Renewing your DOT medical card

Rules checked against the eCFR and FMCSA guidance on November 11, 2026 · Not medical advice

A DOT medical certificate lasts up to 24 months, and often less. Book your next exam before the expiration date printed on your card: once it expires, you're not medically certified to drive interstate.

How long your card lasts

• Up to 24 months is the standard maximum.^[1]
• 12 months at most for drivers certified under the insulin-treated diabetes standard or the alternative vision standard.^[1]
• Shorter periods are common when the examiner wants to monitor a condition. For example, FMCSA guidance suggests at least yearly certification for drivers treated for high blood pressure.^[2]
• A new exam is needed before the end of that period, and also when an injury or illness has affected your ability to do your normal duties.^[1]

How results reach your state (CDL and CLP holders)

Since June 23, 2025, examiners report results through the National Registry, and FMCSA sends them electronically to state driver licensing agencies for your driving record.^[3] CDL and CLP holders with a current certificate no longer have to carry the card on them.^[4] If the electronic record and a paper card disagree, the electronic record controls.^[4]

• States still finishing the switch: in states that haven't implemented the change, you still need a paper certificate to submit to the licensing agency. FMCSA keeps the list on its NRII Learning Center.^[5] FMCSA has also issued temporary waivers during the rollout, so check that page for what applies now.
• Non-CDL commercial drivers (for example, some lighter trucks used interstate) still get a paper certificate from the examiner and must carry it.^[6]
• Check your record. A few weeks after your exam, confirm with your state licensing agency that your medical status shows as certified. States downgrade CDLs when the medical certification lapses.

Renewal tips

• Book a few weeks before your card expires, so there's time for any records the examiner asks for. An examiner can hold a decision for up to 45 days.^[6]
• Bring your current card and an up-to-date medication list. See what to bring.
• Any certified examiner can do your renewal; it doesn't have to be the one you saw last time. Find one near you.

Sources

1. 49 CFR 391.45, Persons who must be medically examined and certified (eCFR)
2. FMCSA, Effect on driver certification of hypertension stages (FAQ)
3. FMCSA newsroom: digital medical certification launch (June 23, 2025)
4. 49 CFR 391.41, Physical qualifications for drivers (eCFR)
5. FMCSA National Registry, NRII Learning Center
6. 49 CFR 391.43, Medical examination (eCFR)

This guide summarizes federal rules for interstate commercial drivers. It isn't medical or legal advice, and your medical examiner makes the final decision. Disclaimer.