Medical Card Tracking
DOT medical card tracking, before a card lapses
TenFour tracks every driver’s medical certification and warns you at 60, 30 and 7 days, enough lead time to book the exam instead of losing a week of loads. Software watches the date; a person checks that the new certificate is legible, current and filed where a reviewer expects it.
What we do
Expiration tracking
Every medical certificate's date is monitored, with escalating alerts as renewal approaches.
Records filed correctly
Current certificates stored in each driver's qualification file, where reviewers expect them.
Renewal reminders that stick
Texts to the driver, copies to the owner, until the new card is in the file.
Examiner guidance
We point you to the official National Registry to find a certified medical examiner near you.
Who it's for: Every CDL operation. This is the single most common quiet lapse for busy drivers.
How long a certificate is actually good for
Twenty-four months is the ceiling, not the default. Section 391.45(b) requires re-examination if a driver has not been certified during the preceding 24 months, and three situations carry a regulatory 12-month cycle instead: exempt intracity zone drivers under 391.62, insulin-treated diabetes under 391.46, and drivers operating under the vision exemption in 391.44.
The blood-pressure myth worth correcting
You will read that hypertension means a one-year card, stated as though it were law. It is not. Those durations live in Appendix A to Part 391 (the Medical Advisory Criteria), which says in its own text that the criteria are strictly advisory and do not have the force and effect of law. Examiners follow them in practice, which is why the shorter card appears. Read the date on your actual certificate rather than assuming a rule of thumb.
What National Registry II changed, and what it did not
Since June 23, 2025, medical certification for CDL and CLP holders moves electronically from the examiner to your state licensing agency and onto your CDLIS driving record. Under 49 CFR 391.43(g), the examiner no longer issues those drivers a paper card, and a “not qualified” determination invalidates previously issued certificates.
Non-CDL interstate drivers were not swept into this. They are still issued the paper Form MCSA-5876 and must still carry it. Conflating the two groups is the most common error published on this subject, and it leads carriers to throw away paper their non-CDL drivers are still required to have.
The October 11, 2026 date
FMCSA’s temporary exemption (permitting reliance on a paper certificate for up to 60 days after issuance while states finish implementing NRII) has a fixed end. The exemption’s last day is October 11, 2026, at 11:59 p.m. From October 12, 2026, for CDL and CLP drivers the state’s CDLIS record is what counts, and a paper copy no longer substitutes for it. The one exception is Alaska: FMCSA provisionally renewed the exemption for drivers with an Alaska-issued CDL or CLP, and their employers, through October 12, 2027. FMCSA extended it four times and said not to expect further nationwide waivers or exemptions.
Why this is the violation that catches good operators
An expired medical certificate announces nothing. There is no warning light and no letter. The date simply passes, and the first indication is usually a roadside inspection or a CDL downgrade notice from the state.
For a one-truck operation the failure mode is structural rather than careless: the person responsible for watching the date is the same person driving, and the date is roughly two years from the last time they thought about it.
Certification periods set by regulation
| Situation | Maximum period | Regulation |
|---|---|---|
| Standard certification | 24 months | § 391.45(b) |
| Exempt intracity zone driver | 12 months | § 391.45(c) / § 391.62 |
| Insulin-treated diabetes | 12 months | § 391.45(e) / § 391.46 |
| Operating under the vision exemption | 12 months | § 391.45(f) / § 391.44 |
| Shorter periods on advisory criteria | Examiner’s discretion | Appendix A to Part 391 (advisory) |
What this costs
TenFour membership, first truck
$99/month
Billed annually ($1,188/yr) · $119 month to month · +$59/month per additional truck
Billed annually; each additional truck +$59/month, every driver included. Every driver's certificate is tracked on its own date. You pay the DOT physical directly to your examiner.
Every price for 1 to 6 trucks is published, no quote form, no sales call. See full pricing. Running 7 or more? Contact us for custom pricing.
What happens if you skip it
Medical certification sits in an unusual place: it is simultaneously a driver qualification requirement, a licensing requirement and an automatic-failure item in a new entrant audit.
