Medical Examiners should conduct the driver medical examination and issue the appropriate Medical Examiner’s Certificate based on “Medical Qualification”.
Drivers that meet the federal medical requirements (with or without a federal exemption) are medically qualified to drive across state lines in interstate commerce. It does not matter if their job does not require them to drive across state lines, they should be issued an interstate certificate.
The only exception is when state law prohibits an otherwise-qualified driver from interstate driving (such as with age requirements).
The State Drivers Licensing Agency can request that a new intrastate certificate be provided. If this is the case, the ME can reissue the certificate but does not need to re-report it to FMCSA.
For drivers that do not meet the federal medical requirements, the Medical Examiner may issue a medical certificate indicating that it must be accompanied by a state variance.
Clarification on the Required Form of Identification Drivers Need to Obtain
a CDL/DOT Physical Exam
The driver must present the Medical Examiner or their staff with a photo ID such as a driver's license, passport, or state identification card.