The N.C. Division of Motor Vehicles' Medical Review Unit Program evaluates drivers when there are concerns that certain medical conditions might have an impact on their ability to safely operate a vehicle.
A staff of licensed medical professionals conducts thorough reviews of medical records and statements in conjunction with driving records and decides what, if any, restrictions should be placed on a driver license.
Reasons for medical evaluations
These conditions include:
- Seizures
- Heart conditions (e.g., irregular heart rhythms, uncontrolled high blood pressure, etc.)
- Diabetes
- Sleep disorders
- Black outs or loss of consciousness
- Impairment of limbs, back or neck (e.g., stroke, injury, etc.)
- Cognitive disorders (e.g., stroke, head injury, dementia, etc.)
- Vision disorders
- Psychiatric disorders
- Neurological disorders (Parkinson's disease, dementia, neurodegenerative disorders)
- Substance use disorders
If a driver's medical condition is stable and documentation from the driver's health care provider has been provided, the Medical Review Unit's decision might involve driving restrictions that include but are not limited to:
- Corrective lenses
- Daylight-driving only
- Limiting driving to speeds less than 45 mph speed and prohibiting interstate driving
- Limiting driving to/from places, such as work, the doctor, church, grocery store
- Limiting driving within a specific radius of the driver's home
Periodic reviews of medical conditions
Depending on the severity of the medical condition – or if the condition worsens – the Medical Review Unit will review a driver's case on a periodic basis to ensure their medical condition does not affect their safety and driving abilities.
In such cases, the driver must submit updated medical documentation each time their case is reviewed. Depending on the medical condition, these updates might be required as often as every three months or as infrequent as once every three years. Drivers with stable medical conditions might not need to be followed by the Medical Review Unit.
Seatbelt waiver
N.C. G.S. 20-135.2A(c) (1) provides a medical exemption from wearing a seatbelt. Specifically, drivers or occupants of a noncommercial motor vehicles with a medical or physical condition that prevents appropriate restraint by a safety belt or with a professionally certified mental phobia against the wearing of vehicle restraints.
In order for the Medical Review Unit to determine your eligibility for this exemption, you must submit a completed medical report and a letter from your physician indicating the medical conditions that requires you to be exempt from wearing a seatbelt.
Requests can be faxed or mailed to the Medical Review Unit.
Requests for medical evaluations
Although anyone may request that a driver be medically evaluated, the requests to the Medical Review Program typically come from:
- Physicians who notify NCDMV about patients who they feel might be at risk to themselves or others
- Law enforcement officers who have observed drivers with poor driving habits related to health problems, such as poor vision, slow reaction time, reports of blackouts, falling asleep or seizures
- Crash reports related to a medical condition that might have contributed to a motor vehicle accident
- Involuntary commitment orders and adjudication incompetency orders submitted by the court system
Anyone requesting that a driver be medically evaluated must complete and sign the Request for Medical Evaluation form. Anonymous requests are NOT accepted.
Download Request for Medical Evaluation form
This recommendation must only be made in the interest of public safety. Advanced age alone cannot be the sole reason for a medical evaluation.
List of occupational therapists
Individuals who are requested to complete an occupational therapist evaluation, including a behind-the-wheel-assessment, can select an evaluator from the following list:
Department of Veteran Affairs Medical Center (Veterans Only)
1601 Brenner Avenue, Salisbury, NC 28144
(704) 638-9000 or (800) 469-8262
Department of Physical Therapy & Occupational Therapy
3000 Erwin Road, Durham, NC 27710
(919) 684-2445
UNC Health Blue Ridge Medical Driving Evaluation and Training
137A West Parker Road, Morganton, NC 28655
(828) 580-6816
Driver Rehabilitation Services
5417 Frieden Church Road, McLeansville, NC 27301
(888) 888-0039
Novant Health Rehabilitation Center
1903 S. Hawthorne Road, Winston Salem, NC 27103
(336) 718-6700
Vidant Medical Rehabilitation Center
Outpatient Neuro Department of Occupational Therapy
2100 Stantonsburg Road, Greenville, NC 27834
(252) 847-6603
You may also contact your local vocation rehabilitation services to see if you qualify for vocation services and a driver evaluation recommendation.
Appealing medical review decisions
Drivers who disagree with decisions by the Medical Review Unit are entitled to a hearing before the Medical Review Hearing Board, if they request the hearing in writing within 10 calendar days of receiving the decision.
Hearings before the Medical Review Board are not subject to hearing fees.
Requests can be faxed or mailed to the Medical Review Unit.
Medical hearings
A hearing officer with the NCDMV as well as two physicians appointed to the Medical Review Hearing Board conduct all medical hearings at the NCDMV driver license office at 3231 Avent Ferry Road in Raleigh.
If you wish to contest the cancellation, you may request a hearing before the Medical Review Board, as permitted under NCGS §20-9, by submitting a signed, written request with 10 days of receiving this notice. A request for a hearing will postpone the imposition of any restriction unless the Division of Motor Vehicles notifies a driver to surrender their driving privilege.
At the time of the hearing, you will present evidence regarding your request for restoration of your license to a panel consisting of a hearing officer and at least two physicians. The hearings are recorded and last approximately 30 minutes. The hearing officer and physicians can ask you questions about your medical, driving and personal history. You will be notified by mail once your reconsideration or hearing is completed.
Please note: All hearings are held in Raleigh, N.C.
Reconsideration process
Requests for reconsideration can be faxed or mailed to the Medical Review Unit.
If you request reconsideration, the Medical Review Unit will review your request within 30 days. You may provide additional information from your medical provider in support of your request for reconsideration. If the cancellation is not lifted following reconsideration, you may request a hearing at that time.
