FMCSA Violation Code

391.41A — Driver lacking required medical certificate

49 CFR 391 • Driver Fitness BASIC • Severity 5/10

Out-of-service eligible Driver citation CSA weight 5

OUT-OF-SERVICE eligible

Code

391.41A

CFR section

49 CFR 391

BASIC

Driver Fitness

Severity

5/10

Out-of-Service

Yes

Unit type

Driver

What this violation means

CDL drivers must hold a current DOT Medical Examiner's Certificate (Med Card) issued by a certified medical examiner from the National Registry. 5 SMS points. OOS until valid Med Card produced. As of 2014, the Med Card status flows automatically to the state DMV in most states, so an expired card also means a downgraded CDL — driver can't legally drive interstate, period.

Why this gets cited

Med Card expired and driver didn't schedule recert (most common — they're typically 2-year cards, sometimes 1-year for monitored conditions). Driver moved states without notifying DMV. Med Card lost / destroyed. New entrant who never got a Med Card.

How to fix / prevent

Track Med Card expirations 60 days out. Schedule annual fleet-wide Med Card renewal drives. Keep a digital photo copy + paper copy in the truck. Most truck stops have certified medical examiners — Concentra and Pilot/Flying J's clinics are common.

Out-of-service criteria

Yes — this violation IS out-of-service eligible. When an inspector finds 391.41A during a Level 1, 2, or 3 inspection, they can place the Driver OOS using the North American Standard Out-of-Service Criteria. OOS means the truck cannot move from the inspection site until the defect is corrected (vehicle OOS) or the driver is replaced (driver OOS). For carriers, every OOS violation adds time-weighted points to your CSA Driver Fitness BASIC — and it shows in the public SMS data within 30 days. For drivers, an OOS event stays on PSP for 3 years.

CSA / SMS impact

391.41A carries a severity weight of 5/10 in FMCSA's Safety Measurement System (SMS). Higher weights mean faster CSA percentile movement. Combined with a time-weighting factor (2× for citations within the last 6 months, decaying over 24 months), this violation can move your Driver Fitness BASIC percentile significantly if it stacks with similar citations across your fleet. The threshold for FMCSA intervention is the 65th percentile for most BASICs (50th for Hazmat and Passenger Carrier). Once you cross that, FMCSA can send a Warning Letter, Off-Site Investigation, or full Compliance Review.

How to read this: a single citation rarely puts you over threshold — it's the pattern. Track your inspection rate per power unit and aim for OOS rate under 5% (industry average is 21%).

Carriers recently cited (last 24 months)

Carriers most-recently cited for 391.41A in FMCSA inspection records (rolling 24-month window).

FEDERAL EXPRESS CORPORATION
DOT #86876 • last cited 2025-09-22
38×
UNITED PARCEL SERVICE INC
DOT #21800 • last cited 2025-08-15
15×
COMPASS GROUP USA INC
DOT #132504 • last cited 2026-02-27
12×
BLESSED TRUCK LLC
DOT #4174903 • last cited 2025-02-18
10×
EXCAV8 SOLUTION LLC
DOT #4112726 • last cited 2026-05-22
9×
VESTIS SERVICES LLC
DOT #221707 • last cited 2025-10-15
8×
GARCIA AYALA TRUCKING LLC
DOT #3968418 • last cited 2025-07-24
8×
HIMA CARRIERS LLC
DOT #3093533 • last cited 2024-12-27
8×
KEYSTONE AUTOMOTIVE INDUSTRIES INC
DOT #778752 • last cited 2026-02-27
7×
BLACKSTONE UNDERGROUND LIMITED
DOT #4048800 • last cited 2025-06-28
7×

Other violations in Driver Fitness

383.51OOS

Driving while CDL disqualified

383.71OOS

Operating with falsified CDL application

383.23A2OOS

Operating CMV without CDL

391.11B2OOS

Driver does not have proper CDL class for vehicle

383.93OOS

CDL lacks required endorsement

391.41B1OOS

Driver does not meet physical qualifications

391.45AOOS

Operating without a medical exam (no Med Card on file)

391.45BOOS

Operating after Med Card expiration

Frequently Asked Questions

Can I be placed out of service for 391.41A?

Yes. 391.41A is on the North American Standard Out-of-Service Criteria list. An inspector who finds this during a Level 1, 2, or 3 inspection can place the Driver OOS at the inspection site. The truck cannot move until the defect is corrected. For vehicle-side OOS, that usually means a mobile mechanic or tow to the nearest shop. For driver-side OOS (HOS, CDL, drug/alcohol), it means the driver is removed from service and a qualified replacement must arrive before the truck can continue. Pro tip: do a thorough pre-trip every shift and address any issue listed in 49 CFR 391 before pulling onto the road — that's the only reliable way to avoid this one.

How long does 391.41A affect my CSA score?

391.41A stays in your CSA Driver Fitness BASIC for 24 months from the inspection date. The impact is time-weighted: 3× points during months 0-6, 2× during months 7-12, 1× during months 13-24, then it drops off. Severity weight is 5/10, so each citation contributes 15 points in the first 6 months and decays from there. On the driver's PSP report, the same citation stays visible for 36 months — and a 5-year history of driver violations is available to motor carriers performing a hire review. If the citation is later dismissed in court (DataQs challenge succeeds, or the underlying ticket is dropped), the SMS record can be removed via FMCSA's DataQs portal — but you have to actively file the challenge.

Can I fight a 391.41A citation?

Yes, and you should consider it. FMCSA's DataQs system at dataqs.fmcsa.dot.gov lets carriers (and drivers) challenge any inspection violation. The two strongest grounds are: (1) the underlying state citation was dismissed or reduced in court — submit court paperwork as evidence; (2) the inspector applied the wrong code — for example, citing 391.41A when the correct citation is a different code with lower severity. DataQs has roughly a 35-40% reversal rate when carriers submit clean court documentation. The catch: you have to file within 24 months of the inspection, and the inspector's narrative usually wins ties. Because this is an OOS-eligible violation, the SMS impact is significant — even a successful DataQs reversal is worth it. Budget 2-4 hours per challenge plus any legal cost.

Does 391.41A show on PSP (Pre-Employment Screening)?

Yes. 391.41A is a driver-side violation, so it appears on the driver's PSP (Pre-Employment Screening Program) report and stays visible for 36 months. Carriers performing hire reviews can see it, and many use it to filter applicants — particularly for over-the-road and hazmat positions. If the driver fights the citation in court and wins, the PSP record can be updated via FMCSA's DataQs portal. If they plead guilty (even to a reduced charge), it stays on PSP. Bottom line: this citation matters for the driver's next job, not just for the carrier's CSA. Drivers should fight any moving violation that risks employment.

What's the difference between 391.41A and similar codes?

391.41A is in the 8-code group sharing the same BASIC. The closest siblings are: 383.51 (Driving while CDL disqualified); 383.71 (Operating with falsified CDL application); 383.23A2 (Operating CMV without CDL). Inspectors often cite multiple sibling codes from the same inspection — for example, a tire condition violation can simultaneously trigger codes for tread depth, sidewall, and inflation pressure. When you get cited under one sibling, check the report for the others before signing — they all count separately against CSA scoring.

How do I prevent 391.41A from getting cited again?

CSA scores rising? Get a compliance audit.

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391.41A — Driver lacking required medical certificate

What this violation means

Related

Frequently Asked Questions

CSA scores rising? Get a compliance audit.

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