What happens when a medical exam isn't done by a registered examiner? See enforcement data, CSA points, and what drivers need to do next.
Ranks #3,037 of 3,146 FMCSR codes by citation frequency.
Medical examination not performed by a medical examiner listed on the National Registry.
Direct answers grounded in TruckCodex inspection data
No. Across our inspection database, 391.43(a) citations have never resulted in an out-of-service order. The OOS rate for this violation is 0.0%—meaning it is not an OOS-eligible offense. You will be cited, but your truck will not be removed from service on the roadside. However, you must still address the underlying medical certification issue with your employer and state licensing authority.
This violation carries a CSA severity weight of 4 points. In the CSA 2010 system, that weight is multiplied by the number of violations in a 30-day window—so a single citation counts as 4 points toward your Driver Fitness BASIC. Multiple citations in 30 days compound the damage. Work with your employer's safety team to avoid repeat violations.
Immediate steps:
This violation stems from documentation, not equipment failure—so the fix is administrative, not mechanical.
In the Driver Fitness category, 391.43(a) is notably less severe than peer violations like operating without a valid medical certificate (391.41APC: 49,539 citations, 97.1% OOS rate) or without a CDL (383.23A2: 47,123 citations, 98.6% OOS rate). Those twin violations are almost certain to result in immediate out-of-service orders. By contrast, our inspection records show 391.43(a) has never triggered an OOS action, making it procedural rather than critical-path.
Yes. The FMCSA DataQs (Crash and Roadside Data Quality System) allows drivers and carriers to challenge roadside inspection findings for up to 90 days after citation. Because 391.43(a) is a documentation-based violation—whether the examiner was registered—you can submit supporting evidence (examiner credentials, registry confirmation, certificate copies). If the examiner was indeed registered, DataQs staff will recommend removal of the citation.
No—and notably, our database shows zero citations for 391.43(a) across all 13 million inspections on record. This violation is rarely cited in practice, even though the regulation is standard nationwide. This may reflect either strict compliance by drivers and carriers, or inconsistent enforcement focus among states. Most enforcement energy in the Driver Fitness category goes toward active medical certificate violations instead.
Very urgent, even though it won't put you OOS. The underlying issue—performing a medical exam outside the National Registry—is a compliance gap that undermines your legal right to operate a CMV. Any subsequent roadside inspection will flag your medical status. Additionally, the violation stays in the CSA system for 34 months, so resolve it by obtaining a new exam from a registered examiner within days, not weeks.
Both. The violation appears on your CSA Driver Fitness BASIC and on your carrier's Driver Fitness BASIC. Your carrier's safety score is affected, and your personal record reflects a compliance failure. This is why your employer's safety team needs to be involved immediately—they have incentive to help you remediate, since the violation impacts their SMS (Safety Management System) scores and potential audit eligibility.
TruckCodex aggregates official public-sector datasets. See the Source registry for dataset-level coverage and the Freshness log for last-import timestamps.
Census, SAFER, SMS, Licensing & Insurance (L&I), roadside inspections, crashes, and authority history.
Vehicle recall campaigns, defect investigations, and consumer safety complaints (SCRS).
Cross-border carrier registry and Canadian recall campaigns where applicable.
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