- Using a medically unqualified driver is among the 16 violations in 49 CFR 385.321(b) that fail a new entrant safety audit on a single occurrence.
- At roadside, an expired certificate typically means the driver is placed out of service, with the load aboard.
- For CDL holders, a lapsed certification on the CDLIS record leads the state toward downgrading the commercial privilege.
- The violation lands on your CSA record, where it stays in the 24-month scoring window and is visible to brokers vetting you.
Sources
- 49 CFR 391.45: Persons who must be medically examined and certified
- 49 CFR 391.43: Medical examination; certificate of physical examination
- Appendix A to Part 391: Medical Advisory Criteria (advisory only)
- FMCSA: National Registry II learning center
- Federal Register: Qualification of Drivers; CVSA Application for Exemption, provisional renewal for Alaska (October 8, 2026)
Last reviewed October 11, 2026. TenFour is a compliance service, not a law firm, and is not affiliated with FMCSA or any government agency. This page explains federal requirements in plain English, verify specifics for your operation against the sources above.
Common questions
How long is a DOT medical card good for?
A maximum of 24 months under 49 CFR 391.45(b). Twelve months is the regulatory maximum for exempt intracity zone drivers, insulin-treated diabetes under 391.46, and drivers using the vision exemption under 391.44. Examiners also certify for shorter periods on medical grounds, read the date on the certificate rather than assuming two years.
Does high blood pressure automatically mean a one-year card?
Not as a matter of law. Those durations come from Appendix A to Part 391, the Medical Advisory Criteria, which states in its own text that it is strictly advisory and does not have the force and effect of law. Examiners commonly follow it, so the shorter card is real in practice, but it is guidance, not a rule.
Do I still need to carry a paper medical card?
If you hold a CDL or CLP in a state that has implemented National Registry II, no, the certification lives on your CDLIS record. If you are a non-CDL interstate CMV driver, yes: you are still issued the paper Form MCSA-5876 and must still carry it. That distinction does not change with the exemption’s end on October 11, 2026.
What is the October 11, 2026 date?
October 11, 2026, at 11:59 p.m., is the last day of FMCSA’s temporary exemption permitting reliance on a paper medical certificate for up to 60 days after issuance. It was extended four times. From October 12, 2026, for CDL and CLP drivers the state’s CDLIS record is what counts, and a paper copy no longer substitutes for it. The one exception is Alaska: FMCSA provisionally renewed the exemption for drivers with an Alaska-issued CDL or CLP, and their employers, through October 12, 2027.
What happens if my medical card expires?
You are not medically qualified to operate, which means you should not be driving. At roadside it typically means an out-of-service order; for a CDL holder it moves the state toward downgrading the license; and in an audit it is a single-occurrence automatic failure. The fix is a new examination, not a workaround.
How do I check whether my certification reached my state record?
Do not assume the examiner’s submission went through. For CDL holders, verify the certification appears on your CDLIS driving record through your state licensing agency. A transmission that silently failed looks exactly like compliance right up until a downgrade notice arrives.
Do you notify my state licensing agency for me?
No, where a self-certification update applies, the submission is yours to make. We tell you what is due, what to submit and where, and we chase you until it is done. We will not represent ourselves as you to a state agency.
What does tracking this cost?
Medical certificate tracking is part of the membership, $99/month for the first truck on the annual plan, $59/month for each additional truck, every driver included, with each driver’s expiration tracked on its own date. The DOT physical itself is paid to the examiner: we do not mark that up or resell it.
Handled, for one published price per truck.
Part of the TenFour membership: $99/month for the first truck on the annual plan, +$59/month for each additional truck, every driver included. Built for carriers with 1 to 6 trucks; fleets of 7 or more are priced by conversation.
$99/month is the annual plan for one truck, billed $1,188 up front, about two months free against $119 month to month. Each additional truck is $59/month ($69 month to month), every driver included, up to six trucks. Cancel any month; remaining full months refunded.