Carrier Duties When a Truck Driver Shows Warning Signs

A medical card that hasn’t expired doesn’t settle whether a driver can safely take the next load. Federal rules put separate duties on the motor carrier, the company that dispatches the driver.

Carrier Duty to Use Qualified Drivers

49 CFR 391.11 bars a carrier from requiring or permitting an unqualified person to drive a commercial motor vehicle. Physical qualification is part of that standard. The card is evidence of qualification, but it doesn’t override facts the carrier learns afterward.

Driver Medical Reexamination After Injury or Illness

Under 49 CFR 391.45, a driver must be reexamined and recertified when an injury or disease has impaired the driver’s ability to do normal duties. Not every illness triggers this. FMCSA’s guidance on drivers returning from illness says a carrier may require a new exam and still has to decide whether the driver remains qualified. That statement is agency guidance, not regulatory text.

Trip Ban for Ill or Fatigued Drivers

49 CFR 392.3 prohibits both the driver and the carrier from starting or continuing a trip when fatigue, illness, or any other cause has impaired, or is likely to impair, the driver’s ability or alertness enough to make driving unsafe. This rule applies on the day of the trip, whatever the card’s expiration date.

Reasonable-Suspicion Drug and Alcohol Testing

49 CFR 382.307 requires a drug or alcohol test when a trained supervisor sees specific, current signs of drug or alcohol use in a driver’s appearance, behavior, speech, or odor. That rule covers drugs and alcohol only. No federal rule creates a general “reasonable suspicion” fitness-for-duty exam for sleepiness or illness.

Disability Law Limits on Employer Medical Exams

Disability law limits medical exams that employers order. In an informal discussion letter, the EEOC describes the job-related, business-necessity standard that applies when an employer requires an exam of a current employee. Observed performance problems or credible reports of safety risk usually support that standard.

Driver Warning Signs That Justify Records Review

Each of these warning signs is a reason to gather records. None proves negligence by itself:

• Reported sleepiness or falling asleep
• Fainting, a seizure, or stroke symptoms
• A new medication that can impair alertness
• A failed or unfinished medical exam
• A hospital stay
• Repeated preventable incidents
• A provider’s restriction
• Treatment noncompliance reported through a company sleep program

2022 Williamsburg, Virginia Fatigue Accident Findings

In its report on the December 16, 2022 accident near Williamsburg, Virginia, the NTSB found the truck driver had worked about 75 hours in the previous seven days with broken rest periods. It attributed the accident to fatigue from excessive driving time and limited sleep opportunity, and it named the carrier’s fictitious ELD accounts as a contributing factor. The report found no evidence that a sleep disorder played a role. This is a fatigue case driven by scheduling, not by a medical condition.

Repeated problems across a fleet are covered in Repeated Driver Fitness Violations in Trucking Company Safety Records. For a broader overview, see the firm’s truck accident practice page.