Medical Certification Requirements

Most drivers are required to get a "certified" medical status and maintain the status to avoid losing their Commercial Driver License. There are four commerce types, two of which require drivers to maintain a current Federal medical examiner’s certificate (49 CFR 391.45), commonly referred to as a medical certificate or DOT card.

Whether they are Excepted or Non-Excepted, all CDL holders must submit a Self-Certification Affidavit to the Tennessee Department of Safety and Homeland Security when they apply for a CDL, apply for a higher class, apply for a new endorsement, transfer a CDL from another State, or renew their CDL.

Interstate commerce is when drivers operate a commercial vehicle from one State to another State or foreign country, or that passes through another State or foreign country while traveling from one location to another within the same State, or that transports cargo that is part of a trip that began or will end in another State or foreign country.

If a commercial vehicle and its cargo are only driven within a State, that is Intrastate Commerce. Drivers who transport both intrastate and interstate commerce, must choose interstate commerce.
 

Interstate Commerce Exception

Most commercial vehicle drivers who transport interstate commerce are non-excepted and are required to maintain a current Medical Certification.

If you drive a commercial vehicle in interstate commerce for the following excepted activities ONLY, you are exempt and do not have to maintain a medical certificate:

• As a Federal, State or local government employee
  • The Federal, State or local government employee exemption DOES NOT apply if you need the hazardous materials, passenger, or school bus endorsement.
• Transporting human corpses or sick or injured persons
• Fire truck or rescue vehicle drivers during emergencies and other related activities
• Transporting of propane winter heating fuel when responding to an emergency condition requiring immediate response such as damage to a propane gas system after a storm or flooding
• Responding to a pipeline emergency condition requiring immediate response such as a pipeline leak or rupture
• Harvesting on a farm or transporting farm machinery and supplies used in the custom harvesting operation to and from a farm or transporting custom harvested crops to storage or market
• Beekeeper in the seasonal transportation of bees
• Transporting agricultural products, farm machinery or farm supplies (no placardable hazardous materials) to and from a farm and within 150 air-miles of the farm, not using a combination vehicle (power unit and towed unit) by a farmer
• Transporting migrant workers
   

Intrastate Commerce Exception

Commercial vehicle drivers who ONLY transport intrastate commerce that does not require a hazardous materials, passenger, or school bus endorsement do not need to have a Medical Certification. If you transport both excepted and non-excepted intrastate commerce, you must maintain a current Medical Certification.
 

Submit a Self-Certification

To submit the self-certification, download and complete the Self-Certification Affidavit selecting which of the four commerce types applies. 

Based on your self-certification, you may need to have a physical performed and have a Medical Examiner's Certificate (Form MCSA-5876) completed by a certified medical professional. The medical professional that performed the physical is required to send a record of the certification to the FMCSA electronically. 

National Registry of Certified Medical Examiner (NRII) final rule, a follow-on rule to the National Registry of Certified Medical Examiners (National Registry), thereby improving safety on your Nation’s roadways.

NRII final rule is to facilitate the electronic transmission of examination results (medically qualified, medically unqualified, and voided) and additional information (e.g., corrective lenses, hearing aid, medical exemption, skill performance evaluation certificate, etc.) from examinations performed for commercial learner’s permit / commercial driver’s license applicants/holders from FMCSA’s National Registry to the State Driver’s Licensing Agencies to be posted on the Commercial Driver’s License Information System driver motor vehicle record.

When must impacted individuals comply?

By June 23, 2025. However, FMCSA will allow states to implement NRII before June 23, 2025, if they are ready to do so. Tennessee will implement on June 15th, 2025. When states implement NRII, medical certification information for CLP applicants and CDL holders in those states will be electronically transmitted from the National Registry to TN. The original/paper Medical Examiner’s Certificate, Form MCSA-5876, shall no longer be used as proof of medical certification. A physical copy of form MCSA-5876 will no longer be accepted as proof of a valid medical examination.  In states that have implemented NRII, the medical examiner is not required to issue the original/paper Medical Examiner’s Certificate, Form MCSA-5876, as the medical certification information will be electronically transmitted to Tennessee.

Drivers must submit their Self-Certification Affidavit to the Tennessee Department of Safety and Homeland Security using e-Services or Driver Services Center. 

Renew a Self-Certification and Medical Certificate

To renew your Self-Certification and Medical Certification, you must have a new physical performed. Submit (upload) your Self-Certification Affidavit and Medical Examiner's Certificate to the Department of Safety and Homeland Security five (5) business days prior to the expiration of your current medical certificate. If you have a variance, you are also responsible for applying to renew it with FMCSA.

If your medical certificate or variance has expired or will expire before you can provide the Department of Safety and Homeland Security with a new one, all CDL privileges will be removed from your license. If your medical certificate will expire before you can renew it, you may be able to change your self-certification to an operating category that does not require a medical certificate.

Once your medical certificate has expired, to get back your CDL privileges, you will need to reapply for a medical certificate which may require retesting and additional fees. If your variance expires you must renew it with FMCSA.

For more information about an expired medical certificate, contact the Commercial Driver License (CDL) MedCert Section at (615) 502-4179.

Do not go a Driver Services Center until advised by the MedCert Section.

Assurance that medical certification information is successfully posted to the driver’s motor vehicle record.

Step 1 - Contact the medical examiner that performed your physical qualification examination, explain the issue, and request that they log into their National Registry account and verify if they received an error message task for your examination. If they have, request that they use the copy
of your driver’s license submitted at the time of the examination to correct any errors and select submit. 

Step 2 - Contact FMCSA to inform them that the medical examiner submitted the validation/correction and to verify that the medical certification information posted. If it has not, and you requested an original/paper Medical Examiner’s Certificate, Form MCSA-5876, at the time of
your examination, verify if it would be helpful to use it to help troubleshoot the issue and resolve it. 

Step 3 - If neither of the steps above resolve the issue, you can contact FMCSA’s National Registry Technical Support Helpdesk at fmctechsup@dot.gov  or (617) 494-3003, to assist in determining the issue and possible corrective actions the agency can assist with.