---
title: Medical variance
description: An FMCSA exemption or alternative standard on which a driver’s medical certification may rest.
date: 2026-10-20
lastReviewed: 2026-10-23
canonical: /glossary/medical-variance
---
A **medical variance** includes FMCSA exemption letters or SPE certificates referenced in [49 CFR 391.51(b)(6)(iii) and (b)(7)](https://www.ecfr.gov/current/title-49/section-391.51). Carriers file copies in the qualification file when certification depends on them.