whispers words or random numbers and should not use only sibilants (s-sounding test materials). If the person fails the whispered voice test, the audiometric test should be administered. If a person meets the criteria by using a hearing aid, the driver must use that hearing aid at all times while driving and have a spare power source for the hearing aid with him or her. If a person meets the criteria by the use of a hearing aid, the following statement must appear on the medical examiner's certificate: “Qualified only when wearing a hearing aid.”
	12. Does not use a controlled substance†, an amphetamine, a narcotic, or any other habit-forming drug
	Exception: a driver may use such a substance or drug if the substance or drug is prescribed by a licensed medical professional who is familiar with the driver's medical history and assigned duties and has advised the driver that the prescribed substance or drug will not adversely affect the driver's ability to safely operate a commercial motor vehicle; this exception does not apply to the use of methadone.
	Summary of advisory criteria: if the driver is using any of the substances named above that can interfere with safe operation of the motor vehicle, it may be cause for the driver to be found medically unqualified. Motor carriers are encouraged to obtain a medical professional's written statement about the effects on transportation safety from the use of a particular drug. A test for controlled substances is not required as part of this biennial certification process.
	13. Has no current clinical diagnosis of alcoholism
	Summary of advisory criteria: the term “current clinical diagnosis” refers to a current alcoholic illness in which the physical condition has not fully stabilized, regardless of the time element. If a person shows signs of having an alcohol-use problem, he or she should be referred to a specialist. After counseling and/or treatment, he or she may be considered for certification.