DOT/FMCSA regulations apply only to interstate drivers - drivers who transport goods and materials from one state to another, who pass through another state even if goods and materials are transported to and from destinations within a state, or who transport goods and materials that originated in a state different from their destination state (e.g., UPS, FedEx, and DHL drivers.)
Drivers who do not meet the definition for interstate drivers may be eligible for intrastate only driving. Each state has its own standards for intrastate drivers, and drivers must apply to their state Department of Motor Vehicles (DMV) to obtain authorization to drive commercially within the state. When a driver does not meet DOT/FMCSA interstate driving standards, but meets a given state's intrastate standards, the designation "Intrastate only" should be indicated on the Medical Examiner's Certificate and on the Medical Examination Report.
If a driver requires a waiver or exemption to be an intrastate driver, this should be indicated on the Medical Examiner's Certificate and the Medical Examination Report (just as it would be for an interstate driver.)