What does 49 CFR 391.45 (Persons who must be medically examined and certified) require?

Short answer

49 CFR 391.45 requires medical examination and certification for certain persons, including those who have not been medically examined and certified in the preceding 24 months, and those with specific medical conditions such as diabetes mellitus treated with insulin. The rule applies to various categories of drivers, including those operating commercial motor vehicles in exempt intracity zones and those with impaired ability to perform normal duties.

The rule says

"The following persons must be medically examined and certified in accordance with 391.43 as physically qualified to operate a commercial motor vehicle: (a) Any person who has not been medically examined and certified as physically qualified to operate a commercial motor vehicle; (b) Any driver who has not been medically examined and certified as qualified to operate a commercial motor vehicle during the preceding 24 months, unless the driver is required to be examined and certified in accordance with paragraph (c), (d), (e), (f), (g), or (h) of this section" (49 CFR 391.45)

"(e) Any driver who has diabetes mellitus treated with insulin for control and who has obtained a medical examiner's certificate under the standards in 391.46, if such driver's most recent medical examination and certification as qualified to drive did not occur during the preceding 12 months" (49 CFR 391.45)

"(g) Any driver whose ability to perform his or her normal duties has been impaired by a physical or mental injury or disease" (49 CFR 391.45)

In plain English

This rule ensures that commercial motor vehicle drivers are medically fit to operate their vehicles safely. It applies to drivers who have not been medically certified in the past 24 months, as well as those with specific medical conditions that may impact their ability to drive. The rule also covers drivers who have been injured or have a disease that may impair their ability to perform their normal duties. In practice, this means that drivers must undergo regular medical examinations to ensure they meet the physical qualification standards for operating a commercial motor vehicle.

What to do

• Ensure that all drivers who meet the criteria under 49 CFR 391.45 undergo a medical examination and certification.
• Verify that drivers with specific medical conditions, such as diabetes mellitus treated with insulin, have obtained a medical examiner's certificate under the standards in 391.46.
• Maintain records of medical examinations and certifications for all drivers.
• Ensure that drivers whose ability to perform normal duties has been impaired by a physical or mental injury or disease are medically examined and certified before returning to duty.