FMCSR 391.45(b): Expired Medical Certificate Q&A

Almost certainly not — but it has happened. Across 13 million inspections, 391.45(b) carries a 3.5% out-of-service rate (337 OOS placements out of 9,698 all-time citations). That is dramatically lower than the all-FMCSR average of 31.4%, meaning inspectors rarely pull a driver for an expired medical certificate alone. However, 'rarely' is not 'never.' If an inspector determines you are medically unqualified to drive and the expired certificate is the evidence, OOS is still on the table. Keep your renewal current and carry proof of your new exam with you at all times.

The STATISTICS block for 391.45(b) does not include a published severity weight, so a specific point value cannot be confirmed here. What is known is that 391.45(b) falls under the Driver Fitness BASIC in the CSA scoring system. Violations in that BASIC count against both the driver's SMS record and the carrier's BASIC percentile. Points are also multiplied based on how recently the inspection occurred — citations in the last 6 months carry the heaviest weight, and the multiplier steps down over the following 18 months. Getting the certificate renewed immediately limits the scoring window for any future inspections.

Take these steps immediately:

1. Schedule a new DOT physical today. The citation exists because your certificate lapsed — a fresh exam and a new card from a certified medical examiner clears the underlying problem.
2. Carry the new certificate in the cab. Inspectors can and do check for it on every subsequent stop.
3. Notify your safety department. The citation will appear in your carrier's Driver Fitness BASIC; fleet managers need to track it.
4. Check for co-occurring violations. Our inspection records show this code appears alongside other driver-fitness and documentation deficiencies — review the full inspection report to ensure no other items were cited.
5. Log the renewal date. Set a reminder 30 days before your next expiration.

Relative to its peers, 391.45(b) is on the lower end of severity. Its 3.5% OOS rate sits far below the all-FMCSR average of 31.4%. Compare that to closely related codes in the Driver Fitness category: 391.41APC (operating without a valid medical certificate) carries a 97.1% OOS rate across 49,539 citations, and 383.23(a)(2) (wrong CDL class) runs 98.4% OOS across 50,385 citations. Those codes are nearly automatic OOS events. An expired certificate under 391.45(b) is still a recordable violation that affects your Driver Fitness BASIC, but inspectors treat it with far more discretion than the outright-no-certificate violations.

Yes, and documentation violations like 391.45(b) are among the more successful DataQs challenges. If your medical certificate was actually valid on the date of inspection — for example, you had a current card in the truck but the inspector recorded it as expired — you can file a Request for Data Review (RDR) through the FMCSA DataQs portal. Submit a copy of the certificate showing the valid expiration date. If the inspection data contains a factual error, the reviewing agency can correct or remove the violation from your SMS record. If the certificate genuinely was expired at the time, DataQs will not change the outcome.

The STATISTICS block for 391.45(b) does not include a state-by-state breakdown, so specific state citation counts cannot be confirmed for this code. What the data does show is that 391.45(b) has accumulated 9,698 all-time citations and ranks #231 out of 3,036 FMCSR codes by total citation volume nationally — meaning enforcement is widespread rather than concentrated in a handful of states. High-volume inspection corridors in any state are where exposure is highest, particularly weigh stations and roadside inspection sites on major freight lanes.

Fix it before your next trip if at all possible. While the 3.5% OOS rate means most drivers cited under 391.45(b) kept rolling that day, driving with a known expired certificate after a citation puts you in a much worse position on any follow-up inspection. Notably, our inspection records show zero citations in the last 90 days and zero in the last 12 months, which suggests this specific code may no longer be actively written under this identifier — but the underlying medical qualification requirement has not changed. A lapsed certificate is still a Driver Fitness deficiency that accumulates in your CSA record and can compound quickly if paired with other violations.

Both are affected, but in different ways. The citation is tied to the driver's inspection record and appears in the Driver Fitness BASIC for the carrier operating the vehicle at the time. The carrier's BASIC percentile moves because the violation happened under their USDOT number. The driver's individual SMS record is also updated, which matters if the driver moves to a new carrier — prospective employers can see Driver Fitness inspection history. Among the carriers with the most 391.45(b) citations in our database, even large national fleets like Federal Express Corporation (USDOT 86876) and United Parcel Service Inc (USDOT 21800) each accumulated citations, showing this is a documentation lapse that happens across carrier sizes.