DS 524 Form – The DS 524 Form (full title: Employer’s Report of Medical Exam Failure / Employer Request for Reexamination of Driver) is a mandatory California DMV document used by employers of commercial drivers. It ensures public safety by reporting drivers who fail required medical examinations. This article provides everything you need to know about the DS 524 PDF, including its purpose, who must use it, step-by-step instructions, and the official download link.
What Is the DS 524 Form?
The DS 524 Form is an official one-page California DMV document titled Employer’s Report of Medical Exam Failure / Employer Request for Reexamination of Driver (revision DS 524 R5, 5/2016). Employers use it to notify the DMV when a commercial Class A or Class B driver fails to qualify for a medical certificate during reexamination.
It also serves as a voluntary tool for employers to request DMV reexamination of any driver (commercial or non-commercial) whose physical or mental condition may impair safe vehicle operation. The form is required under California Vehicle Code (CVC) §14606(b) for medical exam failures and may reference CVC §13800 for reexamination requests.
Why Employers Must Use the DS 524 Form for Commercial Drivers
California law mandates that employers of commercial drivers (Class A or B licenses) report medical exam failures immediately. This applies to drivers required to maintain a valid Medical Examiner’s Certificate (MEC) for operating commercial motor vehicles.
Failing to report can result in compliance issues, especially for companies enrolled in the Employer Pull Notice (EPN) program. The DMV reviews the report, the driver’s record, and any attached medical documentation to decide on reexamination, restrictions, or revocation of driving privileges if an immediate safety hazard exists (per CVC §13953).
This process protects the public by ensuring only medically qualified drivers operate large vehicles, buses, or hazardous material transports.
Who Needs the DS 524 Employer Report of Medical Exam Failure?
- Commercial motor carrier employers (trucking companies, bus operators, etc.) with drivers holding California Class A or B licenses.
- Employers participating in the DMV’s Employer Pull Notice program.
- Any employer who becomes aware that a driver no longer meets federal or state medical standards for commercial driving.
- Employers concerned about a driver’s condition (e.g., vision, hearing, neurological issues, or behavior affecting safety) who want to request a formal DMV reexamination.
Note: Individual drivers do not file this form — only employers do.
How to Complete the DS 524 Form Step by Step?
The DS 524 is straightforward and requires basic driver and employer information. Complete it if known and attach supporting documents such as the failed medical evaluation.
Key fields include:
- Driver Information: Full name, birth date, license/ID number, class of license, state issuing license, phone, and address.
- Physician Information: Name of examining physician, medical number, phone, exam date, and address.
- Employer Information: Employer name/title, company name and address, phone.
- Reexamination Request (optional section): Briefly describe the driver’s condition or behavior that raises safety concerns (for CVC §13800 requests).
Tips for accuracy:
- Print clearly or type the form.
- Attach a copy of the medical evaluation or other pertinent records.
- Sign and date as the employer representative.
Official DS 524 PDF Download and Submission Instructions
Direct official download (current version):
Download DS 524 Form PDF – Hosted directly on the California DMV website.
Submission address (no fax or email option listed):
Department of Motor Vehicles
Driver Safety Services Unit
P.O. Box 942890, M/S J234
Sacramento, CA 94290-9890
For questions or assistance completing the form, call the Driver Safety Services Unit at (916) 657-6452.
Processing typically leads to DMV review of the driver’s record and possible scheduling of a reexamination or immediate action if safety is at risk.
What Happens After DMV Receives Your DS 524 Form?
- DMV reviews the report and attached medical documents.
- The driver’s full record is analyzed for related violations, accidents, or prior issues.
- If warranted, the DMV may schedule a reexamination or revoke the commercial driving privilege without prior notice if an immediate hazard exists.
- The employer is generally not notified of the outcome unless they are the driver’s current employer under specific programs.
This process ensures rapid response to medical disqualifications while protecting driver due process.
Related California DMV Forms for Commercial Drivers
- Medical Examination Report (MCSA-5875) and Medical Examiner’s Certificate (MCSA-5876): Required for initial and renewal medical certification.
- DL 546 Health Questionnaire: Often submitted alongside DS 524 in some cases.
- Employer Pull Notice (EPN) enrollment forms: INF 1100 series for companies monitoring driver records.
All are available on the official DMV Commercial Driver License Medical Eligibility page.
Importance of Medical Certification for California CDL Drivers
Federal and state rules require commercial drivers to meet strict physical standards every two years (or more frequently if conditions warrant). Conditions like uncontrolled diabetes, vision below 20/40, or certain medications can disqualify a driver. The DS 524 Form acts as the enforcement link between medical examiners, employers, and the DMV.
Timely reporting prevents unsafe drivers from continuing operations and helps employers avoid liability.
Frequently Asked Questions About the DS 524 Form
Is the DS 524 form only for commercial drivers?
Primarily yes for mandatory reporting (Class A/B medical failures), but it can be used for any driver when requesting reexamination due to safety concerns.
Can I submit the form electronically?
No. Current instructions require mailing the completed paper form to the Sacramento address.
What if the driver gets a second opinion?
The employer must still report the initial failure. The driver may present new medical evidence during any DMV reexamination.
How current is the DS 524 form?
The version available (R5 2016) remains the official form as of 2026 with no newer revision posted on the DMV site.
Stay Compliant with California DMV Requirements
The DS 524 Form is a critical safety tool for California employers of commercial drivers. Always use the official PDF from the DMV website and submit promptly when a driver fails a required medical exam.
Bookmark the official download link and review your company’s medical certification monitoring procedures regularly. For the latest updates, visit the California DMV Commercial Driver License Medical Eligibility & Exams page.
Official DS 524 PDF Download: https://www.dmv.ca.gov/portal/uploads/2025/05/DS-524-R5-2016-ASB-WWW.pdf
By following this guide, employers can fulfill legal obligations efficiently while contributing to safer roads across California.