Application for Intrastate Medical Waivers to
Operate Class A, B, or C Commercial Motor Vehicles
Registry of Motor Vehicles ● Medical Affairs Division
P.O. Box 55889 ● Boston, MA 02205-5889
P
hone: (857) 368-8020 ● Fax (857) 368-0018
1 MAB105_0719
Medical Waivers for the operation of commercial motor vehicles INTRASTATE ONLY (within the borders
of Massachusetts only) will be issued in accordance with the provisions of 540 CMR 14.05 (1)(c).
The Registrar may issue an intrastate waiver for the following conditions ONLY:
1. A VISION IMPAIRMENT if: the individual has a combined horizontal peripheral field of vision of not less than 120
degrees, provided the individual also has a distant visual acuity of at least 20/40 (Snellen) in either eye, with or
without corrective lenses, and the ability to distinguish the colors red, green, and amber;
2. A DIABETIC CONDITION if: the individual submits a written statement from his or her physician (defined on
reverse side of this application) which: provides specific reasons why the individual is not at risk or is no longer at risk
of suffering hypoglycemic spells or episodes; and recommends a specific date for the Registry to re-evaluate the
individual s ability to operate a commercial motor vehicle safely;
3. A CARDIOVASCULAR CONDITION if: the individual does not have an implanted cardiac defibrillator for a
“sudden death” event and does not have Class III or Class IV heart disease according to the American Heart
Association functional guidelines for classifying heart disease; and
4. A LOSS OR IMPAIRMENT OF LIMB so long as such loss or impairment of limb is not likely to interfere with the
safe operation of a commercial motor vehicle.
5. A HEARING IMPAIRMENT if: the certifying physician states the condition will not interfere with the safe operation
of a commercial vehicle. For vehicles with air brakes, an applicant must be able to hear the air compressor cutting out
and detect an actual air leak in the braking system- a safety precaution in case the gauges have malfunctioned.
Therefore, a profoundly deaf person would not pass this portion of the test and would be restricted to a commercial
vehicle without airbrakes.
Individuals with these specified conditions may obtain an intrastate waiver provided that the condition will not interfere
with the safe operation of a commercial motor vehicle, as certified by their physician.
Please note: Applicants who need to pass the Commercial Driver Road Test may request a reasonable
accommodation limited to additional time to perform the pre-trip inspection and maneuvers. The request for a
reasonable accommodation must be from a physician, written on the physician’s letterhead, describing the medical
need of additional time. ONLY accommodations for additional time will be granted. All applicants must pass all
aspects of the Commercial Driver Road Examination.
Intrastate waivers shall NOT be applicable to SCHOOL BUS operator certificates.
The following documentation MUST be submitted with this completed application, certified by your medical professional,
to the Medical Affairs Division:
1. A copy of the results of a recent DOT medical examination performed pursuant to 49 CFR 391.43, upon whic
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t
he examining physician has indicated that you are only qualified to operate a commercial motor vehicle with an
intrastate medical waiver; and
2. A letter from your employer acknowledging that you have a medical waiver and that you drive commercially as
a requirement of employment within the borders of Massachusetts only.