FMCSA Violation Code

391.45A — Operating without a medical exam (no Med Card on file)

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

Out-of-service eligible Driver citation CSA weight 5

OUT-OF-SERVICE eligible

Code

391.45A

CFR section

49 CFR 391

BASIC

Driver Fitness

Severity

5/10

Out-of-Service

Yes

Unit type

Driver

What this violation means

Sister rule to 391.41A — driver has no DOT medical exam on file at all (not just expired). Common with new-entrant carriers and brand-new drivers. 5 SMS points, OOS.

Why this gets cited

New drivers hired without proper qualification file. Carrier records were lost or never created. Driver got CDL without DOT physical (legal in some states for intrastate-only, but not for interstate).

How to fix / prevent

Driver Qualification File (DQ File) per 391.51 must include the original Med Card and the long form (CDL drivers don't get a long form, just the card). Build DQ checklist into hire packet.

Out-of-service criteria

Yes — this violation IS out-of-service eligible. When an inspector finds 391.45A 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

391.45A 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%).

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

391.41AOOS

Driver lacking required medical certificate

391.41B1OOS

Driver does not meet physical qualifications

391.45BOOS

Operating after Med Card expiration

Frequently Asked Questions

Can I be placed out of service for 391.45A?

Yes. 391.45A 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 391.45A affect my CSA score?

391.45A 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 391.45A 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 391.45A 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 391.45A show on PSP (Pre-Employment Screening)?

Yes. 391.45A 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 391.45A and similar codes?

391.45A 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 391.45A from getting cited again?

Driver Qualification File (DQ File) per 391.51 must include the original Med Card and the long form (CDL drivers don't get a long form, just the card). Build DQ checklist into hire packet.

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391.45A — Operating without a medical exam (no Med Card on file)

What this violation means

Related

Frequently Asked Questions

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