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DOL Form WH-515: MSPA Doctor's Certificate

Anyone who drives migrant or seasonal agricultural workers under the Migrant and Seasonal Agricultural Worker Protection Act needs a doctor's certificate showing they meet the physical standards in 49 CFR 398.3(b). The doctor examines the driver and certifies them qualified, or qualified only when wearing glasses, and keeps a completed examination on file.

Who completes it

A licensed doctor of medicine or osteopathy completes the page 1 certificate with the finding, date, place, name, signature and address. The driver signs and adds their address.

Submitting and payment

How to submit it
Return the form to the patient, not to the Department of Labor. The driver copies it for the employer and themselves and submits the original with the Farm Labor Contractor application, Form WH-530.
Who pays
The form lists no fee.

Good to know

  • Standards include no loss of foot, leg, hand or arm, no disease or limitation likely to interfere with safe driving, and no addiction to narcotics or excessive alcohol use.
  • Eyesight: 20/40 Snellen in each eye with or without glasses, a 140 degree horizontal field, and red, green and yellow color recognition; hearing at least 10/20 in the better ear unaided.
  • Drivers must carry the certificate or a legible copy whenever transporting covered workers; without it they aren't authorized at that time and civil money penalties can apply.
  • The form is approved under OMB 1235-0016, expiring 8/31/2027, and the current edition is printed as Rev. xx/15.

Get the official form

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

Doctor's Certificate

Official pagePDF

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.

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Frequently asked questions

Who can sign the WH-515 Doctor's Certificate?

A licensed doctor of medicine or osteopathy. The driver brings the form, the doctor reads the standards on page 2, examines the driver and fills in the certificate, marking qualified or qualified only when wearing glasses. The doctor keeps a completed examination on file in the office.

Where does the completed WH-515 go?

Back to the patient. The form says not to send it to the Wage and Hour Division. The driver keeps a copy, gives one to the employer, and submits the original with the Farm Labor Contractor or Farm Labor Contractor Employee application, Form WH-530.