Connecticut P-142SPE: SPE Orthopedic Medical Report

Connecticut intrastate commercial drivers with a limb impairment or amputation who seek a Skill Performance Evaluation waiver need this orthopedic report. The specialist examines the applicant against the job duties the applicant describes and assesses muscle strength, mobility, joint and trunk stability, power grasp and prehension, any prosthesis or orthosis, and whether the condition will stay medically stable over the applicant's lifetime.

Who completes it

The applicant completes Parts I and II, giving contact details, vehicle type, job duties, environmental factors, physical demands and a sworn certification. Part III must be completed by a board-certified or board-qualified orthopedic surgeon or physiatrist only.

Submitting and payment

How to submit it
All parts are submitted to DMV Driver Services by email or mail with the R-314 Intrastate Medical Waiver Application. Incomplete forms are returned.
Who pays
The form lists no fee.

Good to know

  • It applies only to intrastate driving, meaning the commercial vehicle operates only within Connecticut's boundaries.
  • The examination must be personal and within the past 90 days; it is the exam required by section 391.49 of the Federal Motor Carrier Safety Regulations.
  • Explain every NO answer to questions 3 through 7 in full detail, with attachments if needed.
  • Item 11 lists the vehicle types the applicant can operate and any modifications; item 12 sets periodic medical reporting intervals if needed.

Get the official form

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

SPE Orthopedic Medical Report

Fill it with Vero

If your copy of the form is a fillable PDF, upload it once and Vero Documents fills it from the visit note and the chart, ready for you to review and sign. Download, print, or email the finished form, with the patient’s consent.

How this list is checked

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.

Vero is not affiliated with, or endorsed by, the agencies and insurers listed here. Read our editorial policy.

Frequently asked questions

Who can complete Part III of the Connecticut P-142SPE?

Only a board-certified or board-qualified orthopedic surgeon or physiatrist. The physician certifies having reviewed Parts I and II and completed Part III under penalty of false statement, and checks whether they are a physiatrist or orthopedic surgeon and board certified or qualified.

What does the specialist assess on the SPE orthopedic report?

Whether the applicant has adequate strength, mobility, joint and trunk stability, and power grasp and prehension for the job tasks in Part II. For limb impairment, whether the condition will remain medically stable for life; for upper limb loss, whether each limb can manage knobs, switches and the steering wheel.