If a driver requests a hearing, their case will be reconsidered by the Medical Review Program's medical advisers in preparation for the hearing. The reconsideration process determines if the initial decision on the driver license was accurate and warranted. A driver will be notified by mail if the status of their case changes.
To learn more about the DMV’s recommendations or the information required to have a decision reconsidered, please contact the Medical Review Unit at (919) 861-3570 or (919) 861-3809.
Drivers who disagree with the Medical Review Hearing Board's decisions can appeal to Wake County Superior Court.
If you do not comply with the Medical Review Unit's decision in a timely manner, your driver license will be canceled until you comply.
Requesting medical records
Drivers may request a copy of their medical records on file at the NCDMV by mailing a completed and notarized release form and $10 check or money order to the Medical Review Unit.
An attorney requesting the records on a driver's behalf must submit the signed and notarized form, along with a Letter of Representation.
Please allow up to seven business days for processing.
Requesting removal from Medical Review Program
Drivers who would like to be considered for removal from the Medical Review Program should mail a completed Removal Request form or a signed, written request that includes their name, date of birth, and driver license number, to the Medical Review Unit.
The Medical Review Unit will notify a driver once it receives the request and a decision has been made.
Submitting a removal request does not guarantee that a driver will be removed from the Medical Review Program. Removal is based on the driver's current health status, their health care provider's recommendation and medical fitness to drive health standards.
To consider removal, the Medical Review Unit may request additional health information, and a driver might need to submit additional information for a final decision.
Submitting a removal request does not delay or reverse any license restrictions. A
driver who receives a letter stating that restrictions must be placed on their license
should visit a local driver license agency to have the restrictions placed.
Please note: North Carolina commercial driver license holders in the Intrastate Waiver Program who would like to be removed from the waiver program, may visit a local driver license agency to surrender (or downgrade) the commercial driver license to a Class C license. A driver may voluntarily surrender their commercial driver license (at no additional cost) at any time prior to the expiration of their NCDOT medical certificate and waiver.
If a driver's request for removal is denied, the driver may submit a future request if their condition changes or improves.
If the Medical Review Unit has requested updated information, it must be received before the removal request can be reviewed. Please note that submitting a removal request does not pause the restriction. However, drivers may request a reconsideration or a hearing regarding the restriction, which will stay the restriction unless the driver is determined to pose an imminent threat.
Commercial driver waivers
The Medical Review Unit administers the state’s medical waiver program for intrastate commercial drivers. The program ensures that drivers with certain medical impairments can safely operate a commercial motor vehicle when their condition is stable and monitored regularly.
This program applies only to intrastate commercial drivers, meaning drivers who operate commercial motor vehicles only within North Carolina. Interstate commercial drivers are not eligible and should contact the Federal Motor Carrier Safety Administration (FMCSA) regarding its exemption programs.
Purpose of the waiver program
The North Carolina medical waiver program evaluates commercial drivers who may not meet federal medical standards but can safely operate a commercial motor vehicle under state-issued waiver conditions. Drivers must:
- Otherwise qualify for a North Carolina DOT medical certificate
- Have completed a DOT physical examination within the past year
- Operate only within North Carolina
Waivers may be granted for up to, but no more than, two years.
Available waiver types
Limb waiver
North Carolina offers one type of intrastate waiver, the Limb Waiver. A limb waiver is required for drivers who do not meet the minimum federal limb requirements, including those with:
- Loss or impairment of a hand or finger that interferes with power grasping
- Loss or impairment of an arm, foot, or leg
- Any other significant limb defect or limitation that affects the ability to perform normal tasks associated with operating a commercial motor vehicle
Key points:
- Limb waivers are valid for up to two years.
- Drivers may request a waiver for only one medical condition.
- The Medical Review Unit does not issue more than one waiver per driver.
Required documentation:
- CDL Waiver Cover Sheet
- Current DOT Medical Examination Report (Form MCSA 5875)
- Vehicle Driving Condition Report, Limb Waiver Form
Vision waiver
The North Carolina Medical Review Unit no longer issues vision waivers. Under updated FMCSA regulations, drivers who do not meet federal vision standards must follow FMCSA’s medical certification process.
Under the FMCSA Vision Standard (87 FR 3390, Jan. 21, 2022):
- Drivers who do not meet federal vision standards in one eye must be medically examined at least annually.
- A Medical Examiner must receive a completed Vision Evaluation Report (Form MCSA 5871) from an ophthalmologist or optometrist.
- The Medical Examiner’s exam must begin within 45 days of the date the Vision Evaluation Report is signed.
For questions about federal vision exemptions, drivers should contact FMCSA.
Approval of waiver
If approved, the Medical Review Unit will notify the driver by letter. The letter will outline the terms, conditions, and limitations of the waiver. Drivers must always carry the waiver letter while operating a commercial motor vehicle.
Frequently asked questions
If the driver has submitted all requested medical documents in a timely manner, the driver's documentation will be reviewed within 45 days of receipt. School bus drivers will be reviewed within 30 days of receipt of the medical report.
You may request a medical waiver for your condition if you have a vision disorder, limb impairment or insulin-dependent diabetes. The Medical Review Program currently offers one waiver per driver. Call (919) 861-3809 to learn more about the waiver program.
No. School buses cannot be modified to accommodate a window tint.
Medical review assistance
If you need to contact the ADA coordinator regarding this Medical Review recommendation, you are encouraged to do so. The ADA coordinator can be contacted via email at ADA@ncdot.gov, or by mail at:
N.C. Department of Transportation
ADA Unit
1501 Mail Service Center, Raleigh, NC 27695-1501
Related forms
Contact
Mailing Address:
NC Division of Motor Vehicles
Medical Review Unit
3112 Mail Service Center
Raleigh, NC 27696-3112
Phone: (919) 861-3570 & (919) 861-3809
Fax: (919) 733-9569