DOT Exam report form

Medical Examination Report for Commercial Driver Fitness Determination (MER)FORM, MCSA-5875, Long Form):
Download here

Federal Diabetes Program

The Federal Diabetes and Vision Driver Exemption Programs have specific requirements for each application. Medical exams, employment history, driving experience and motor vehicle records must be submitted with the application. The Agency will make a final decision within 180 days of receipt of the complete application.

Applying for an Exemption
An individual may apply for an exemption from the diabetes and vision standard, section 391.41(b)(3) and 391.41(b)(10) of the regulation, by utilizing these programs. If you do not currently meet the diabetes and/or vision standard and are unable to obtain a medical card, you may be an eligible candidate.
Please note that all exemption programs are for drivers who intend to operate commercial motor vehicles (CMVs) in interstate commerce. FMCSA does not have statutory authority to grant waivers/exemptions to drivers from states' intrastate requirements. Therefore, the FMCSA waivers/exemptions do not permit regulatory relief for drivers who plan to limit their operations to intrastate commerce.

Insulin Diabetic

Vision Package

Interstate Commerce

Interstate Commerce is trade, traffic, or transportation involving the crossing of a State boundary. Either the vehicle, its passengers, or cargo must cross a State boundary, or there must be the intent to cross a State boundary to be considered an interstate carrier. Intrastate commerce is trade, traffic, or transportation within a single State.

Interstate commerce is determined by the essential character of the movement, manifested by the shipper's fixed and persistent intent at the time of shipment, and is ascertained from all of the facts and circumstances surrounding the transportation. When the intent of the transportation being performed is interstate in nature, even when the route is within the boundaries of a single state, the driver and the CMV are subject to Federal Motor Carrier Safety Regulations.

Please note that the exemption programs are for drivers of CMVs that intend to operate in interstate commerce in the United States. The Federal Motor Carrier Safety Regulations define the United States as the 50 states and the District of Columbia.

Federal Motor Carrier Safety Administration
Driver Medical Exemptions
1200 New Jersey Avenue SE
Washington, DC 20590
United States

Skill Performance Evaluation (SPE) Certificate

The Skill Performance Evaluation program is for CMV drivers who drive in interstate commerce. The SPE certification allows drivers with missing or impaired limbs to drive CMVs across state lines if they have been fitted with (and are wearing) the right prosthetic device, and the driver can demonstrate the ability to drive the truck safely by completing on-and off-road activities. If the driver passes the driving test, he or she will receive a SPE certificate. Over the years, FMCSA has granted more than 3,000 SPE certificates to truck drivers who have shown that they can drive safely on the nation's highways.

SPE Certificates

Drivers with physical impairments which affect their ability to safely operate CMVs according to their medical examiners, or with missing limbs (e.g., a hand or finger, an arm, foot or leg), are required to obtain SPE certificates.

Eastern Service Center
4749 Akron Mall Drive, Suite 300A
Matteson, IL 60443
Phone: (708) 283-3577
FAX: (708) 283-3579


Private Pilots Medical



Dr. Scotadam J. Chernov graduated in 1995. He is fully licensed and registered with DOT Board of Certified Examiners. Dr. Chernov has had his office since 1996 with thousands of loyal and happy patients.

Member of National Registry of Certified Medical Examiners.

Get in Touch