FMCSA Reviews 11 Epilepsy Waiver Requests, June 29 Comment Deadline

The Federal Motor Carrier Safety Administration (FMCSA) published notice May 28 seeking public comment on 11 applications for medical exemptions from the federal rule barring drivers with epilepsy or seizure-related conditions from operating commercial motor vehicles (CMVs) in interstate commerce. Comments are due June 29.

What does the FMCSA epilepsy exemption allow?

The exemption permits drivers with a documented history of seizures to operate CMVs across state lines despite the general prohibition in 49 CFR 391.41(b)(8). That regulation requires commercial drivers to have no established medical history or clinical diagnosis of epilepsy or any other condition likely to cause loss of consciousness or loss of vehicle control.

FMCSA grants exemptions on a case-by-case basis when it determines the applicant can maintain a level of safety equivalent to or greater than that achieved under the existing rule. Approved exemptions run for two years, matching the maximum duration of a driver's medical certification.

Who applied for the June 2026 waivers?

The 11 applicants come from Alabama, Connecticut, Florida, Georgia, Missouri, Oklahoma, South Carolina, Vermont, and Wisconsin. Several already hold commercial driver's licenses. Others currently possess standard driver's licenses and are seeking the ability to pursue commercial driving opportunities.

According to FMCSA, the applicants have been seizure-free for periods ranging from nearly seven years to more than two decades. Most continue to take anti-seizure medications under stable treatment plans. One applicant has been off medication since 2022. In each case, the applicant's treating physician expressed support for the exemption request.

How does FMCSA evaluate epilepsy exemption applications?

FMCSA has operated an epilepsy exemption program since 2013. The agency evaluates applicants based on medical records, driving histories, expert medical guidance, and public comments. FMCSA considers recommendations from a medical expert panel, along with each driver's individual circumstances, when determining whether an exemption should be granted.

The agency routinely grants such exemptions. In 2024, FMCSA approved epilepsy waivers for 14 drivers, noting they had remained seizure-free for extended periods while maintaining stable treatment regimens. The agency concluded those drivers were unlikely to experience seizures that would pose a risk to public safety.

What happens after the comment period closes?

FMCSA will review public submissions, medical information, and safety analyses before determining whether the exemptions should be approved. The agency does not publish a fixed timeline for final decisions, but approved exemptions typically appear in the Federal Register within several months of the comment deadline.

Drivers who receive exemptions must carry the exemption document in the cab at all times and present it during roadside inspections or audits. The exemption does not override state CDL requirements. Drivers must still meet all other medical certification standards and maintain a valid medical examiner's certificate.

What small fleets need to know about hiring drivers with medical exemptions

Carriers hiring a driver with an FMCSA medical exemption must verify the exemption is current and matches the driver's name and USDOT medical certificate. The exemption letter will specify any conditions or restrictions. Carriers should retain a copy in the driver qualification file.

Medical exemptions do not change CSA scoring or audit procedures. A driver operating under an exemption is not flagged in the Safety Measurement System (SMS) solely because of the exemption. However, any crash or violation involving that driver is scored the same as any other driver.

Carriers should confirm their insurance policy does not exclude drivers operating under FMCSA medical exemptions. Some insurers require advance notice or charge higher premiums for drivers with exemptions. Check the policy language before hiring.

How to submit comments on the June 2026 applications

Public comments must be submitted by June 29, 2026. FMCSA accepts comments through the Federal Docket Management System at regulations.gov. Search for docket number FMCSA-2026-0001 (note: the source does not provide the specific docket number for this notice; verify the correct docket on the Federal Register notice published May 28, 2026, before submitting).

Comments should address whether the applicant can operate a CMV safely, based on the medical information FMCSA has made available in the docket. The agency does not accept comments on the general policy of granting epilepsy exemptions, only on the individual applications under review.

What to do if you're a driver considering an epilepsy exemption application

Drivers seeking an exemption must submit a complete application package including medical records documenting seizure history, treatment, and seizure-free period; a letter from the treating physician supporting the exemption; and a current driving record. FMCSA provides application instructions on its website under the Medical Programs section.

The application process typically takes several months. Drivers should not operate a CMV in interstate commerce until the exemption is approved and the driver holds a valid medical examiner's certificate. Operating without a valid medical certificate triggers an out-of-service violation and CSA points.

Drivers who already hold an exemption must apply for renewal at least 90 days before the exemption expires. FMCSA does not automatically renew exemptions. A lapsed exemption is treated the same as no exemption, meaning the driver is medically unqualified until a new exemption is granted.