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Every CDL or CLP holder must tell the State driver licensing agency (SDLA) which type of commercial motor vehicle (CMV) operation they do or expect to do. Drivers who self-certify as non-excepted interstate must have a current medical certification on their state driving record. A driver who lets it lapse becomes "not certified" and the state will downgrade the CDL.

How medical certification reaches the state

• Since June 23, 2025: after the DOT physical, the medical examiner reports the result to FMCSA through the National Registry, and FMCSA sends the medical certification information to the state electronically. CDL and CLP holders no longer need to take a copy of the certificate to the state or carry it while driving (49 CFR 391.41(a)(2), 49 CFR 391.43(g)).
• Before June 23, 2025: drivers had to give the state a copy of each new Medical Examiner's Certificate.
• Drivers who need a medical variance, such as an FMCSA exemption or skill performance evaluation certificate, must still carry the variance document when on duty.

Choosing a type of operation

There are four categories: non-excepted interstate, excepted interstate, non-excepted intrastate, and excepted intrastate. Most CDL holders who drive across state lines are non-excepted interstate. See Determine the type of CMV operation for the step-by-step decision.

What employers should do

• Check each CDL driver's medical certification status on the state driving record (motor vehicle record) when hiring and when the certification expires.
• Do not let a driver operate a CMV without a current medical certification.
• Track expiration dates in Med-Stop; see license and medical certificate expirations.