How to Fill Out and Submit Form MCSA-5875: Medical Examination Report

The MCSA-5875, Medical Examination Report Form, is the federal document a certified medical examiner uses to record your DOT physical. You fill out Part 1 with your personal information and health history before the exam; the examiner completes Part 2 during the clinical evaluation and keeps the completed form as the medical record behind your Medical Examiner’s Certificate (MCSA-5876), which is the card you actually carry.¹ Interstate CMV drivers have to keep that certificate current to stay on the road, and a standard certificate is valid for up to 24 months — shorter if certain health conditions apply.²

Before Your Appointment

Download the current version of the MCSA-5875 from the FMCSA website and confirm the examiner you’re booking with is listed on the National Registry of Certified Medical Examiners.³ You can search the registry by zip code on the FMCSA site. An exam performed by anyone not on the registry is invalid, and no certificate will be issued.

Expect to pay somewhere between $60 and $200. The DOT doesn’t set a standard fee, so call ahead. Insurance rarely covers DOT physicals because they’re treated as occupational rather than diagnostic. Bring a government-issued photo ID and any glasses, hearing aids, or other corrective devices you use while driving.

If you use a CPAP for sleep apnea, bring a compliance report from your device. It needs to cover at least 90 days, be no more than 30 days old, show at least four hours of use per night on 70 percent of nights, and reflect a treated AHI below 10. If the numbers fall short, the examiner will likely send you back to your sleep specialist before issuing a certificate.

Filling Out Part 1

Part 1 is yours to complete. It asks for your name, address, date of birth, driver’s license number, and the type of driving you do (interstate or intrastate). Then comes a checklist of medical conditions and symptoms: heart disease, seizures, diabetes, sleep disorders, hearing loss, vision problems, mental health conditions, and more. For any “yes” answer, write in the details — when you were diagnosed, what treatment you received, and your current status.

List every prescription medication with dosage and frequency. Add over-the-counter supplements and herbal products too. When you sign and date the form, you’re legally certifying that everything you reported is accurate. The form itself warns that false or missing information can invalidate the exam and your certificate, and that intentionally fraudulent information violates 49 CFR 390.35 and can trigger civil or criminal penalties.⁴ The examiner reviews your answers with you during the appointment. Trying to hide a condition that shows up in the clinical exam creates a much worse problem than disclosing it upfront.

What the Examiner Does in Part 2

The clinical evaluation follows the physical qualification standards in 49 CFR 391.41.⁵ The examiner works through each body system and records findings directly on the MCSA-5875:

Vision: at least 20/40 acuity in each eye with or without correction, a field of vision of at least 70 degrees horizontally in each eye, and the ability to distinguish traffic-signal colors.
Hearing: perceive a forced whisper from at least five feet away, or pass an audiometric test showing no more than 40 decibels of average hearing loss in the better ear at 500, 1,000, and 2,000 Hz. Hearing aids are allowed for both tests.⁶
Urinalysis: a sample every exam, checked for specific gravity, protein, blood, and sugar. Abnormal readings don’t automatically disqualify you but trigger follow-up.
Cardiovascular: blood pressure, pulse, and signs of heart disease, arrhythmias, or vascular problems.
Respiratory: breath sounds and any condition that could cause loss of consciousness.
Neurological: reflexes, coordination, equilibrium, tremors. A history of seizures or epilepsy is disqualifying unless a federal exemption applies.
Musculoskeletal: range of motion, grip strength, and limb function.
Abdomen: palpation for enlarged organs, hernias, or masses.

Each system is marked “normal” or “abnormal,” and any abnormal finding needs a written explanation in the comments. If you use corrective lenses or a hearing aid, the examiner notes those restrictions on the form and they appear on your certificate, so keep those devices with you whenever you drive.

How Blood Pressure Affects Your Certificate Length

Blood pressure is the single most common reason DOT physicals produce a shortened certificate or a disqualification. The tiers work like this:

Below 140/90: eligible for the full 24-month certificate.
140–159 / 90–99 (Stage 1): up to one year, at the examiner’s discretion.
160–179 / 100–109 (Stage 2): a one-time certificate of up to three months, with a required recheck.
180+ / 110+ (Stage 3): automatic disqualification until treatment brings readings down.

If your pressure tends to run high, take your medication as prescribed in the days before the exam and skip caffeine the morning of. A single elevated office reading can cost you a full-length certificate even when your pressure is normally controlled.

