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                Medical Qualification Requirements
    

    
    
          The following frequently asked questions (FAQs) were developed to highlight the medical qualification requirements for foreign drivers operating in cross-border transportation in the United States.  The FMCSA has published a significant number of medical requirement FAQs for all motor carriers and drivers operating a commercial motor vehicle in the United States, therefore please refer to the FMCSA website for additional FAQs.



**LIMB IMPAIRMENTS, WAIVERS AND SKILLS PERFORMANCE EVALUATIONS**



**Q1: Will****Canadian drivers with limb impairments be required to obtain a waiver from FMCSA to drive in the United States?**



**A1:**  No, the National Safety Code (NSC) Medical Standards for Drivers and the FMCSR have been deemed equivalent with respect to limb impairments contained in 49 CFR 391.49. To obtain a Canadian provincial/territorial license, such drivers must be fitted with a prosthetic device as appropriate, and must have demonstrated their ability to operate the vehicle.



**Q2:  Is a****Canadian driver with a limb impairment required to wear a prosthesis?**



**A2:**  Yes, if the driver is required to wear the prosthesis in Canada while driving, it is also required in the United States.  If there is a question, enforcement officials can contact the appropriate Canadian provincial/territorial licensing agency to determine if a prosthetic device is required.



**Q3:  How will enforcement officials know that a limb-impaired Canadian driver has demonstrated their ability to driver a commercial motor vehicle in accordance with the National Safety Code (NSC) standards?**



**A3:**  The fact that the driver possesses a valid Canadian commercial driver’s license, with the proper class for the vehicle configuration being operated, is proof that the driver demonstrated his/her ability to drive a commercial motor vehicle.



**Q4:  Can a****Canadian driver apply for a Skill Performance Evaluation (SPE) certificate to drive in the United States?**



**A4:**  The reciprocity agreement between the United States and Canada does not permit drivers who do not meet the medical fitness requirements of Canada to drive in the United States. Both countries agree that Canadian drivers who do not meet the medical provisions in the National Safety Code of Canada but have a waiver by one of the Canadian Provinces or territories would not be qualified to operate a CMV in the United States. The National Safety Code states that a driver must wear a prosthesis and demonstrate his/her ability in an on-road test. Some of the Canadian provinces have not adopted the National Safety Code.

If a driver has no prosthesis when entering the United States., the driver is not qualified to operate here.

It is not necessary for a Canadian driver to apply for a Skill Performance Evaluation certificate to drive in the United States. A valid commercial driver’s license issued by a Canadian Province or Territory is proof of medical fitness to drive. If a Canadian driver is required to wear prosthesis, the driver must wear the prosthesis while operating a commercial vehicle in the U.S. If a driver has no prosthesis when entering the U.S., the driver is not qualified to operate here.



**Q5:  Will a U.S. driver currently holding a SPE certificate issued by the FMCSA for a limb impairment be able to drive in Canada?**



**A5:**  The FMCSA changed the term “waiver” previously used in 49 CFR 391.49 (and other sections) to “Skills Performance Evaluation (SPE) certificate”.  A U.S. driver with an SPE certificate, which is not a waiver but an alternative physical qualification, will be allowed to operate in Canada.  The driver must have met the requirements of 49 CFR 391.49 to be issued an SPE certificate and must carry the appropriate documentation whenever on duty.



**MEDICAL CERTIFICATES**



**Q1:  Do all Canadian****drivers need to carry the medical certification when driving a CMV in the United States?**



**A1:**  No, only Canadian Class 5, Alberta Class 3, New Brunswick Class 3 and Ontario Classes D and G Canadian CMV drivers are required to carry proof of medical qualifications when operating in the United States.



**Q2:  I****operate a CMV in the United States but reside outside of the United States. Can I use my foreign medical certificate?**



**A2:**  Yes, if you are a resident of Mexico or Canada. Drivers certified in Canada are certified to drive in the United States, providing they meet U.S. requirements. For Mexican drivers, the medical examination is part of the Licencia Federal. It is not necessary for Mexican drivers to carry a separate medical certifying document.

