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New Hampshire DSMV 558: CDL Physical Deficiency Waiver

Commercial drivers who operate only within New Hampshire, carry no hazardous materials and cannot meet the federal medical standards can apply on DSMV 558 for a state waiver under RSA 266:72-a, III. The seven-page application, filed jointly with the employer, needs a licensed physician's Medical Evaluation Summary. The Commissioner decides, and a waiver lasts up to two years.

Who completes it

The driver and the employer or motor carrier complete the application and the employment and driving history. A licensed physician completes and signs the Medical Evaluation Summary on page 7, using the driver's description of the job tasks.

Submitting and payment

How to submit it
The driver sends the application with all supporting documents to the DMV Director's Office. The Director reviews it and the Commissioner decides, notifying the applicant in writing.

Good to know

  • Under Saf-C 909.07, the summary covers functional capabilities for commercial driving tasks, how the impairment interferes, any prosthetic device, a recommended waiver period, and whether the condition will stay medically stable.
  • Attach the 49 CFR 391.43 medical examination results and medical certificate, plus driving records for the past 3 years and at-fault accident reports for 10 years.
  • The waiver covers only the vehicle types it names and must be carried on duty. Renewal can start 60 days before expiration, and it is valid in New Hampshire only.
  • The physician, driver and employer sign under penalty of unsworn falsification (RSA 641:3), and false information is cause to deny or revoke the waiver. Rev 06/23.

Get the official form

Download the current version from the source each time; forms change without notice.

Application for Waiver of Physical Deficiency

Official pagePDF

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A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms and their requirements change without notice, so check the official page for the current version before you complete one.

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Frequently asked questions

Who completes the medical part of New Hampshire's CDL waiver?

A licensed physician completes the Medical Evaluation Summary on page 7 of DSMV 558, as Saf-C 909.07 requires, using the driver's description of the job tasks. The summary goes with the federal medical examination report and medical certificate, and the driver and employer complete the rest of the application.

Does the New Hampshire physical deficiency waiver allow hazmat or interstate driving?

No. RSA 266:72-a, III lets the Commissioner waive medical standards only for drivers who operate exclusively in intrastate commerce and do not carry hazardous materials, when public safety is not jeopardized. The form calls it a New Hampshire only medical waiver, valid for up to two years.

What happens if a DSMV 558 waiver is denied?

The applicant may petition the Department of Safety's Bureau of Hearings in writing for a review of the application and the denial, giving their name, address and date of birth. Approved waivers carry whatever terms, conditions and limitations the Commissioner sets.