Conditions and Medications That Can Disqualify You

Some conditions bar certification outright unless a federal waiver applies: a current diagnosis of epilepsy, insulin-treated diabetes without an exemption, a cardiovascular condition known to cause fainting or sudden collapse, and a diagnosis of alcoholism.⁵

Medications matter too. Any Schedule I controlled substance is an automatic bar. Anti-seizure medications used to prevent seizures are disqualifying regardless of how well controlled the condition is. Amphetamines, narcotics, and other habit-forming drugs are prohibited unless a licensed practitioner has prescribed them, and the examiner still has discretion to deny certification if the drug could affect safe driving.⁷ For non-Schedule I controlled substances, bring a letter from the prescribing doctor confirming the medication won’t impair your driving. The examiner isn’t required to accept it, but showing up without one almost guarantees a problem.

Waiver and Exemption Programs

Drivers who can’t meet a standard requirement aren’t necessarily out of options:

Insulin-Treated Diabetes Mellitus: your treating clinician completes an MCSA-5870 confirming a stable insulin regimen and controlled blood sugar. You must give it to the medical examiner within 45 days of the clinician completing it. Certification is 12 months instead of 24.²
Alternative vision standard: if you don’t meet the standard in your worse eye, your better eye must have distant acuity better than 20/40 and a field of vision of at least 70 degrees horizontally, your deficiency must be stable, and you must have had time to adapt. Certification is 12 months.
Skill Performance Evaluation: drivers with a missing or impaired limb apply through the FMCSA Service Center for their region (email is the preferred submission method), fit the appropriate prosthetic, and demonstrate safe operation through on- and off-road testing.⁸

Each program has its own paperwork and timeline. Start early. Waiting until your current certificate is about to expire creates a gap that puts you off the road.

After the Exam

If you’re physically qualified, the examiner completes and hands you an MCSA-5876 Medical Examiner’s Certificate.⁹ The MCSA-5875 itself stays with the examiner as the underlying medical record. The MCSA-5876 is what you carry, show during roadside inspections, and give a copy of to your employer for the driver qualification file.

The examiner is required to upload every exam result — pass or fail — to the National Registry by midnight local time of the next calendar day after the exam.³ That upload is how the FMCSA and state licensing agencies see your status in near-real time. If the examiner misses the deadline or enters something incorrectly, it can show up as a gap in your record, so check the system within a few days to confirm your status posted correctly.

Filing With Your State Licensing Agency

Getting the certificate from the examiner isn’t the last step. You also have to self-certify your operating category with your State Driver Licensing Agency (SDLA) and provide a copy of your MCSA-5876. Most CDL holders fall under non-excepted interstate, meaning they drive across state lines and need a federal medical certificate; three other categories cover excepted interstate driving and intrastate-only operations.¹⁰

If your SDLA doesn’t receive an updated medical certificate before the old one expires, your CDL can be downgraded, and you lose commercial driving privileges even though you may still hold a regular license. Each state runs its own process — some accept online submissions, others want you in person — so confirm the method and any state deadlines with your DMV.

If You’re Denied: Second Opinions

You have the right to seek a second opinion from a different certified medical examiner. There are rules. You must tell the second examiner you’re seeking a second opinion and provide the same medical documentation the first examiner reviewed: test results, specialist reports, treatment records. Showing up at another clinic without disclosing the first exam looks like doctor shopping and creates bigger problems than the original disqualification.

When two conflicting reports reach the National Registry, the FMCSA reviews both. The agency looks at continuity between the reports and the supporting evidence. If one report certifies you and the other doesn’t, the agency generally uses the certifying report, but only when the underlying medical evidence supports it. A second opinion isn’t a guaranteed override; it’s a legitimate route when you believe the first examiner made an error or worked from incomplete information.

1
Federal Motor Carrier Safety Administration. Medical Examination Report (MER) Form, MCSA-5875
2
eCFR. 49 CFR 391.45 – Persons Who Must Be Medically Examined and Certified
3
Federal Motor Carrier Safety Administration. National Registry of Certified Medical Examiners
4
Federal Motor Carrier Safety Administration. MCSA-5875 Medical Examination Report Form
5
eCFR. 49 CFR 391.41 – Physical Qualifications for Drivers
6
Federal Motor Carrier Safety Administration. What Are the Hearing Requirements for CMV Drivers?
7
Federal Motor Carrier Safety Administration. What Medications Disqualify a CMV Driver?
8
Federal Motor Carrier Safety Administration. Skill Performance Evaluation Certificate Program
9
Federal Motor Carrier Safety Administration. Medical Examiner’s Certificate (MEC), Form MCSA-5876
10
Federal Motor Carrier Safety Administration. How Do I Determine Which of the 4 Categories of Commercial Motor Vehicle (CMV) Operation I Should Self-Certify To?