FMCSA Updates Commercial Driver Medical Criteria

The Federal Motor Carrier Safety Administration (FMCSA) has updated medical advisory criteria that are used by certified medical examiners to qualify commercial motor vehicle operators for safe operations. The criteria, published as an appendix in the Code of Federal Regulations (CFR), provide guidance for medical examiners to help them comply with standards, including information related to testing and how to make a physical qualification determination.

In a related action, the FMCSA published the 2024 edition of its Medical Examiner’s Handbook to update medical advisory criteria published in Appendix A to 49 CFR part 391. It replaces all previous editions; medical examiners are advised not to rely on prior versions. Of particular note:

• Sleep apnea: Section 4.8.3.6 of the handbook related to obstructive sleep apnea replaces a January 2015 directive. Medical examiners are permitted to decide when an individual should be screened for sleep apnea based on individual circumstances.
• Vision: Guidance on vision standard 87 FR 3390 permits individuals who do not satisfy, with the worse eye, either the existing distant visual acuity standard with corrective lenses or the field of vision standard, or both, to be qualified to operate commercial motor vehicles in interstate commerce.
• Diabetes: Qualifications for drivers with insulin-treated diabetes reflect that they are no longer absolutely prohibited from driving commercial motor vehicles in interstate commerce.