FMCSA Grants an Epilepsy CDL Exemption to 39 Drivers in November 2026

On November 4, 2026, FMCSA published three notices in the Federal Register granting an epilepsy CDL exemption to 39 drivers. All of them take anti-seizure medication, and without the exemption none of them could drive a truck across state lines. Now they can. The notices are short and full of docket numbers, so here is what they mean for a driver who has had a seizure and wants to keep or start a trucking career.

Three notices covered three groups of applicants

FMCSA handles seizure exemptions in batches. Each batch gets its own docket, a notice asking for public comments, and then a second notice with the decision. The three decisions published on November 4 close batches that were first announced in May and June 2026.

Look at the dates. The exemptions took effect in July, about four months before the Federal Register notices came out. The drivers were told in writing when FMCSA decided, so they could go to work long before the public record caught up. Every one of the 39 had kept the same medication plan for the last two years, and in each case the treating physician confirmed the seizure history and supported commercial driving. The one public comment, in the largest docket, backed a single applicant.

Why a seizure history stops a medical card in the first place

The physical standard is one line long. To drive a commercial vehicle in interstate commerce, a person must have no established medical history or clinical diagnosis of epilepsy or of any other condition likely to cause loss of consciousness or loss of control of the vehicle. That is 49 CFR 391.41(b)(8). Medication that controls the seizures does not satisfy it on its own, because the rule looks at the diagnosis, not at how well it is treated.

Appendix A to part 391 tells medical examiners how to apply it, and the advice is strict. A driver with a history of epilepsy can be certified only after being off anti-seizure medication and seizure-free for 10 years or more. Anyone with a current epilepsy diagnosis, or anyone taking medication to prevent seizures, is not physically qualified. A single unprovoked seizure that was not epileptic needs 5 years off medication without another one.

Read that twice if your medication works. Your neurologist may say you have been stable for a decade, and the examiner at the clinic still can't sign your card. The appendix gives the examiner one more option: refer you to FMCSA for evaluation under the federal seizure exemption. That referral is the door the 39 drivers walked through. If you are new to the DOT physical, our guide to DOT physical exam requirements covers the rest of the standards.

What FMCSA looks for before it grants the exemption

The program started on January 15, 2013 (78 FR 3069). Since then FMCSA has published its criteria in the application letter it sends to drivers, and they depend on what kind of seizure you had.

• Epilepsy or a seizure disorder: 8 years seizure-free, on or off medication. If you stopped the medication, the 8 years count from the day you stopped.
• A single unprovoked seizure, with no known trigger: 4 years seizure-free, on or off medication.
• A single provoked seizure with low risk of coming back, such as one caused by a medication, alcohol withdrawal or a brief head injury with loss of consciousness of 30 minutes or less: judged case by case.
• A provoked seizure with moderate to high risk, such as one after a stroke, a brain tumor or a penetrating head injury: 8 years seizure-free.
• On medication: the plan must be stable for 2 years, which FMCSA defines as no change in drug, dosage or how often you take it.

These are guidelines, and the November notices show FMCSA applying them to each person. The 16-driver batch included applicants seizure-free for as little as one year, which fits the shorter path for a provoked, low-risk seizure. FMCSA also pulls your certified driving record from the state. A crash on it means the agency asks for the police report and the citation before it decides.

How to apply, step by step

There is no online form. The application is a packet. FMCSA's instructions ask for a signed statement from you with your name and contact details and a line saying you intend to drive in interstate commerce. Add a statement from your treating physician on letterhead that describes your seizure history, your medication and your stability. Then get your driving record from your state licensing agency. The doctor's letter and the driving record must both be dated within three months of the day you apply.

You send the packet to the FMCSA Medical Programs Division by email, mail or fax. One method only. Duplicate packets slow the file down. The email address on the current instructions is FMCSAseizureexemptions@dot.gov.

FMCSA then publishes your name, state and a summary of your seizure history in the Federal Register and gives the public 30 days to comment. It takes months. In the November batches, notices of the applications came out on May 28 and June 22, and the exemptions applied from July. Plan around that if you are leaving CDL school or coming back to the road after a break, a situation we walk through in getting back into trucking.

