Am I required to have a medical certificate if I only operate a CMV in my home State (intrastate commerce)?

 Intrastate drivers are subject to the physical qualification regulations of their States. All 50 States have adapted their regulations based on some of the Federal requirements. Many states grant waivers for certain medical conditions.

NOTE: FedEx, UPS and DHL drivers usually do not leave the state but are subject to interstate regulations.

Last Updated : April 1, 2014 FMCSA

I get a lot of questions regarding drivers or motor carriers who come in to our urgent care or occmed centers for a DOT medical exam and want a medical certificate, but who state they don’t require a “certified medical examiner” and don’t need to qualify under DOT medical guidelines (CFR 391.41) because they only drive “intrastate.”

While it is true that the federal DOT/FMCSA medical qualification standards and guidelines apply to interstate commerce, most states have adopted the requirement for commercial drivers with class A, B or C licenses to meet the federal medical qualifications, and in fact require the same federal medical form and certificate.  Some states modify the form to be quite similar to the federal form.

Here is an excerpt from Delaware’s commercial driver manual:

Above all else, this manual and our Commercial Driver’s License (CDL) program is dedicated to improving safety on our highways. This
manual provides information necessary to pass the knowledge examinations (written tests) that you will need to take in order to qualify for the CDL Learners Permit. Part Four of the manual explains the skills test you will need to pass before the CDL License is issued. The information in this Manual provides general guidance and does not discuss all possible situations or circumstances contained in Federal or State laws which control CDL licensing.
– Be 18 years of age with 1 year driving experience for driving intrastate
– Be 21 years of age (with at least 1 year driving experience) to drive interstate Commerce or to transport hazardous materials
– Delaware resident
– Not denied, suspended, disqualified, revoked or cancelled in Delaware or any other state
– Able to obtain medical certification under the Federal Motor Carrier Safety Regulations Under Part 391.41 – Physical Qualifications for Drivers
– If you do not meet requirements of 49 CFR §391.41 Physical Qualifications for Drivers, you may be able to obtain a
Delaware intrastate only restricted CDL medical waiver, if otherwise qualified to drive a motor vehicle (excluding
transporting passengers or hazardous materials)

 And here is what FMCSA has to say regarding state laws and intrastate commerce:

§ 350.341: What specific variances from the FMCSRs are allowed for State laws and regulations governing motor carriers, CMV drivers, and CMVs engaged in intrastate commerce and not subject to Federal jurisdiction?
(a) A State may exempt a CMV from all or part of its laws or regulations applicable to intrastate commerce, provided that neither the GVW, GVWR, GCW, nor GCWR of the vehicle equals or exceeds 11,801 kg (26,001 lbs.). However, a State may not exempt a CMV from such laws or regulations if the vehicle: (1) Transports hazardous materials requiring a placard.(2) Is designed or used to transport 16 or more people, including the driver.(b) State laws and regulations applicable to intrastate commerce may not grant exemptions based upon the type of transportation being performed (e.g., for-hire, private, etc.). (c) A State may retain those exemptions from its motor carrier safety laws and regulations that were in effect before April, 1988, are still in effect, and apply to specific industries operating in intrastate commerce. (d) State laws and regulations applicable to intrastate commerce must not include exemptions based upon the distance a motor carrier or driver operates from the work reporting location. This prohibition does not apply to those exemptions already contained in the FMCSRs nor to the extension of the mileage radius exemption contained in 49 CFR 395.1(e) from 100 to 150 miles. (e) Hours of service—State hours-of-service limitations applied to intrastate transportation may vary to the extent of allowing the following:(1) A 12-hour driving limit, provided driving a CMV after having been on duty more than 16 hours is prohibited. (2) Driving prohibitions for drivers who have been on duty 70 hours in 7 consecutive days or 80 hours in 8 consecutive days.(f) Age of CMV driver—All CMV drivers must be at least 18 years of age.(g) Grandfather clauses—States may provide grandfather clauses in their rules and regulations if such exemptions are uniform or in substantial harmony with the FMCSRs and provide an orderly transition to full regulatory adoption at a later date. (h) Driver qualifications:(1) Intrastate drivers who do not meet the physical qualification standards in 49 CFR 391.41 may continue to be qualified to operate a CMV in intrastate commerce if the following three conditions are met: (i) The driver was qualified under existing State law or regulation at the time the State adopted physical qualification standards compatible with the Federal standards in 49 CFR 391.41.(ii) The otherwise non-qualifying medical or physical condition has not substantially worsened. (iii) No other non-qualifying medical or physical condition has developed.(2) The State may adopt or continue programs granting variances to intrastate drivers with medical or physical conditions that would otherwise be non-qualifying under the State’s equivalent of 49 CFR 391.41 if the variances are based upon sound medical judgment combined with appropriate performance standards ensuring no adverse effect on safety. (3) The State may decide not to adopt laws and regulations that implement a registry of medical examiners trained and qualified to apply physical qualification standards or variances continued in effect or adopted by the State under this paragraph that apply to drivers of CMVs in intrastate commerce.
Citation: [65 FR 15102, Mar. 21, 2000, as amended at 77 FR 24126, Apr. 20, 2012; 78 FR 58478, Sept. 24, 2013] 

So a driver can’t just come in and say “give me an intrastate waiver, doc”.  If they are disqualified according to medical qualifications under CFR 391.41, in most states they must go to the state DMV and apply for an intrastate waiver, if such programs exist.  The waiver would specify under what conditions the individual may drive commercially.  When certifying such a driver and submitting the national registry 5850 form, you would mark “intrastate only” and “accompanied by other waiver/exemption” and fill in the explanation of the state waiver:



Here is a listing of all state DMV websites for further reference to your particular state

Here are state-by-state instructions for submitting medical certificates


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