The CDL Medical Card: What It Is and How to Keep It (2026)
The “CDL medical card” is the certificate you get when you pass a DOT physical. Here is exactly what it is, how it connects to your license, and the mistake that quietly downgrades a CDL — letting it lapse.
Quick answer
- What it is
- The Medical Examiner's Certificate (Form MCSA-5876) — proof you passed a DOT physical
- Who issues it
- A certified examiner on the FMCSA National Registry, after your DOT physical
- How long it lasts
- Up to 24 months — sometimes shorter if a condition needs monitoring
- The catch
- You also self-certify a category with your state; non-excepted drivers must keep the card current
- If it lapses
- Your state downgrades the CDL to a regular license (typically within 60 days) until you re-certify
Requirements verified July 20, 2026 against FMCSA (49 CFR 383.71–383.73)
What the card actually is
The CDL medical card is the Medical Examiner's Certificate, officially Form MCSA-5876. A certified examiner on the FMCSA National Registry issues it when you pass a DOT physical. The card records that you met the federal physical qualification standard on the exam date, lists any restrictions (such as “corrective lenses”), and shows the expiration date. It is valid for a maximum of 24 months, and sometimes for a shorter period when a condition needs to be re-checked sooner.
Self-certification: the step people skip
Passing the physical is only half the picture. When you apply for or renew a CDL, you must also self-certify to your state which type of driving you do. This choice (49 CFR 383.71) tells the state whether a federal medical card is required for you at all.
| Code | Category | Who it fits | Medical card? |
|---|---|---|---|
| NI | Non-excepted Interstate | You drive (or plan to) across state lines and are subject to the federal Part 391 rules. | Yes — you must have a current DOT medical certificate on file. |
| EI | Excepted Interstate | You drive across state lines but only in operations the federal rules specifically except (e.g., certain government, custom-harvester, or non-business driving). | No federal medical card required — you certify you are excepted. |
| NA | Non-excepted Intrastate | You drive only within your own state and are subject to your state’s driver rules. | Per your state — some states require a medical card, some don’t. |
| EA | Excepted Intrastate | You drive only within your state and only in operations your state excepts from its driver rules. | No — you certify you are excepted under state rules. |
Source: 49 CFR 383.71. Most people getting a truck-driving job pickNI (Non-excepted Interstate). If you’re unsure which applies, ask your employer or your state licensing agency — choosing wrong can put a hold on your CDL.
Only the non-excepted categories carry a federal medical certificate. Most drivers taking an over-the-road job self-certifyNI (Non-excepted Interstate) and must keep the card current. If you certify the wrong category, or your card and category don’t match, the state can place a hold on your CDL.
How the card reaches your state
Your medical status has to be recorded on your CDL record, held in the Commercial Driver’s License Information System (CDLIS). For years, that meant handing a copy of the MCSA-5876 to your state licensing agency, which posted the certification date to your record.
Since National Registry II took effect on June 23, 2025, certified examiners transmit exam results to FMCSA electronically, and the data flows to State Driver Licensing Agencies. In states that have fully adopted the electronic system, you may no longer need to submit a paper copy yourself — the electronic record is authoritative. Because the rollout is phased, confirm the current process with your state agency, and keep any paper certificate the examiner gives you.
What happens when the card lapses: downgrade
If your certification status becomes “not-certified” — because the certificate expired or never made it onto your record — federal rule 49 CFR 383.73 requires your state to downgrade your CDL to a non-commercial license, typically within 60 days of notifying you. You keep a regular driver license, but you lose commercial driving privileges until you re-certify and the record is corrected. A downgrade can cost you work, so treat the expiration date as a hard deadline.
How to keep it current
- Note your certificate’s expiration date and set a reminder well before it.
- Schedule your next DOT physical with a certified National Registry examiner a few weeks early.
- Confirm the new certification reached your state record — don’t assume it did.
- Keep your self-certification category accurate if your type of driving changes.
- Hold onto any paper certificate as backup, even in electronic-record states.
Related pages
Start at the DOT physical hub for the full exam overview. See the exact standards on DOT physical requirements, and the conditions that can affect certification onDOT physical disqualifications. New to the process? Read how to get a CDL. Note that CDL disqualifications from driving offenses are a separate topic from medical certification. State rules differ — for example, California.
CDL medical card FAQ
Is the CDL medical card the same as the DOT physical?
No — they are two parts of one process. The DOT physical is the exam. The CDL medical card (the Medical Examiner’s Certificate, Form MCSA-5876) is the document you receive when you pass. People use the terms interchangeably, but the card is the paperwork that proves you met the standard.
How do I submit my medical card to the state?
Historically, drivers handed a copy of the MCSA-5876 to their state licensing agency, which posted the certification to the CDL record. Since National Registry II (June 23, 2025), certified examiners transmit results to FMCSA electronically, and the data flows to your state. In states that have moved fully to the electronic system, you may not need to submit a paper copy — confirm with your state agency.
What happens if my medical card expires?
If your certification status becomes “not-certified” — because the card expired or is missing from your record — your state must downgrade your CDL to a non-commercial license, generally within 60 days of notifying you. You keep a personal driver license but cannot legally drive commercially until you re-certify and your record is updated.
How do I keep my medical card current?
Get re-examined by a certified National Registry examiner before your current certificate expires, and make sure the new certification reaches your state record. Do not wait until the last day — leave room for the exam, any follow-up paperwork, and processing so your CDL is never downgraded.
Do all CDL holders need a medical card?
No. Only drivers in the “non-excepted” self-certification categories carry a federal medical certificate. Excepted and some intrastate drivers may not need one. You choose your category when you self-certify with your state, so it is important to pick the one that matches how you actually drive.
Official sources
Every requirement on this page traces to one of these official sources.