Medical Waivers

There are two types of medical waivers to operate a commercial motor vehicle: interstate exemptions and intrastate waivers. The federal government sets medical standards for driving commercially but allows State jurisdictions to grant intrastate waivers for commerce within those jurisdictions.

 

Interstate Exemptions

The federal government has a vision and diabetes medical exemption program for interstate commercial driving.

 

Commercial drivers who do not meet the federal vision and/or diabetes medical standards may be able to obtain an exemption from those standards for interstate commerce from the federal government. (See http://www.fmcsa.dot.gov/rules-regulations/topics/medical/exemptions.htm)

 

A commercial driver who has obtained a medical interstate exemption should continue to have in his/her possession the original or copy of that medical exemption documentation at all times when operating a commercial vehicle.

 

Massachusetts Intrastate Waivers

The Registry of Motor Vehicles will waive compliance with the federal medical requirements pertaining to commercial motor vehicles for the purposes of driving intrastate (within the borders of Massachusetts only) and will issue intrastate medical waivers for the following conditions only, provided the Registrar determines that the condition, in an individual case, will not interfere with the safe operation of a commercial motor vehicle.  A customer who is issued an intrastate medical waiver must have a “W” (Commercial Motor Vehicle Intra-state Only with Medical Waiver) restriction put on his/her license.

 

To apply for an intrastate waiver, a customer should complete an Application for Intrastate Medical Waivers to Operate Class A, B, or C Commercial Motor Vehicles. In addition to the application, the following documentation must be submitted, certified by a customer's medical professional, to the Medical Affairs:

1.  A copy of the results of a recent Department of Transportation  medical examination performed pursuant to 49 CFR 391.43, upon which the examining physician has indicated that the customer is only qualified to operate a commercial motor vehicle with an intrastate medical waiver

2.  A letter from a customer's employer acknowledging that he/she has a medical waiver and that he/she drives

3.  Commercially as a requirement of employment within the borders of Massachusetts only.

 

Intrastate Waiver for a Vision Impairment

The Registry of Motor Vehicles will only issue an intrastate medical waiver for a vision impairment if:

1.  The customer has a combined horizontal peripheral field of vision of not less than 120 degrees

2.  The customer also has a distant visual acuity of at least 20/40 (Snellen) in either eye, with or without corrective lenses

3.  The customer has the ability to distinguish the colors red, green, and amber

 

Intrastate Waiver for a Diabetic Condition

The Registry of Motor Vehicles will only issue an intrastate medical waiver for a diabetic condition if the customer submits a written statement from his/her health care provider which:

1.  Provides specific reasons why the customer is not at risk or is no longer at risk of suffering hypoglycemic spells or episodes

2.  Recommends a specific date for the Registry of Motor Vehicles to re-evaluate the customer's ability to operate a commercial motor vehicle safely

 

Intrastate Waiver for a Cardiovascular Condition

The Registry of Motor Vehicles will only issue an intrastate medical waiver for a cardiovascular condition if the customer:

1.  Is not classified according to the American Heart Association functional classification system as an American Heart Association functional Class III or IV heart patient

OR

2.  Has had an Automated Implantable Cardiac Defibrillator placed for a "sudden death event" and will not be eligible for an active intrastate Commercial Driver's License waiver until a six month period during which there is documentation of no episodes of appropriate device firing

 

If a customer with an Automated Implantable Cardiac Defibrillator is determined to have an Automated Implantable Cardiac Defibrillator that appropriately "fires", he/she will be considered the same as a customer who has had a "sudden death event" and be subject to a six month period during which there is documentation of no episodes of appropriate device firing. 

 

A customer for whom the Automated Implantable Cardiac Defibrillator is placed purely for prophylactic reason is eligible for an intrastate Commercial Driver's License waiver and will not be subject to the six month, no-trigger, "waiting" period. 

 

A customer who was formerly deemed ineligible to receive a waiver due to his/her Automated Implantable Cardiac Defibrillator implant or classification as a Class III or IV heart patient, and who is now eligible, must submit a written statement from his/her health care provider to the Registry of Motor Vehicles which indicates that:

1.  An Automated Implantable Cardiac Defibrillator implanted for a “sudden death event” has not fired in a six month period or that the Automated Implantable Cardiac Defibrillator was implanted for prophylactic reasons and has not fired in a six month period

2.  He/she is classified as either American Heart Association functional Class I, Class II, or does not have heart disease

3.  To a reasonable degree of medical certainty, he/she is medically qualified to operate a commercial vehicle

 

Intrastate Waiver for a Loss or Impairment of Limb

The Registry of Motor Vehicles will only issue an intrastate medical waiver for a loss or impairment of limb if such loss is not likely to interfere with the safe operation of a commercial motor vehicle.

 

Intrastate Waiver for a Deaf and Hard of Hearing

The Registry of Motor Vehicles will only issue an intrastate medical waiver for a deaf and hard of hearing if the certifying health care provider states the condition will not interfere with the safe operation of a commercial vehicle.

Note: For vehicles with air brakes, a customer must be able to hear the air compressor cutting out and detect an actual air leak in the braking system- a safety precaution in case the gauges have malfunctioned.  Therefore, a profoundly deaf person would be restricted to a commercial vehicle without airbrakes.

 

Medical Waivers Issued Prior to June 16, 1998

A customer who is unable to meet the medical qualifications to obtain a medical waiver as set forth in the 2010 Commercial Driver's License intrastate medical waiver guidelines, but who held a valid intrastate medical waiver prior to June 16, 1998, will be eligible to retain or renew his/her intrastate medical waiver, provided:

1.  He/she satisfies the Commercial Driver's License intrastate medical waiver qualification standards in effect immediately prior to June 16, 1998 (See below)

2.  He/she provides a letter from his/her health care provider certifying that, to a reasonable degree of medical certainty, the customer is medically qualified to safely operate a commercial motor vehicle

3.  The Registry has no other cause to believe, based upon the customer’s driving history or otherwise, that the customer cannot safely operate such commercial motor vehicle

Commercial Driver's License intrastate medical waiver qualifications in effect immediately prior to June 16, 1998  required that customers with any one of the following conditions may be granted an intrastate medical waiver provided the condition will not interfere with the safe operation of a commercial motor vehicle:

      Visual acuity of 20/40 in the better eye with a total field of 120 degrees

      Insulin dependent diabetes that is under control

      Minor afflictions such as loss of finger

      Any other condition that the Registry determines in a customer case will not interfere with the safe operation of a commercial motor vehicle