All Commercial Driver License (CDL) or Commercial Learner’s Permit (CLP) applicants and current CDL or CLP holders must provide a self-certification to the Department of Revenue regarding the type of commercial motor vehicle (CMV) operation they do or expect to do. Drivers certifying to operating in certain types of commerce will be required to submit a current medical examiner's certificate to the Department in order to add or retain a "certified" medical status as part of their driving record.

CDL or CLP holders required to have a “certified” medical status who fail to provide and maintain an updated medical examiner’s certificate with the Department will become “not-certified” and they may lose their CDL. (See 302.768, RSMo and 49 CFR Section 383.71.)

The following FAQs will help you in determining how to meet medical certification requirements.

When you:

  • Apply for a CDL or CLP;
  • Renew a CDL or CLP;
  • Apply for a higher class of CDL or CLP;
  • Apply for a new endorsement on a CDL or CLP;
  • Transfer a CDL from another state; or
  • Have been issued an updated Medical Examiner’s Certificate

…you will be required to self-certify to a single type of commercial operation as part of your driver license application. Based on that self-certification, you may need to provide a current valid medical examiner’s certificate and show any variance (waiver or Skills Performance Evaluation (SPE)) you may have in order to obtain or retain your CDL or CLP.

For the purpose of complying with the requirements for medical certification, it is important to know how you are using the CMV. To help you decide, follow these steps:

Step 1: Do you, or will you, use a CDL to operate a CMV in interstate commerce or intrastate commerce?

Interstate commerce is when you drive a CMV:

  • From one state to another state or a foreign country;
  • Between two places within a state, but during part of the trip, the CMV crosses into another state or foreign country; or
  • Between two places within a state, but the cargo is part of a trip that began or will end in another state or foreign country.

Intrastate Commerce is when you drive a CMV within a state and you do not meet any of the descriptions above for interstate commerce.

If you operate in both intrastate commerce and interstate commerce, you must choose interstate commerce.

Step 2: Once you decide you operate or will operate in interstate commerce or intrastate commerce, you must decide whether you operate (or expect to operate) in a non-excepted or excepted status. This decision will tell you to which of the four types of commerce you must self-certify.

Interstate Commerce:

You operate in excepted interstate commerce when you drive a CMV in interstate commerce only for the following excepted activities:

  • To transport school children and/or school staff between home and school;
  • As federal, state or local government employees;
  • To transport human corpses or sick or injured persons;
  • Fire truck or rescue vehicle drivers during emergencies and other related activities;
  • Primarily in the transportation 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;
  • In response to a pipeline emergency condition requiring immediate response such as a pipeline leak or rupture;
  • In custom harvesting on a farm or to transport farm machinery and supplies used in the custom harvesting operation to and from a farm or to transport custom harvested crops to storage or market;
  • Beekeeper in the seasonal transportation of bees;
  • Controlled and operated by a farmer, but is not a combination vehicle (power unit and towed unit), and is used to transport agricultural products, farm machinery or farm supplies (no placardable hazardous materials) to and from a farm and within 150 air-miles of the farm;
  • As a private motor carrier of passengers for non-business purposes; or
  • To transport migrant workers.

If you answered yes to one or more of the above activities as the only operation in which you drive, you operate in excepted interstate commerce and do not need a federal medical examiner’s certificate.

If you answered no to all of the above activities, you operate in non-excepted interstate commerce and are required to provide a current medical examiner’s certificate (49 CFR 391.45) to the Department. Most CDL holders who drive CMVs in interstate commerce are non-excepted interstate commerce drivers.

If you operate in both excepted interstate commerce and non-excepted interstate commerce, you must choose non-excepted interstate commerce to be qualified to operate in both types of interstate commerce.

Intrastate Commerce:

You operate in excepted intrastate commerce when you drive a CMV only in intrastate commerce activities for which Missouri has determined do not require you to meet the state’s medical certification requirements.

