Medical Standards for Commercial Driver's Licenses (CDL)

There are specific Massachusetts and Federal medical guidelines that must be met for a driver to be eligible to operate a commercial vehicle.

Overview

You must meet minimum, federally-mandated medical standards to get a commercial driver's license (CDL). You are physically qualified to drive a commercial motor vehicle if you either:

To ensure that you meet these medical standards, you must pass a Department of Transportation (DOT) medical examination.

A Department of Transportation (DOT) physical examination must be conducted by a licensed "medical examiner" listed on the Federal Motor Carrier Safety Administration (FMCSA) National Registry. 

Follow this link to find a medical examiner who is certified by the FMCSA to perform DOT physical exams: https://nationalregistry.fmcsa.dot.gov/NRPublicUI/Drivers.seam

A DOT medical examiner's certificate is generated by this examination. Medical examiner's certificates are valid for a maximum of 2 years.

In order to operate a Commercial Motor Vehicle with a gross vehicle rating in excess of 10,000 pounds in interstate commerce, a medical examiner's certificate may also be required, even if you do not have a CDL.

Additional Resources

Medical Waivers

Interstate Exemptions

The federal government has a vision and diabetes medical exemption program for interstate commercial driving.

If you do not meet the federal vision and/or diabetes medical standards, you may be able to obtain an exemption from those standards for interstate commerce from the federal government.

A commercial driver who has obtained a medical interstate exemption should continue to have in his/her possession the original or copy of that medical exemption documentation at all times when operating a commercial vehicle.

Massachusetts Intrastate Waivers

The RMV will waive compliance with the federal medical requirements pertaining to commercial vehicles for the purposes of driving intrastate (within the borders of Massachusetts only) and will issue intrastate medical waivers for the following conditions only, provided the Registrar determines that the condition will not interfere with the safe operation of a commercial vehicle. If you are issued an intrastate medical waiver you must have a “W” (Commercial Motor Vehicle Intra-state Only with Medical Waiver) restriction put on your license.

To apply for an intrastate waiver, you have to complete an Application for Intrastate Medical Waivers to Operate Class A, B, or C Commercial Motor Vehicles. In addition to the application, the following documentation must be submitted, certified by a medical professional, to the Medical Affairs:

  • A copy of the results of a recent DOT medical examination, upon which the examining physician has indicated that you are only qualified to operate a commercial motor vehicle with an intrastate medical waiver
  • A letter from your employer acknowledging that you have a medical waiver and that you drive commercially as a requirement of employment within the borders of Massachusetts only
Intrastate Waiver for a Vision Impairment

The RMV will only issue an intrastate medical waiver for a vision impairment if you have:

  • A combined horizontal peripheral field of vision of not less than 120 degrees
  • A distant visual acuity of at least 20/40 in either eye, with or without corrective lenses
  • The ability to distinguish the colors red, green, and amber
Intrastate Waiver for a Diabetic Condition

The RMV will only issue an intrastate medical waiver for a diabetic condition if you submit a written statement from your health care provider which:

  • Provides specific reasons why you are not at risk or are no longer at risk of suffering hypoglycemic spells or episodes
  • Recommends a specific date for the RMV to re-evaluate your ability to operate a commercial motor vehicle safely
Intrastate Waiver for a Cardiovascular Condition

The RMV will only issue an intrastate medical waiver for a cardiovascular condition if you:

  • Are not classified according to the American Heart Association functional classification system as an American Heart Association functional Class III or IV heart patient

OR

  • Have had an Automated Implantable Cardiac Defibrillator placed for a "sudden death event" and will not be eligible for an active intrastate Commercial Driver's License waiver until a 6 month period during which there is documentation of no episodes of appropriate device firing

If you have an Automated Implantable Cardiac Defibrillator and are determined to have an Automated Implantable Cardiac Defibrillator that appropriately "fires", you will be considered the same as a customer who has had a "sudden death event" and be subject to a 6 month period during which there is documentation of no episodes of appropriate device firing. 

If you have an Automated Implantable Cardiac Defibrillator placed purely for prophylactic reasons, you are eligible for an intrastate Commercial Driver's License waiver and will not be subject to the 6 month, no-trigger, "waiting" period. 

If you were formerly deemed ineligible to receive a waiver due to your Automated Implantable Cardiac Defibrillator implant or classification as a Class III or IV heart patient, and are now eligible, you must submit a written statement from your health care provider to the RMV which indicates that:

  • An Automated Implantable Cardiac Defibrillator implanted for a “sudden death event” has not fired in a 6 month period or that the Automated Implantable Cardiac Defibrillator was implanted for prophylactic reasons and has not fired in a 6 month period
  • You are classified as either American Heart Association functional Class I, Class II, or do not have heart disease
  • To a reasonable degree of medical certainty, you're medically qualified to operate a commercial vehicle
Intrastate Waiver for a Loss or Impairment of Limb

The RMV will only issue an intrastate medical waiver for a loss or impairment of limb if such loss is not likely to interfere with the safe operation of a commercial motor vehicle.

Intrastate Waiver for a Deaf and Hard of Hearing

The RMV will only issue an intrastate medical waiver for a deaf and hard of hearing if the certifying health care provider states the condition will not interfere with the safe operation of a commercial vehicle.

For vehicles with air brakes, you must be able to hear the air compressor cutting out and detect an actual air leak in the braking system- a safety precaution in case the gauges have malfunctioned. Therefore, a profoundly deaf person would be restricted to a commercial vehicle without airbrakes.

Medical Waivers Issued Prior to June 16, 1998

If you are unable to meet the medical qualifications to obtain a medical waiver as set forth in the 2010 CDL intrastate medical waiver guidelines, but held a valid intrastate medical waiver prior to June 16, 1998, you will be eligible to retain or renew your intrastate medical waiver, provided:

  • You satisfy the CDL intrastate medical waiver qualification standards in effect immediately prior to June 16, 1998
  • You provide a letter from your health care provider certifying that, to a reasonable degree of medical certainty, the customer is medically qualified to safely operate a commercial motor vehicle
  • The RMV has no other cause to believe, based upon the customer's driving history or otherwise, that the customer cannot safely operate such commercial motor vehicle

CDL intrastate medical waiver qualifications in effect immediately prior to June 16, 1998 required that customers with any one of the following conditions may be granted an intrastate medical waiver provided the condition will not interfere with the safe operation of a commercial motor vehicle:

  • Visual acuity of 20/40 in the better eye with a total field of 120 degrees
  • Insulin dependent diabetes that is under control
  • Minor afflictions such as loss of finger
  • Any other condition that the RMV determines in a customer case will not interfere with the safe operation of a commercial motor vehicle

Additional Resources

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