In short
A medical report (ärztliches Gutachten) under § 11 (2) FeV (Driving Licence Regulation, Fahrerlaubnis-Verordnung; Abs. 2 = subsection 2) clarifies purely medical doubts about your fitness to drive, such as an illness, a dependence or the use of narcotics. An MPU (medical-psychological assessment, Medizinisch-Psychologische Untersuchung) under § 11 (3) FeV combines a medical examination, a performance test and a psychological interview, and additionally clarifies whether you have changed your behaviour in a stable way. For alcohol, for example: a suspicion of dependence first leads to a medical report (§ 13 No. 1 FeV), while 1.6 per mille or misuse leads to an MPU (§ 13 No. 2 FeV).
What is a medical report within the meaning of the FeV?
A medical report is an assessment by a doctor that the driving licence authority (Fahrerlaubnisbehörde) can order if facts give rise to concerns about your physical or mental fitness (§ 11 (2) FeV). This applies in particular to illnesses or deficiencies listed in Annexes 4 or 5 of the FeV.
In the order, the authority specifies who is to prepare the report. Under § 11 (2) sentence 3 FeV, the following are possible:
- a specialist responsible for the question, with a qualification in traffic medicine,
- a doctor at the public health office (Gesundheitsamt) or another doctor in public administration,
- a doctor with the specialist title occupational medicine or the additional title company medicine,
- a specialist in forensic medicine,
- a doctor at an assessment centre (Begutachtungsstelle für Fahreignung).
The specialist should not at the same time be your treating doctor. So a certificate from your GP does not replace a report that has been ordered.
What is the MPU in comparison?
The MPU is a medical-psychological expert report (Gutachten) from an officially recognised assessment centre (§ 11 (3) FeV). It always consists of three parts: a medical examination, a performance and reaction test, and a psychological interview. The assessment day takes about 3 to 4 hours.
The decisive difference lies in the psychological part. The MPU does not only ask whether your body is healthy, but whether you have understood a previous incident and changed your behaviour in a stable way. The page What is an MPU? explains exactly what happens.
How do the two reports differ at a glance?
Both reports answer a question put by the authority, but with a different focus:
| Feature | Medical report | MPU |
|---|---|---|
| Legal basis | § 11 (2) FeV | § 11 (3) FeV |
| Who prepares it | Doctor as specified by the authority (e.g. specialist with a qualification in traffic medicine) | Officially recognised assessment centre |
| Focus | Physical or mental fitness, illness, dependence, use | Additionally behaviour, attitude, change |
| Components | Medical examination, findings | Medical examination, performance test, psychological interview |
| Typical reasons | Illness, medication, suspected dependence or drug use | 1.6 ‰, repeated offences, criminal offences, points, clarification after withdrawal |
When does the authority order which report for alcohol?
For alcohol, § 13 FeV clearly distinguishes between the two reports. A medical report is ordered if facts give reason to assume alcohol dependence (§ 13 sentence 1 No. 1 FeV).
An MPU is ordered under § 13 sentence 1 No. 2 FeV if:
- the medical report finds no dependence, but signs of misuse, or other facts suggest misuse,
- offences under the influence of alcohol were committed repeatedly,
- a vehicle was driven with a blood alcohol concentration of 1.6 ‰ or breath alcohol of 0.8 mg/l or more,
- the driving licence was revoked for one of these reasons,
- it otherwise has to be clarified whether misuse or dependence no longer exists.
The medical report can therefore be the first step, followed by an MPU. You can read more about the blood alcohol limits on the page MPU because of alcohol.
When does the authority order which report for drugs and medication?
For narcotics and medicinal products, § 14 FeV sets out the order in a similar way. A medical report is ordered if facts give reason to assume dependence, the use of narcotics or the misuse of psychoactive medicinal products (§ 14 (1) FeV). Unlawful possession can also trigger a medical report.
An MPU has to be ordered under § 14 (2) FeV if the driving licence was revoked for one of these reasons, if it has to be clarified whether you are still dependent or are continuing to use, or if there have been repeated offences under § 24a StVG (Road Traffic Act, Straßenverkehrsgesetz). For cannabis, the separate provision § 13a FeV has applied since 2024.
What applies to illnesses?
For illnesses, the medical report is usually the main focus. Typical topics are diabetes, epilepsy, eyesight, cardiovascular diseases, mental disorders or long-term medication. A specialist's report is often used as evidence, as a rule no older than 3 months, with an explicit statement on fitness to drive.
If that is not sufficient, the authority can additionally require an MPU after evaluating the medical report (§ 11 (3) No. 1 FeV). Many illnesses can be treated well, and fitness to drive is then often retained, possibly with conditions or a time limit. The page Medical MPU explains the details.
For both reports, § 11 (6) and (8) FeV applies: the authority sets a deadline, and if you do not provide the report on time, you risk the authority concluding that you are unfit to drive. The guide File inspection at the driving licence authority shows how to prepare for the order.
What other types of report are there?
Besides the medical report and the MPU, § 11 FeV also provides for the report of an officially recognised expert or examiner for motor vehicle traffic (§ 11 (4) FeV). It can be ordered if it is additionally necessary after evaluating the other reports, or in the case of disabilities of the musculoskeletal system. The question then is whether you can drive the vehicle safely with the necessary technical aids.
Also important is § 11 (7) FeV: if the authority is already certain that you are unfit to drive, it does not order a report at all. A report is therefore always a tool for clarifying doubts, not a formality. That is why you should read the question in the order carefully, because this is exactly the question the report answers.
What you can do now
- Read the order carefully: does it refer to § 11 (2) (medical) or § 11 (3), or § 13, § 13a or § 14 FeV (MPU)?
- Note the question and the deadline and, if necessary, apply for file inspection (Akteneinsicht).
- For a medical report, commission the type of doctor specified by the authority, not simply your GP.
- If you have doubts about the order, ask a lawyer specialising in traffic law (Fachanwalt für Verkehrsrecht).
- For an MPU, start your preparation early: find suitable preparation.
Frequently asked questions
Can my GP write the medical report?
As a rule, no. In the order, the authority determines which type of doctor prepares the report, and the specialist should not at the same time be your treating doctor. However, findings from your GP can be helpful as supporting documents.
Is a medical report always followed by an MPU?
No, not automatically. An MPU is added if it is additionally necessary after evaluating the medical report, for example if no dependence on alcohol is found, but there are signs of misuse.
Can the assessment centre also prepare a purely medical report?
Yes, that is possible. § 11 (2) FeV explicitly also names a doctor at an assessment centre as a possible assessor. Which centre is eligible is stated in the authority's order.
Do I have to pay for a medical report myself?
Yes, under § 11 (6) FeV you undergo the examination at your own expense. The amount depends on the assessor and the scope; ask for a cost estimate in advance.
