Questions & Answers
Canada/US Medical Reciprocity Agreement

August 6, 1999

1. When did the Canada/US Medical Reciprocity Agreement come into force?

   The Canada/US Medical Reciprocity Agreement came into force on March 30, 1999.

2. What is the purpose of the Canada/US Medical Reciprocity Agreement and what jurisdictions are parties to it?

   The purpose of the agreement is to recognize that Canadian and American medical standards are practically identical and to provide for reciprocal arrangements on medical fitness requirements for Canadian and American drivers of commercial vehicles.

   The agreement binds all Canadian provincial and territorial jurisdictions, including Ontario, and the United States (US).

3. What was the reason for the creation of the reciprocal agreement?

   The US Federal Code of Regulations had required all Canadian drivers wanting to drive commercial vehicles in the US to undergo a medical examination every two years conducted by a physician authorized by the US Federal Highway Administration. They then had to carry a "medical fitness card" while driving in the US as proof of medical fitness.

   Having determined that medical standards for commercial drivers were practically the same in both countries, the Canadian and US governments agreed that the solution to the problem was to finalize a reciprocal agreement on medical standards for drivers of commercial vehicles in both countries. The agreement eliminates the need for Canadian drivers to get two medicals and supports free trade. As of March 30^th, the two countries recognize the commercial driver's licence as proof of medical fitness to drive in both countries.

4. How does the reciprocal agreement benefit Canadian drivers of commercial vehicles?

   The reciprocal agreement eliminates the need for Canadian drivers to carry a "medical fitness card" while driving in the US. Consequently, the requirement to obtain and pay for a second medical examination by a physician authorized by the US Federal Highway Administration has also been eliminated. The elimination of these requirements will make it easier for Canadian drivers to comply with US standards.

5. Does the implementation of the reciprocal agreement mean that the medical standards in the Canada and the US will be the same for drivers of commercial vehicles?

   No. Both governments have recognized that the medical standards in both countries are similar and so signed the agreement. However, there will still be differences in medical standards for drivers of commercial vehicles in both countries. Before the agreement, Canadian drivers were not issued medical fitness cards and could not drive in the US if they were insulin-dependant diabetics, had monocular vision, were hearing impaired or were epileptic on anticonvulsive medication. Canadian drivers with these conditions can still be licensed to drive in Canada. However, as before the agreement, they will not be permitted to drive in the US if they have one of these medical conditions.

6. How will drivers, employers and enforcement agencies know whether or not a driver is eligible to drive in the US now that medical fitness cards are no longer required?

   Canada and the U.S. have agreed to develop a universal code that will indicate on the driver's licence and driving record that a driver is ineligible to drive in the US or Canada

   The universal code must be implemented on the licence and driving record by December 30, 2001. Ontario will begin identifying and coding commercial drivers (class A and D) as part of the normal three-year medical cycle at that time.

7. In the interim, until December 30, 2001, how will drivers, employers and enforcement agencies know whether or not a driver is eligible to drive in the US now that medical fitness cards are no longer required?

   The Ontario Ministry of Transportation (MTO) is working with the Canadian Council of Motor Transport Administrators (CCMTA) and other provincial jurisdictions to adopt a procedure for identifying Canadian drivers who are ineligible to drive in the US. In the mean time, MTO has asked its major stakeholders to communicate the terms of the agreement to their drivers.

8. What documentation will a Canadian driver be required to carry to verify that they meet the National Safety Code (NSC) medical standards for drivers?

   A Canadian Provincial driver's licence will serve as proof that the driver meets the NSC requirements.

9. If I have had a medical waiver issued by Ontario for a previous medical condition that meets NSC standards, am I eligible to drive a commercial vehicle in the US?

   Yes. Canadian drivers with an Ontario waiver (other than a waiver for one of the four excluded medical conditions) are eligible to drive in the US under the terms of the Reciprocal Agreement. All waivers issued by Ontario meet or exceed the National Safety Code (NSC) standards and therefore do not disqualify Canadian drivers from driving in the US.

   The issuance of an Ontario waiver is not indicated on the face of an Ontario driver's licence. The driver's licence constitutes sufficient proof of eligibility to drive in the US. It is not necessary for Canadian drivers with a valid commercial licence to divulge waiver information while driving in the US as additional proof of eligibility.

10. How has MTO informed stakeholders and drivers about the implementation and terms of the reciprocal agreement?

    MTO has written letters to all of its major stakeholders groups informing them of the implementation of the agreement and the terms within. These stakeholders include trucking and transportation associations, enforcement agencies, and medical associations.

    MTO has requested that each stakeholder ensure that their members are made aware of the agreement.

11. What efforts have been made in the US to communicate the implementation of the agreement to US personnel who deal with commercial driver and vehicle enforcement?

    The US Federal Highway Administration (FHWA) has undertaken a nationwide communication and training strategy to inform all US personnel involved with commercial driver and vehicle enforcement, including roadside and border crossing personnel, of the agreement. Special emphasis has been placed on communicating the fact that Canadian drivers no longer require a US medical fitness card to drive in the US.

12. What should a Canadian driver do if he/she is cited in the US for non-compliance for not having a medical fitness card, or stopped at the border, because an enforcement officer or customs official is not aware of the new reciprocal agreement?

    The FHWA, Transport Canada and the CCMTA have agreed upon a procedure to resolve any such occurrences after March 30, 1999.

    Should a Canadian driver be cited for being in non-compliance for not having a medical fitness card, or denied access at the border, the driver should record the following information:

    • Agency name/organization
    • Officer's name
    • Location
    • Date and time
    • Name of driver and company

    This information should be submitted as soon as possible to the carrier, who should then forward it to the Canadian Trucking Alliance (CTA). The CTA should then forward the information to the Director of Programs, CCMTA, 2323 St. Laurent Blvd., Ottawa, Ontario, K1G 4J8. The issue will then be resolved immediately with the FHWA.

13. What will happen to a Canadian driver who is caught driving in the US and is ineligible under the terms of the reciprocal agreement?

    Ineligible Canadian drivers caught driving a commercial vehicle in the US are liable to fines and/or imprisonment.