Violation code

391.45F

Medical (Certificate) - Operating a commercial motor vehicle when impaired by a physical or mental injury or disease discovered after current medical certification date.

Driver Fitness2Non-OOS· SMS Appendix A v3.20

391.45F is a Physical violation under 49 CFR §391.45F. It falls in the Driver Fitness BASIC with a severity weight of 2/10. Nationally it was cited 2 times in the last five years, with an OOS rate of 0.0%.

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National roadside inspection stats

as of 6/20/2026

Inspections

that found this code

Violations

total written

OOS rate

0.0%

0 OOS

Source: FMCSA roadside inspection data (last 5 years). The OOS rate is the share of these violations that led the officer to mark the driver or vehicle out of service.

Violation group: Physical
Regulation §: 391.45F
Severity weight: 2
Used in SMS: Yes
Status: Active
Updated: 6/20/2026

Last updated June 2026

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Notes

DSMS: Y | Comment: Added in 3.15 | Footnote: As of February 1, 2023, the violations in this table are included in SMS. Only violations cited on or after February 1 are included in SMS calculations. This update aligns SMS with how violations are being cited in a new software used for roadside inspections.

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Challenging 391.45F through FMCSA DataQs

If this violation was written incorrectly, here are the angles trucking-safety managers use to contest it. Playbook: Driver Fitness.

Relevant 49 CFR49 CFR § 391.45

Persons who must be medically examined and certified

“Except as provided in §391.67, the following persons must be medically examined and certified as physically qualified to operate a commercial motor vehicle: any person who has not been medically examined and certified as physically qualified to operate a CMV; any driver whose medical examiner's certificate has expired.”

Common ways to challenge this code

Medical certificate was valid and on file
A valid medical examiner's certificate was in the driver's qualification file and was either not produced at roadside or not properly recognized.
Evidence that wins
- ✓Copy of the valid medical examiner's certificate
- ✓Driver qualification file index
- ✓National Registry verification printout
CDL class / endorsement was correct for the operation
The driver's CDL class and endorsements were correct for the vehicle and cargo being operated.
Evidence that wins
- ✓Copy of the valid CDL with endorsements
- ✓Vehicle registration showing GVWR/configuration
- ✓Bill of lading or shipping papers showing cargo

Common pitfalls — avoid these

⚠A medical certificate that expired the DAY of inspection still fails — there is no grace period

⚡ Draft a challenge for 391.45F →Read the DataQs guide first

More codes in Driver Fitness

Same BASIC category — ranked by national citation volume

View all Driver Fitness codes →

Other Physical codes

Codes under the same FMCSA violation group

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Frequently asked questions about 391.45F

What does violation 391.45F mean?

391.45F is the FMCSA roadside-inspection violation code for "Medical (Certificate) - Operating a commercial motor vehicle when impaired by a physical or mental injury or disease discovered after current medical certification date.", part of the Physical group, cited under 49 CFR §391.45F.

What BASIC does 391.45F affect?

391.45F falls under the Driver Fitness BASIC in the FMCSA Safety Measurement System (SMS).

What is the CSA severity weight of 391.45F?

391.45F carries a severity weight of 2 out of 10. Higher weights indicate violations more closely tied to crash risk, and they count more toward a carrier's Driver Fitness score.

Is 391.45F an out-of-service (OOS) violation?

No. 391.45F is not an out-of-service violation, so on its own it does not trigger an out-of-service order at the roadside.

How many CSA points does 391.45F add to a carrier's score?

The point contribution of 391.45F depends on its severity weight (2/10) multiplied by a time weight of 3, 2, or 1 based on how recent the inspection is. You can calculate the exact contribution with the CSA points calculator.

Can 391.45F be challenged through DataQs?

Yes. If you believe 391.45F was recorded in error, you can file a Request for Data Review (RDR) through the FMCSA DataQs system with supporting evidence. A successful challenge can remove or correct the violation on your record.

Keep going

CSA points calculator How to challenge a violation Draft a DataQs letter for 391.45F Driver Fitness BASIC Carrier CSA lookup CSA glossary