A CMV operator from Canada or Mexico who has been issued a valid commercial driver’s license by a Canadian Province or the Mexican Licencia Federal is no longer required to have a medical certificate. The driver’s medical exam is part of the driver’s license process and is proof of medical fitness to drive in the United States. However, Canadian and Mexican drivers  who have epilepsy or who are hearing-and-vision impaired are not qualified to drive CMVs in the United States. Furthermore, Canadian drivers who do not meet the medical fitness provisions of the Canadian National Safety Code for Motor Carriers but who have been issued a waiver by one of the Canadian Provinces or Territories are not qualified to drive CMVs in the United States. Similarly, Mexican drivers who do not meet the medical fitness provision of The Licencia Federal de Conductor but who have been issued a waiver by The Licencia Federal de Conductor are not qualified to drive CMVs in the United States.



**USE OF CONTROLLED SUBSTANCES AND ALCOHOL**



**Q1:  Does the legalization of the use and possession of marijuana by a State, or other country that has drivers who operate in the United States, change the treatment of marijuana use under federal regulations applicable to drivers operating a commercial motor vehicle (CMV) (as defined in 49 CFR § 390.5)?**



**A1:**  No. Marijuana, including a mixture or preparation containing marijuana, continues to be classified as a Schedule I controlled substance by the Drug Enforcement Administration (DEA) in 21 CFR § 1308.11. Under the Federal Motor Carrier Safety Regulations (FMCSRs), a person is not physically qualified to drive a CMV if he or she uses any Schedule I controlled substance such as marijuana. (See 49 CFR §§ 391.11(b)(4) and 391.41(b)(12)). In addition to the physical qualification requirements, the FMCSRs prohibit a driver from being in possession of or under the influence of any Schedule I controlled substance, including marijuana, while on duty, and prohibit motor carriers from permitting a driver to be on duty if he or she possesses, is under the influence of, or uses a Schedule I controlled substance. (See 49 CFR §§ 392.2 and 392.4). Legalization of marijuana use by States and other jurisdictions also has not modified the application of U.S. Department of Transportation (DOT) drug testing regulations in 49 CFR parts 40 and 382. (See https://www.transportation.gov/odapc/medical-marijuana-notice and https://www.transportation.gov/sites/dot.gov/files/docs/odapc-notice-recreational-mj.pdf.)



**Q2:  Can****a driver meet the qualification standards under 49 CFR § 391.41(b)(12) if using medical marijuana recommended by a licensed medical practitioner in the United States or another country?**



**A2:**  No. Marijuana, including a mixture or preparation containing marijuana, continues to be classified as a Schedule I controlled substance by the Drug Enforcement Administration (DEA) in 21 CFR § 1308.11. Under the Federal Motor Carrier Safety Regulations (FMCSRs), a person is not physically qualified to drive a CMV if he or she uses any Schedule I controlled substance such as marijuana. (See 49 CFR §§ 391.11(b)(4) and 391.41(b)(12)). Accordingly, a driver may not use marijuana even if is recommended by a licensed medical practitioner.



**Q3:  Are****Canadian and Mexican drivers conducting operations in the United States subject to the Drug and Alcohol Clearinghouse requirements?**



**A3:**  Yes, all Mexican or Canadian employers, employees or service agents currently required to comply with DOT and FMCSA drug and alcohol testing requirements must comply with the Clearinghouse final rule.



**INSULIN-TREATED DIABETES MELLITUS**



**Q1: Are U.S. or Canadian licensed CMV drivers permitted to operate cross-border in a CMV if they have been medically qualified with insulin-treated diabetes mellitus?**



**A1:** Yes.  On September 24, 2019, the medical reciprocity agreement between the U.S. and Canada was amended to remove the prohibition for cross-border operation for CMV drivers with insulin-treated diabetes mellitus, provided a U.S. driver has been physically qualified by a medical examiner based on the updated medical qualification standard.

FMCSA recommends U.S. CMV drivers with ITDM follow the updated procedures to be physically qualified by a medical examiner and then contact their licensing agencies to have the restriction (generally code “V”) removed from their physical license and driver’s record. https://www.fmcsa.dot.gov/international-programs/canada/removal-operating-prohibition-commercial-drivers-insulin-treated

FMCSA recommends Canadian CMV drivers with ITDM contact their licensing agencies to determine the requirements to have the restriction (generally code “W”) removed from their physical license and driver’s record.  https://www.fmcsa.dot.gov/international-programs/canada/removal-operating-prohibition-commercial-drivers-insulin-treated-0
      
    
          Last updated: Monday, February 10, 2020 U.S. DEPARTMENT OF TRANSPORTATION

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