391.41 Violation: What It Means and How to Fix It
Data through September 24, 2026 · Last updated October 28, 2026 · By Chad Griffith, founder
Quick Answer
391.41 (Physical qualifications for drivers) was cited 14,277 times in roadside inspections of interstate for-hire carriers with 5 to 50 trucks from September 25, 2024 to September 24, 2026, and 74.2% of those citations put the driver or vehicle out of service. The most common version is 391.41APC: Medical (Certificate) - Operating a property-carrying vehicle without a valid medical certificate in possession or on file with the state drivers licensing agency.
14,277
Citations on carriers with 5 to 50 trucks
74.2%
Out of service
134,054
All carriers, same period
What the rule says
A driver must be medically certified to drive a commercial motor vehicle (49 CFR 391.41). Since June 23, 2025, CDL holders do not carry the paper certificate; the state driving record shows it.
When it puts you out of service
Driving without a valid medical certificate is 74% out of service here (98% for the most common code, 391.41A-PC).
The codes on the inspection report
| Code | What the officer wrote | Severity weight | Citations, 5 to 50 trucks | Out of service |
|---|---|---|---|---|
| 391.41APC | “Medical (Certificate) - Operating a property-carrying vehicle without a valid medical certificate in possession or on file with the state drivers licensing agency” | 1 | 7,507 | 97.4% |
| 391.41A-MCPC | “Medical (Certificate) - Operating a commercial motor vehicle without showing proof of a valid medical certification upon request but presents proof prior to com” | 1 | 2,830 | 16.5% |
| 391.41A | “Operating a property-carrying vehicle without a valid medical certificate in possession or on file with the state drivers licensing agency. History of either fail” | 1 | 1,486 | 51.4% |
| 391.41B10-MC | “Medical (Certificate) - Operating a commercial vehicle without corrective lenses or hearing aid as indicated on the driver's medical certificate” | 2 | 1,449 | 97.8% |
| 391.41A1-NPH | “Operating a property-carrying vehicle without possessing a valid medical certificate - no previous history” | 1 | 363 | 27.8% |
| 391.41A-MCPVI | “Medical (Certificate) - Operating a passenger-carrying vehicle without a valid medical certificate in possession or on file with the state drivers licensing agenc” | 1 | 340 | 91.8% |
| 391.41A-F | “Operating a property-carrying vehicle without possessing a valid medical certificate.” | 1 | 185 | 62.7% |
| 391.41A1-FPC | “Operating a property-carrying vehicle without possessing a valid medical certificate. Previously Cited on [DATE]” | 1 | 51 | 90.2% |
| 391.41A-FPC | “Operating a property-carrying vehicle without possessing a valid medical certificate. Previously Cited on [DATE]” | 1 | 30 | 100.0% |
| 391.41A1-P | “Operating a passenger-carrying vehicle without possessing a valid medical certificate” | 1 | 14 | 78.6% |
| 391.41A1-LOC | “No medical certificate in driver's possession - vision hearing insulin using epilepsy or any condition causing loss of consciousness” | 1 | 10 | 90.0% |
| 391.41A1-MCOOS | “Medical (Certificate) - Operating a commercial motor vehicle while not medically certified as physically qualified to do so.” | 1 | 9 | 66.7% |
How it scores (violation points)
How it scores: in FMCSA's Safety Measurement System each violation counts its severity weight, plus 2 if it put the driver or vehicle out of service, times 3 in its first 6 months, 2 from 6 to 12 months, and 1 from 12 to 24 months. FMCSA has approved a simpler scale that is not live yet.
How to fix it
- The driver gets a new exam from an examiner on FMCSA's National Registry before driving again.
- For a CDL driver, pull a motor vehicle record that shows the new certification and put it in the qualification file (49 CFR 391.51(b)).
Stop it happening again
- Track every driver's medical certificate expiry and book the exam 60 days ahead.
Challenging it in DataQs
Use DataQs (dataqs.fmcsa.dot.gov) only when the report is wrong: the wrong carrier or vehicle, a violation that did not happen, or a citation a court dismissed without a fine or found you not guilty of, which removes it from the Safety Measurement System; a conviction of a different charge lowers its weight to 1 (FMCSA adjudicated citations policy). Fixing the defect afterward is not a reason to remove it; keep the repair record instead.
FileFlo tracks every driver's medical certificate and CDL dates and chases the renewal before it lapses.
Run it yourself: the Audit-Ready Setup, $499 through December 31, 2026, then $199 a month for up to 15 trucks. Or FileFlo runs it: $1,500 a month for up to 15 trucks, Setup included, and your first month back if you are not happy.
About these numbers
Counts are violations cited in roadside inspections used in FMCSA's Safety Measurement System from September 25, 2024 to September 24, 2026 (dataset 8mt8-2mdr on data.transportation.gov, October 2026 run). Carriers with 5 to 50 trucks means 66,936 active interstate for-hire carriers with 5 to 50 power units and more trucks than buses, based in the 50 states or DC, from FMCSA's census file. This is FileFlo's reading of public FMCSA data, not an FMCSA rating. Severity weights are the current SMS weights.