Commercial Driver Medical Examination| Rules and Regulations

The Federal Vision Exemption Program-New Proposed Changes and Distinction from 49 CFR 391.64

Federal Vision Exemption Program:  The current Vision Exemption Program was established in 1998.  It was preceded by the Vision Waiver Program of 1992.  The criteria used to determine commercial driver eligibility, as well as the condition and reporting standard that must be met by drivers approved for participation, was established in the Waiver Program, and later implemented into the 1998 Exemption Program.  Go to Federal Vision Exemption Program for information on what the requirements are for a driver to be considered for an exemption. (Separate applications exist for Florida and Indiana due to different accident and citation reporting requirements in those states.  Applicant from those States have to submit a full driving record).

Vision exemptions are considered on a case by case basis.  There are specific standards that must be met with the better eye, as well as optometrist/ opthalmology evaluation, to include formal perimetry readings for each eye.  There are conditions that must be met for the exempted driver to continue to hold the exemption.  They include stable or no worsening of their visual deficiency and yearly opthalmology/optometry evaluations.

Recently, on December 2013, after a study showing no higher motor vehicle accident rate for drivers under the Vision Exemption Program compared to non-impaired drivers, the FMCSA proposed changes to the 3 year driving experience criteria for safe driving to either a 1 year requirement or to eliminate it altogether.  Other proposed changes include requiring that the driver be evaluated by a medical examiner who issues a Medical Examiner’s Certificate that states the driver is qualified to drive if accompanied by a Federal Vision Exemption.  Currently, since monocular vision is disqualifying, medical examiners usually terminate the evaluation process.  If the driver is found qualified to drive except for the visual impairment, the medical examiner should now check off the box to indicate the Certificate needs to be accompanied by a vision exemption or waiver.  The driver can then submit the Medical Examiner’s Certificate and all the required documentation to the FMCSA  for consideration in the Federal Vision Exemption Program.  These changes would make the Federal Vision Exemption Program application process more consistent with the Diabetes Exemption Program process.

The exemption is good for 2 years and renewable.  A driver who has received an exemption from the Federal Vision Exemption Program will carry such exemption at all times along with his Medical Examiner’s Certificate to present to State, Federal, and Local authorities when requested.  The exemption should also be presented to the medical examiner when they go for their physical at the annual re-certification process.   If the driver is found qualified otherwise, the medical examiner will check off the accompanied by a vision exemption checkbox, fill in “vision” in the space provided, and issue the Medical Examiner’s Certificate for 1 year.

49 CFR 391.64:  This is sometimes a source of confusion to some and it might be a good place and time to address it here.  Recently a certain manager from a certain trucking company I was evaluating was insistent that all his driver’s Medical Examiner’s Certificate should have that box checked off.  The check box marked qualified by operation of 49 CFR 391.64 represents a “grandfathered ” status that only applies to the 2,656 drivers with monocular vision that participated in an FMCSA study between 1992-1996 prior to the implementation of the Vision Exemption Program.  Reportedly, very few of these drivers remain, so do not confuse that box with the checkbox for the Federal Vision Exemption Program.  If you do meet such a “grandfathered” driver, he must present the letter verifying his participation in the vision study program and a copy of the eye specialist report.  Such driver if physically qualified otherwise, would similarly get a 1 year Medical Examiner’s Certificate.  Please see 391.64 Diabetes and Vison Grandfathering program.



At the top left of the Medical Examiner’s Certificate under the driver’s name, usually the third selection box down that says accompanied by a______________ waiver/exemption would be where to input “Vision” to indicate exemption is by the Federal Vision Program (this box would also be used to fill in whatever other exemptions the driver may have such as for the “Federal diabetes”.   The last box on the opposite side to the right that says qualified by operation of of 49 CFR 391.64 is reserved for the few drivers remaining from the original 2,656 drivers involved in the 1992 – 1996 FMCSA study.  Please see 391.64 Grandfathering For Certain Drivers Participating In Vision and Diabetes Waiver Study Programs.