You operate in non-excepted intrastate commerce when you drive a CMV only in intrastate commerce and are required to meet the state medical certification requirements.

If you operate in both excepted intrastate commerce and non-excepted intrastate commerce, you must choose non-excepted intrastate commerce.

Step 3: Provide the Department with your self-certification of your operating status. If you self-certify to non-excepted interstate, or non-excepted intrastate, you must provide a copy of your current medical examiner’s certificate.

If your medical examiner's certificate is only valid with a a skills performance evaluation variance or waiver/exemption waiver granted by the Federal Motor Carrier Safety Administration (FMCSA) or the Missouri Department of Transportation (MoDOT), you are also required to provide a copy of that variance or waiver/exemption document to the Department.

You should carry the document for at least ten days after update or issuance to ensure all record updates are completed. After such time you are not required to carry the card during operation, however you will be required to present the certificate again at the time of your next license transaction.

The Department will notify you that you are no longer medically certified to operate a CMV. The Department will then remove all your CDL privileges from your license.

You must have a new medical examination and obtain a new medical certificate. You must then provide a new medical examiner's certificate to the Department. You are also responsible for applying to FMCSA for a renewal of your variance (waiver). Note: the Department will update variance information received from FMCSA or MoDOT if a current medical certification is on file, however you must submit the required self-certification and updated medical certificate to your local license office to complete the record updates.

The Department will notify you that you are no longer medically certified to operate a CMV. If the updated medical certificate and variance information, when applicable, is not updated within sixty days of expiration of the prior certificate or waiver, the Department will downgrade your license to remove all CDL privileges.

No. You must be examined by a medical professional listed on the National Registry of Certified Medical Examiners. Only medical examiners that have completed the required training and testing for Federal Motor Carrier Safety Administration (FMCSA) physical qualification standards will be added to the registry. The registry is maintained by FMCSA, and inquiries regarding participation in the registry must be submitted through that agency.

If the medical examiner's certificate has expired, you must obtain a new one and provide it to the Department. If the variance (waiver) has expired, you must renew it with FMCSA and it must be provided to the Department. Retesting for the CDL may not be required unless you voluntarily downgrade your license by applying for non-commercial license or let your CDL license remain expired for more than six months.

Commercial drivers have the following options for submitting a medical certificate update request:

  1. Apply in person at any Missouri contract license office. Must present current commercial driver license or noncommercial driver license and commercial learners permit and the new medical examiner certificate along with any supporting Skills Performance Evaluation (SPE) form or waiver form if applicable.
  2. Submit the following required documents via email or fax to a participating Missouri contract license:
    • Form 5463 Commercial Driver License Medical Certification – Completed in full, signed and dated by the driver. Electronic signatures are not acceptable.
    • Copy of the front and back of the current valid and unexpired Missouri commercial driver license or Missouri noncommercial driver license and commercial learner’s permit.
    • Valid, unexpired, completed in full Medical Examiner Certificate form issued within previous 10 days.
    • If applicable, the valid supporting Skills Performance Evaluation (SPE) or waiver form to confirm variance indicated on certificate.


    • Notes:
      • The following individuals are not eligible to submit their medical examiner certificate electronically and must submit documents in person at any Missouri contract license office:
        • Drivers who are no longer domiciled in Missouri who are required to transfer commercial privileges to a new state of domicile.
        • Drivers whose most current medical examiner certificate will require the addition or removal of a V-Variance restriction when an SPE or waiver has been issued to support the medical certificate, or drivers who, based on medical certificate and supporting documents must add or remove a K-Intrastate only restriction.
      • Not all Missouri contact offices are eligible to process medical examiner certificate update transactions via an electronic submission option. To review the list of offices accepting electronic submission go to the Motor Vehicle and Driver License Office Locator page and access the License Offices Accepting Electronic Commercial Driver Medical Examiner Certificate Update Requests.