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  4. Medical & Fitness Requirements

Periodic Review with Medical Review Services (MRS)

Skip to main content
  • Medical & Fitness Requirements
    • Medical Review Process
    • Medical Review of Drivers
    • Appeals Process
    • Why am I on Review Plus Possible Outcomes
    • Medical Policies
    • Vision Requirements Overview
    • Vehicle Sun-Shading Medical Authorization
    • Bioptic Telescopic Lens Wearers
    • Conditions of Variance for CDL Driver to Haul Hazardous Materials
    • DMV Cognitive Impairment Policy
    • DMV Pain Management Policy
    • DMV Policy for Adaptive Equipment and Certified Driving Rehabilitation Specialist Referrals
    • DMV Policy for Drivers Experiencing a Crash Due to a Pedal Application Error
    • DMV Policy for Drivers with Heart-Assist Device
    • DMV Policy for Drivers with Psychiatric Disorders
    • DMV Policy for Drivers with Respiratory Conditions Requiring Supplemental Oxygen and/or Sleep Disorders
    • DMV Diabetes Policy
    • DMV Seizure/Blackout Policy
    • DMV Substance Abuse Policy
    • DMV Transient Ischemic Attack and/or Cerebral Vascular Accident Policy
    • DMV Vaso-Vagal Syncope Policy
    • DMV Visual Field Policy
    • Driving Under the Influence of Prescription Medications
    • Interpreting Letters / Instructions from the Medical Review Services (MRS) Team
    • Medical Advisory Board
    • Periodic Review with Medical Review Services (MRS)
    • Report an Impaired Driver
    • Suspension Date Approaching / Past

How do customers go on periodic review?

After a customer is referred to Medical Review Services (MRS), depending on the information provided, a customer medical report, customer vision report or both may be required.

Once the customer attends a medical appointment with their provider, the provider will submit the required documentation to MRS.

A trained evaluator on the MRS team reviews this documentation, pursuant to policies established in consultation with DMV's Medical Advisory Board, or the Code of Virginia, which may require the customer to enter Periodic Review. Some considerations may be, but are not limited to a customer's:

  • Medical Condition(s)
  • Instability/ Decline of a Medical Condition(s)
  • Medical Event(s) and/or
  • Usage (even temporary) of a medication(s).

What does it mean once I am on periodic review with Medical?

Being on Medical Review does not mean your driving privileges will be permanently restricted or suspended. For the standard driver on Periodic Review, you will receive additional letters from the Medical Review team with reminders to submit updated medical information to DMV. This will require some coordination on your end, since an "updated" report will require you to re-visit your doctor. 

See the timeline below for the recommended steps based on the receipt of different DMV Notices:

Periodic Review with Medical Review Services (MRS)

At this point in the Medical Review process, you have already:

  • Received an initial request for a MED 2/ MED 4
  • Attended an appointment with your provider, where you passed along all correspondence from MRS to date and a completed customer page of your MED 2/ MED 4

...And the following actions have occurred:

  • Your provider completed your MED 2/ MED 4 and submitted your report(s) to MRS
  • MRS received your report and completed your review
  • MRS sent you a letter placing you on periodic review

This should be the first letter you receive as it relates to Periodic Review. Your driving privileges are tied to your compliance with periodic review. At this stage, we recommend scheduling your next appointment 2 months prior to your next review date. For example, if your next report is due March 15, 2025, you would schedule the appointment with your provider for January 15, 2025 (or as close to that date as possible).

The next letter, the MDRL (Medical Reminder Letter) automatically generates 60 days before your next periodic review. At this point, DMV recommends scheduling an appointment as soon as possible, so your provider has time to complete an updated report and MRS has time to process it. Delays in receiving completed reports can cause unnecessary lapses in driving status, although MRS makes every effort to avoid this.

If DMV does not receive your MED 2/ MED 4 prior to your suspension date, you will receive another reminder letter (MD03) that grants additional time for you to provide your MED 2/ MED 4. If you receive this letter, that means your medical report was due and you are now at risk of your driver's license being suspended. At this point, DMV recommends you secure an appointment as soon as possible. After the deadline passes on this final letter, your driver's license will be suspended. DMV will not send a suspension notice.

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