---
kind: "section"
citation: "49 C.F.R. § 391.45"
title: "49"
number: "391.45"
heading: "Persons who must be medically examined and certified."
url: "https://uscodex.org/cfr/49/391.45"
---

# §391.45. Persons who must be medically examined and certified.


The following persons must be medically examined and certified in accordance with [§ 391.43](/cfr/49/391.43.md) as physically qualified to operate a commercial motor vehicle:

- (a) Any person who has not been medically examined and certified as physically qualified to operate a commercial motor vehicle;
- (b) Any driver who has not been medically examined and certified as qualified to operate a commercial motor vehicle during the preceding 24 months, unless the driver is required to be examined and certified in accordance with paragraph [(c)](#c), [(e)](#e), [(f)](#f), [(g)](#g), or [(h)](#h) of this section;
- (c) Any driver authorized to operate a commercial motor vehicle only within an exempt intracity zone pursuant to [§ 391.62](/cfr/49/391.62.md), if such driver has not been medically examined and certified as qualified to drive in such zone during the preceding 12 months;
- (d) [Reserved]
- (e) Any driver who has diabetes mellitus treated with insulin for control and who has obtained a medical examiner's certificate under the standards in [§ 391.46](/cfr/49/391.46.md), if such driver's most recent medical examination and certification as qualified to drive did not occur during the preceding 12 months;
- (f) Any driver who does not satisfy, with the worse eye, either the distant visual acuity standard with corrective lenses or the field of vision standard, or both, in [§ 391.41(b)(10)(i)](/cfr/49/391.41.md?p=b-10-i) and who has obtained a medical examiner's certificate under the standards in [§ 391.44](/cfr/49/391.44.md), if such driver's most recent medical examination and certification as qualified to drive did not occur during the preceding 12 months;
- (g) Any driver whose ability to perform his or her normal duties has been impaired by a physical or mental injury or disease; and
- (h) On or after June 23, 2025, any person found by a medical examiner not to be physically qualified to operate a commercial motor vehicle under the provisions of [paragraph (g)(3)](/cfr/49/391.43.md?p=g-3) of § 391.43.

## Notes

### Amendments

[83 FR 47520, Sept. 19, 2018, as amended at 86 FR 32651, June 22, 2021; 87 FR 3419, Jan. 21, 2022; 88 FR 80192, Nov. 17, 2023; 89 FR 90623, Nov. 18, 2024; 91 FR 45661, July 21, 2026]

### Authority

Authority: 49 U.S.C. 504, 508, 31133, 31136, 31149, 31502; sec. 4007(b), Pub. L. 102-240, 105 Stat. 1914, 2152; sec. 114, Pub. L. 103-311, 108 Stat. 1673, 1677; sec. 215, Pub. L. 106-159, 113 Stat. 1748, 1767; sec. 32934, Pub. L. 112-141, 126 Stat. 405, 830; secs. 5403 and 5524, Pub. L. 114-94, 129 Stat. 1312, 1548, 1560; sec. 2, Pub. L. 115-105, 131 Stat. 2263; and 49 CFR 1.87.

### Source

Source: 35 FR 6460, Apr. 22, 1970, unless otherwise noted.

### Amendments

[83 FR 47520, Sept. 19, 2018, as amended at 86 FR 32651, June 22, 2021; 87 FR 3419, Jan. 21, 2022; 88 FR 80192, Nov. 17, 2023; 89 FR 90623, Nov. 18, 2024; 91 FR 45661, July 21, 2026]