For the purpose of complying with the new requirements for medical certification, it is important to know how you are using the CMV. To help you decide, follow these steps: Step 1: Do you, or will you, use a CDL to operate a CMV in interstate or intrastate commerce? Interstate commerce is when you drive a CMV: - From one State to another State or a foreign country;
- Between two places within a State, but during part of the trip, the CMV crosses into another State or foreign country; or
- Between two places within a State, but the cargo is part of a trip that began or will end in another State or foreign country.
Intrastate commerce is when you drive a CMV within a State and you do not meet any of the descriptions above for interstate commerce. If you operate in both intrastate commerce and interstate commerce, you must choose interstate commerce. Step 2: Once you decide you operate or will operate in interstate commerce or intrastate commerce, you must decide whether you operate (or expect to operate) in a non-excepted or excepted status. This decision will tell you to which of the four types of commerce you must self-certify. Interstate Commerce: You operate in excepted interstate commerce when you drive a CMV in interstate commerce only for the following excepted activities: - To transport school children and/or school staff between home and school;
- As Federal, State or local government employees;
- To transport human corpses or sick or injured persons;
- Fire truck or rescue vehicle drivers during emergencies and other related activities;
- Primarily in the transportation of propane winter heating fuel when responding to an emergency condition requiring immediate response such as damage to a propane gas system after a storm or flooding;
- In Response to a pipeline emergency condition requiring immediate response such as a pipeline leak or rupture;
- In custom harvesting on a farm or to transport farm machinery and supplies used in the custom harvesting operation to and from a farm or to transport custom harvested crops to storage or market;
- Beekeeper in the seasonal transportation of bees;
- Controlled and operated by a farmer, but is not a combination vehicle (power unit and towed unit), and is used to transport agricultural products, farm machinery or farm supplies (no placardable hazardous materials) to and from a farm and within 150 air-miles of the farm;
- As a private motor carrier of passengers for non-business purposes ; or
- To transport migrant workers.
If you answered yes to one or more of the above activities as the only operation in which you drive, you operate in excepted interstate commerce and do not need a Federal medical examiner’s certificate. If you answered no to all of the above activities, you operate in non-excepted interstate commerce and are required to provide a current medical examiner’s certificate (49 CFR 391.45),commonly referred to as a medical certificate or DOT card, to your SDLA. Most CDL holders who drive CMVs in interstate commerce are non-excepted interstate commerce drivers. If you operate in both excepted interstate commerce and non-excepted interstate commerce, you must choose non-excepted interstate commerce to be qualified to operate in both types of interstate commerce. Intrastate Commerce: You operate in excepted Intrastate commerce when you drive a CMV only in intrastate commerce activities for which your State of licensure has determined do not require you to meet the State’s medical certification requirements. You operate in non-excepted intrastate commerce when you drive a CMV only in intrastate commerce and are required to meet your State of licensure’s medical certification requirements. If you operate in both excepted intrastate commerce and non-excepted intrastate commerce, you must choose non-excepted intrastate commerce. Step 3: Provide your SDLA with your self-certification of your operating status. If you self-certify to non-excepted interstate on or after January 30, 2012, you must provide your SDLA with either the original or copy of your current medical examiner’s certificate as required by your SDLA. If your medical examiner’s certificate is only valid with a vision, diabetes or a skills performance evaluation variance granted by FMCSA, you may also be asked by your SDLA to provide a copy of that variance document. 
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