Everything the FMCSA requires, what the examiner checks, and how to avoid the mistakes that cost drivers a two-year card.
Any driver operating a commercial motor vehicle in interstate commerce that weighs over 10,000 lbs, carries hazardous materials, or transports passengers (8+ for compensation, 15+ otherwise). That includes every CDL holder — and your medical card must stay current or your CDL is downgraded. In Laredo that means drayage drivers running the bridges, long-haul operators on I-35, oilfield and aggregate crews, and every carrier fleet on Mines Road.
| Test | Standard to pass |
|---|---|
| Vision | 20/40 or better in each eye and both together (glasses/contacts fine), 70° peripheral vision in each eye |
| Hearing | Hear a forced whisper from 5 feet (hearing aid allowed), or pass audiometry |
| Blood pressure | Under 140/90 for a 2-year card; see the chart below |
| Urinalysis | Screens for protein, blood, and sugar — this is a kidney/diabetes check, not a drug test |
| Physical exam | Heart, lungs, spine, neuro, hernia check, range of motion |
| Reading | Result |
|---|---|
| Below 140/90 | 2-year certificate |
| 140–159 / 90–99 (Stage 1) | 1-year certificate |
| 160–179 / 100–109 (Stage 2) | One-time 3-month certificate to get it controlled |
| 180/110 or higher (Stage 3) | Disqualified until controlled; 6-month card once it is |
Driver tip: skip the energy drinks and cigarettes the morning of your exam, get a night of real sleep, and hydrate. Borderline readings are the #1 reason drivers lose a year off their card.
Very few things are permanent disqualifiers: unmanaged insulin use without the ITDM process, epilepsy without the exemption, current alcohol dependence, and use of Schedule I drugs (including marijuana — legal state or not, it's federally disqualifying for CDL drivers). Almost everything else is a documentation problem, not a career-ender.