What does 49 CFR 391.43 (Medical examination; certificate of physical examination) require?

Short answer

49 CFR 391.43 requires a medical examination by a certified medical examiner, with exceptions for certain medical professionals and specific conditions. The medical examiner must be knowledgeable about the physical and mental demands of operating a commercial motor vehicle and use the medical protocols necessary for the examination.

The rule says

"Except as provided by paragraph (b) of this section, the medical examination must be performed by a medical examiner listed on the National Registry of Certified Medical Examiners under subpart D of part 390 of this chapter." (49 CFR 391.43(a))

"Medical examiners shall: (1) Be knowledgeable of the specific physical and mental demands associated with operating a commercial motor vehicle and the requirements of this subpart, including the medical advisory criteria prepared by the FMCSA as guidelines to aid the medical examiner in making the qualification determination; and (2) Be proficient in the use of and use the medical protocols necessary to adequately perform the medical examination required by this section." (49 CFR 391.43(c))

In plain English

This rule ensures that commercial motor vehicle drivers are medically fit to operate their vehicles safely. The examiner must use established medical protocols to evaluate the driver's fitness for duty. In practice, this means that drivers must undergo a thorough medical examination by a qualified professional, and the examiner must provide a certificate of physical qualification if the driver meets the required standards.

What to do

• Ensure that all commercial motor vehicle drivers undergo a medical examination by a certified medical examiner.
• Verify that the medical examiner is listed on the National Registry of Certified Medical Examiners.
• Maintain records of the medical examination and certification for each driver.
• Ensure that drivers are aware of the requirements for medical certification and the consequences of not meeting those requirements.