The results of the four required tests: vision, hearing, blood pressure/pulse, and urinalysis are recorded on the second page of the Medical Examination Report Form. Abnormal test results may disqualify a driver or indicate that additional evaluation and/or testing are needed.

Drug and alcohol testing are not required for the driver medical examination unless findings indicate they are needed to determine medical fitness for duty.

The medical examiner or a licensed ophthalmologist or optometrist can examine and certify vision test results.

Visual acuity is measured in each eye individually and both eyes together—

• Distant visual acuity of at least 20/40 (Snellen) in each eye, with or without corrective lenses.
• Distant binocular visual acuity of at least 20/40 (Snellen) in both eyes, with or without corrective lenses.
• Field of vision of at least 70° in the horizontal meridian in each eye.

Color vision must be sufficient to recognize and distinguish traffic signals and devices showing the standard red, amber, and green colors.

When corrective lenses are used to meet vision qualification requirements, the corrective lenses must be used while driving.

Follow the links for more information regarding vision tests.

• Snellen Test.
• Protocol for screening the visual field.

A driver with monocular vision, who is otherwise medically qualified, may apply for a Federal vision exemption. The driver with a Federal vision exemption may be certified for up to 1 year. Follow the Federal Vision Exemption Program link for more information.

The medical examiner may certify the driver who meets vision qualification requirements, with or without the use of corrective lenses, for up to 2 years. For more information on vision qualification requirements, examination, and certification determination, follow the link to Vision (b)(10).

To qualify, the driver must meet the hearing requirement of either the forced whisper test or the audiometric test in one ear. 

The requirement for the:

• Forced whisper test is to first perceive a forced whispered voice, in one ear, at not less than five feet.
• Audiometric test is to have an average hearing loss, in one ear, less than or equal to 40 decibels (dB).

The driver who wears a hearing aid to meet the hearing qualification requirement must wear a hearing aid while driving.

Follow the links for more information regarding hearing tests.

• Forced whisper test.
• Audiometric test.

For more information on hearing qualification requirements, examination, and certification determination follow the link to Hearing (b)(11).

Record pulse rate and rhythm on the Medical Examination Report Form.

The cardiovascular recommendations for certification using the JNC-6 stages of hypertension are summarized in the Medical Examination Report Form table. Blood pressure (BP) readings are defined as:

• 140-159/90-99 = Stage 1 hypertension.
• 160-179/100-109 = Stage 2 hypertension.
• Greater than or equal to 180/110 = Stage 3 hypertension.

The driver with hypertension and a BP less than or equal to 139/89 may be certified for up to 1 year. Confirm an elevated BP by a second elevated BP later in the examination. The driver with Stage 1 or Stage 2 hypertension may be certified in accordance with the cardiovascular recommendations, which take into consideration known hypertension history. Disqualify a driver with Stage 3 hypertension.

Record the test results of the required dipstick urinalysis (UA) in the Laboratory and Other Medical Test Findings section of the Medical Examination Report Form. The dipstick urinalysis must measure specific gravity and test for protein, blood, and glucose in the urine. Positive test results may indicate that additional evaluation is needed.

Attach copies of additional test results and interpretation reports to the Medical Examination Report Form.