Do you need a Medical Card to drive a truck with trailer under 26000 pounds?

Any commercial use vehicle or combination with a Gross Vehicle Weight Rating or Gross Combination Weight Rating in excess of 10,000 lbs. requires a DOT medical card for interstate operations. Intrastate operations tends to be a little bit of a grey area, although some state laws clearly require it.

If the Gross Combination Weight Rating (combined GVWRs of both power unit and trailer) exceeds 26,000 lbs., and this is a commercial use vehicle, then it will require a CDL (Class A if the trailer has a GVWR in excess of 10,000 lbs., Class B if the trailer has a GVWR of 10,000 lbs. or less), and thus a medical card will be required.