The rules you live by for two years

An exemption is a set of conditions. Break one and FMCSA can revoke it. FMCSA issues medical exemptions for two years to match the medical certificate. During that time each driver must:

1. Stay seizure-free on a stable treatment and report to FMCSA within 24 hours if a seizure happens or the treatment changes.
2. Send FMCSA a yearly report from the treating physician confirming stable treatment and no seizures.
3. Pass a DOT physical every year with a certified medical examiner.
4. Give a copy of each medical certificate to the employer for the driver qualification file.
5. Report any crash to FMCSA within 7 days, along with any citation or conviction for a disqualifying offense.
6. Send FMCSA a certified state driving record every year.
7. Carry a copy of the exemption in the truck and show it to an officer on request.

The yearly physical means one more appointment to fit into home time, and with a 4+1 schedule it is easy to book months ahead. Since June 23, 2025, the examiner sends each result electronically to FMCSA, which passes it to your state, and the temporary paper card stopped counting after October 11, 2026. Exemption holders follow the same process. Check that your state record shows the new date after each exam, as explained in paper medical card after the NRII change. A missed annual report is the most common way to lose a clean exemption, so put the date in your phone the day the letter arrives.

Interstate only, and the state still has its own rules

The federal exemption lifts 391.41(b)(8) for interstate driving. While it is in effect, the notices say no state may enforce a law that conflicts with it for the person who holds it. That protects you on an OTR run across ten states. It does not change the rules a state applies to a driver who stays inside its borders, and intrastate standards for seizures vary from state to state. Check with your state licensing agency before you count on intrastate work.

The exemption also does not replace the CDL tests. The notices say the driver must still meet every CDL testing requirement, and the usual disqualifications still apply. A conviction listed in our article on CDL disqualification has to be reported to FMCSA within 7 days on top of everything else.

What to tell a carrier when you apply

Tell the recruiter. The carrier has to keep your medical certificate in your qualification file, and with an exemption it also needs a copy of the exemption letter. Hiding the condition at the physical is the worst option. A seizure behind the wheel without a valid medical card puts your CDL, your health and other people on the road at risk, and lying on the medical history form is a separate federal violation.

ASTEL hires new drivers without experience, and the medical card rules are the same for everyone. If you have a seizure exemption, say so at the first call and send the letter with your application. During the run, reefer freight moves year-round and dispatch answers 24/7, so if you feel unwell on the road you call before you drive another mile. Our guide to getting sick on the road covers what happens next.

Frequently asked questions

Can you get a CDL if you have epilepsy?

For interstate driving, only with a federal seizure exemption from FMCSA or after 10 years seizure-free and off anti-seizure medication. A medical examiner cannot certify a driver who currently takes medication to prevent seizures.

How long do you have to be seizure-free to drive a truck?

Under FMCSA's exemption guidelines, 8 years for epilepsy and 4 years after a single unprovoked seizure, on or off medication, with 2 years on a stable medication plan. Without an exemption, a medical examiner needs 10 years off medication for epilepsy.

How many drivers did FMCSA exempt in November 2026?

39. Three notices published on November 4, 2026, exempted 11, 12 and 16 drivers. The exemptions took effect in July 2026 and expire in July 2028.

How do I apply for an FMCSA seizure exemption?

Send FMCSA's Medical Programs Division your signed statement, a letter from your treating physician on letterhead and your state driving record, with the letter and the record dated within three months. Use email, mail or fax, but only one of them. FMCSA publishes the request and takes public comments for 30 days before it decides.

Does a federal seizure exemption cover intrastate driving?

No. It covers interstate commerce. Drivers who stay inside one state follow that state's medical rules, which vary.

Sources: FMCSA, "Qualification of Drivers; Exemption Applications; Epilepsy and Seizure Disorders," notices of final disposition, 91 FR 69633 (docket FMCSA-2026-0039), 91 FR 69634 (FMCSA-2026-0041) and 91 FR 69638 (FMCSA-2026-0038), Federal Register, November 4, 2026; application notices 91 FR 31824 and 91 FR 31828 (May 28, 2026) and 91 FR 37222 (June 22, 2026); 78 FR 3069 (January 15, 2013); 49 CFR 391.41(b)(8) and Appendix A to part 391 (eCFR, November 2026); FMCSA Medical Programs Division, Federal Seizure Exemption application letter for new applicants (July 2024 version). FMCSA criteria and application addresses may change, so check the current instructions before you send anything. Current as of November 4, 2026. General information, not medical or legal advice.