Medical standards for all commercial drivers

We assess commercial drivers directly against the national medical standards provided by the Canadian Council of Motor Transport Administrators.

Vision standards for class A, B, C, D, E and F drivers

Vision standards apply to all drivers. Applicants and holders of class A, B, C, D, E and F licences must have:

  • a visual acuity that is not poorer than:
    • 20/30 with both eyes open and examined together
    • 20/100 in the weaker eye, with or without corrective lenses (glasses or contact lenses)
  • a horizontal visual field with both eyes open and examined together of at least:
    • 150 continuous degrees along the horizontal meridian
    • 20 continuous degrees above and below fixation

Hearing standards apply to applicants and holders of class B, C, E and F licences.

If you are a driver whose hearing in one ear is better than in the other, you must either:

  • be able to perceive in the better ear a forced whisper at a distance of 1.5 metres, with or without a hearing aid
  • not have a loss in the better ear of more than 40 decibels at 500, 1000 and 2000 hertz (if an audiometer is used to test the driver's hearing)

For more information, consult Ontario Regulation 340/94 (s. 17).

Medical reporting requirements for class A, B, C, D, E and F licences

If you are applying for a class A, B, C, D, E or F licence, you need to submit a medical report. The medical report form can be completed by a physician or a nurse practitioner (RN-EC) licensed to practice medicine in Canada. The form can be obtained from your local DriveTest centre.

If you already have a Class A, B, C, D, E and F commercial licence, you need to submit a medical report:

  • every five years, under age 46
  • every three years, age 46-64
  • every year, age 65 and over

If you are already a holder of a class A, B, C, D, E or F licence, you will receive a medical report form by mail 90 days before it is due. It will be mailed to the address showing on your driving record. If you need to change your address visit ServiceOntario.

As of July 1, 2018, class D licence holders are required to submit regular medical reports, based on the date of the last medical report filed and your age.

Submitting your medical report form


If your physician or nurse practitioner has access to eForms at their clinic, they may submit your completed medical report form to the Ministry of Transportation’s Driver Medical Review office online. This option is available to some clinics starting May 2022.  

In person

To submit your form in person:

  • if your physician or nurse practitioner has answered "yes" or "no" to question 1 and "no" to questions 2-9 on the front of the medical report.

By mail

Submit your form to the address noted on the form:

  • if your physician or nurse practitioner has answered "yes" to any question 2-9.

Before you submit a medical report, you should check with your medical practitioner about the cost to complete the form. You are responsible for paying the examination fee.

Late medical reports

If we don’t receive your medical report by the due date:

  • your licence will be downgraded to a class G licence
  • if you hold a class M licence, it will be maintained

If a satisfactory medical report is filed within one year of the downgrade:

  • your licence will be automatically upgraded to the class you held before, as long as you have no other outstanding tests or requirements
  • after one year, additional tests may be required

Licence downgrade

If your medical report indicates that you may no longer meet the medical standards for a commercial licence, you may be asked to submit additional information from your treating physician or nurse practitioner.

If the report confirms that you don't meet the required medical standards, your licence will be downgraded. We will let you know about:

  • what is required to have your case reconsidered
  • your right to appeal the decision, if applicable

Medical waiver program

The medical waiver program was eliminated as of January 1, 2011. However, some waivers will continue to be renewed, including:

  • medical waivers granted in 1977-1978 during the period of conversion, as long as there is no deterioration in the medical condition for which you received the original waiver
  • Class A and D vision waivers granted during the 1996-2006 Vision Waiver Pilot Program

Medical standards for Class D or G drivers operating a commercial vehicle in the United States

If you are a Canadian commercial driver with a class D or G licence and you operate a commercial vehicle in the Unites States, you must:

  • meet defined medical standards
  • file medical reports on an ongoing basis
  • have a medical confirmation letter, even if you only drive once or twice a year
  • complete a medical examination indicating you are physically qualified to safely operate a commercial vehicle
    • This applies if your commercial vehicle has a weight/rating of 4,536 kg (10,001 pounds) or more, according to the Gross Vehicle Weight Rating, Gross Combination Weight Rating, Gross Vehicle Weight or Gross Combination Weight.
    • If you fail to have proof of medical fitness to operate a commercial vehicle based on the weight/rating above, you may be fined or placed out-of-service by United States enforcement officials.

You can find more information about the United States Federal Motor Carrier Safety Administration (FMCSA) definition of a commercial motor vehicle at Federal Motor Carrier Safety Regulations Section 390.5.

Who is qualified

Canadian licensed commercial drivers are qualified to operate in the United States if they meet all of the medical requirements to operate in Canada and do not have:

  • hearing impairment
  • history of epilepsy or seizures
  • monocular vision

If you have any of the above noted medical conditions, you are not allowed to operate a commercial vehicle in the United States. A 'W' condition code will be placed on your driver's licence.

Your ability to obtain a Medical Confirmation Letter depends on your medical report. Failure to meet national medical standards may result in:

  • a request for additional medical information
  • denial of the Medical Confirmation Letter (Class G and D)
  • licence downgrade (Class D)
  • driver’s licence suspension

Proof of medical fitness

In the United States, holders of Class A, B, C, E or F driver’s licences are considered to have proof that a medical report has been completed. This is due to the Canada-United States medical reciprocity agreement. If you hold a Class A, B, C, E, or F driver’s licence, you do not need to get additional proof of medical fitness.

Class D and G drivers need to get proof of medical fitness. To get proof of medical fitness to operate commercially in the United States, you must choose one of the three options below.

Option 1: submit a medical report to FMCSA

Submit a completed FMCSA medical report to the Ministry of Transportation and receive a Medical Confirmation Letter.

  1. Download the FMCSA medical report form.
  2. Once you complete the form, fax both sides of the report to the Driver Medical Review Office at the number indicated on the form.
    • Keep the original medical report and fax confirmation for your records. The Driver Medical Review Office commits to reviewing and processing medical reports within 15 business days. Please submit your medical reports as soon as possible.
  3. If your medical report is satisfactory and you are deemed compliant with United States law, you will receive a Medical Confirmation Letter from the ministry by mail to the address on your driving record. You must carry this letter as proof of medical fitness at all times while operating a commercial vehicle in the United States.

Option 2: upgrade an existing Class D or G licence

You can upgrade an existing Class D or G licence to a higher licence class where regular medical reporting is required, including A, B, C, E and F.

If you have submitted a Ministry of Transportation Medical Report Form for a Class D licence within the last six months, you can request a FMCSA confirmation letter by contacting the Driver Medical Review Office.

Learn more about upgrading your licence, including what documents are required to upgrade and the fees for knowledge and road tests.

If you choose to upgrade your driver’s licence, you will be required to file a medical report when you apply and when you renew, based on the age requirements below.

Option 3: get a U.S. medical certificate

You can find a certified medical examiner in the United States to issue you a medical certificate.

Renewing your Medical Confirmation Letter

You will be required to reapply for the Medical Confirmation Letter every:

  • five years for drivers 18 to 45 years of age
  • three years for drivers 46 to 64 years of age
  • one year for drivers 65 years of age or older

It is your responsibility to apply for a new Medical Confirmation Letter prior to the expiry date outlined in the letter from the ministry.

Contact us

If you have questions about the United States FMCSA commercial-use vehicle requirements, contact FMCSA at 202-366-4001.

Contact the Ontario Ministry of Transportation:

Ministry of Transportation
Driver Medical Review Office
77 Wellesley Street West, Box 589
Toronto, Ontario M7A 1N3

Business hours: 8:30 a.m. to 5 p.m., Monday to Friday