Truck Driver Medical Card Limits in Accident Investigations

An interstate truck driver’s medical card shows only that a certified medical examiner found the driver met federal physical standards for a set period. The card, Form MCSA-5876, lists the driver, the examiner, the examiner’s National Registry number, the expiration date, and any conditions, such as corrective lenses. According to the certificate’s own certification statement, the examiner’s findings are kept in the full examination report and its attachments at the examiner’s office.

Full Medical Exam Report Contents

The full report is Form MCSA-5875. It asks whether the driver was ever denied a certificate or given one for less than two years. It asks about prescription and over-the-counter medications, head injuries, seizures, fainting, stroke, heart disease, sleep disorders, loud snoring, daytime sleepiness, and prior sleep testing. The examiner also records blood pressure, vision, hearing, urinalysis, and physical findings.

The driver signs a statement that the answers are complete. The form warns that false or missing information may invalidate both the exam and the certificate. A one-page card shows none of this.

Driver Medical Exam Outcomes

An exam can end in one of four ways:

• Meets the standards: the driver qualifies, sometimes with a shorter certification period or monitoring.
• Determination pending: the examiner needs more information. Under the form’s instructions, a pending exam that isn’t resolved within 45 days becomes invalid.
• Incomplete: the exam stopped for another reason.
• Does not meet the standards: the driver is not qualified.

Earlier Medical Cards After a Failed Exam

Under 49 CFR 391.43, when an exam on or after June 23, 2025 finds a driver not qualified, every certificate issued to that driver before then stops being valid for federal qualification. For exams before that date, investigators have to use the rule that applied at the time. A later failure doesn’t automatically erase an earlier card under every older version of the rule.

Second Driver Medical Exams

A second exam isn’t misconduct by itself. Treatment, new test results, or a specialist’s letter can legitimately change the outcome. Questions come up when the answers about medical history change with no medical reason, when a prior failed exam goes unmentioned, or when supporting records disappear between exams. 49 CFR 390.35 prohibits intentionally false entries in required records. Intent still has to be proven.

Medical Examiner Records and Registry Listings

Examiners must keep the long form and a copy of the certificate for at least three years. They must also report results to FMCSA by midnight local time on the next calendar day. Under 49 CFR 390.115, an examiner removed from the National Registry stays publicly listed for three years along with the removal date. Removals older than that require records requests.

CDL Medical Status on State Driver Records

For CDL holders, National Registry II sends qualified exam results from FMCSA to the state, which posts the medical status to the driver record. FMCSA’s temporary exemption let a paper certificate serve as proof for up to 60 days after it was issued, from April 11 through October 11, 2026. Starting October 12, 2026, drivers licensed in every state except Alaska, and their employers, can no longer rely on the paper certificate as proof of medical certification, according to an FMCSA Federal Register notice. Alaska, the only state that hasn’t implemented National Registry II, received a separate one-year exemption. Drivers who don’t need a CDL still rely on the paper certificate and the carrier’s qualification file.

Falsified Driver Medical Exams

DOT’s Office of Inspector General reported the sentencing of Atlanta examiner Anthony Lefteris for falsifying DOT medical examinations, after an earlier guilty plea. His case shows that a card can look valid on its face while the exam behind it never happened.

How sleep records are evaluated is in Proving Sleep Apnea Caused a Truck Accident. What a carrier has to do once it learns of a problem is in Carrier Duties When a Truck Driver Shows Warning Signs.