FAQ – Blood Pressure DOT Guidelines
What are the blood pressure requirements to pass the DOT physical?
Can I get a DOT medical card if I have hypertension?
Can I pass the DOT physical if I’m on blood pressure medication?
What if I don’t normally have high blood pressure, but I have “white coat syndrome”?
What are the blood pressure requirements to pass the DOT physical?
Here are the medical guidelines according to the Federal Motor Carrier Safety Regulations (FMCSRs). Note that employers are allowed to impose more stringent medical requirements.
Normal Range:
A driver with a BP of less than 140 / 90 Â may be medically certified to drive for a two-year period.
First time BP elevated:
Stage 1:
A driver with a BP of 140 â 159 systolic and /or a BP of 90-99 diastolic, has stage 1 hypertension, and may be medically certified to drive for a one-year period. Certification examinations should be done annually thereafter and should be at or less than 140/90.
Stage 2:
A driver with a BP of 160-179 systolic and/or a BP of 100-109 diastolic, has stage 2 hypertension, and is a candidate for antihypertensive drug therapy. The driver is given a one-time certification of three months to reduce his or her blood pressure to less than or equal to 140/90. Provided treatment is well tolerated and the driver then demonstrates a BP value of 140/90 or less, he or she may be re-certified for one year from the date of the initial exam. The driver is certified annually thereafter.
Stage 3:
A driver with a BP at or greater than 180 systolic and / or 110 diastolic has stage 3 hypertension and is disqualified. The driver may not be qualified, even temporarily, until blood pressure is reduced to equal to or less than 140/90 and treatment is well tolerated. The driver may then be certified for 6 months and biannually (every 6 months) thereafter, if at recheck BP is equal to or less than 140/90.
Other Medical Conditions:
Drivers with Type 1 or Type 2 diabetes, or kidney disease require treatment if their blood pressure rises above 130/80, since they already have a high risk of heart disease.
Can I get a DOT medical card if I have hypertension?
The DOT blood pressure limit for you to get a medical card depends on your level of hypertension. You can get a limited medical card for first-time stage 1 or 2 hypertension. The hypertension stages and limits are laid out in the Q&A above which describes the FMCSA blood pressure requirements to pass a DOT physical. The medical examiner may require clearance from your treating physician before you can be considered for certification.
Can I pass the DOT physical if I’m on blood pressure medication?
Taking blood pressure medication will reduce your DOT medical certificate to one year. Your blood pressure must be controlled and be below 140 / 90 at the time of your DOT examination.
Help the CME to certify you: Bring a note from your treating physician that states that your condition is being treated and that the treatment has been shown to be effective, safe and your condition is stable. Â This information helps the medical examiner back up a decision to pass you on the DOT physical.
What if I don’t normally have high blood pressure, but I have “white coat syndrome”?
First off, we understand that this is a very real concern for some drivers. If you have “white coat syndrome”, tell the CME. Ask to have multiple BPâs taken. The examiner should be taking 2-3 readings anyhow, especially if you say so up front.
Look for certified medical examiners on this website. Â Each DOT Physical Doctor in our trusted network has a page describing their office and services. Find one who you would feel comfortable with. This should help reduce your “white coat syndrome”.
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Can i request that the DoT Doctor use a hand pump BP tester rather than electronic. I have never tested high till last week. He gave me a 3 month card and told me to come back after getting meds. I just completed and passed a 2 year Physical not even a month before. (starting better paying job). I requested to have it done with hand pump and they refused. To me it seems like he just wants to bring in more pay for another physical. The doctor did’ not even check it himself.
@ Michael
Go get a second opinion from somewhere else. Your request should have been honored.
BP and sleep Apnea..
Yesterday I went for my 2 year annual DOT physical which is to expire today. Anyway my mother passed 2 days prior and since then I’ve really haven’t slept and so emotiontally drained. When the nurse took my BP twice both times readings were high. I brought that up to nurse. I also brought that up to the Dr. about mothers passing, Dr. asked how my sleep was, and I mentioned I really havn’t been able to sleep since her passing. When Dr. handed me the paperwork he granted a 3 month medical card ext. and recommended I contact my primary for a sleep apnea screening and reevaluate my BP. I never had BP or Sleep issues under normal circumstances. I called DMV asked some questions. One was a Dr. 2nd opinion(taking another physical) DMV said that’s entirely up to me. Another one was, who sends the new updated Medical card to DMV the Dr. Office or me? DMV said I’m responsible to submit the new Medical card and DMV grants a 30 day extension before my CDL gets down graded. I can’t drive my truck, but it gives me some time for my spirits to get better before I retake another physical.
@ Jerry P
We are so sorry for your loss, it would be tough on anyone. Your 3 month card is an opportunity to get things straight again. Have your MD check for blood pressure issues. Sleep study screening, given the situation, we would have you hold on that one. Reporting your medical card to the DMV is your responsibility, some offices will do it for you, but confirm, don’t assume.
Take your 3 month card and go somewhere else next month.
That’s not too effective because if she goes somewhere else and has the same issue she will be wasting money.
@ Alisha
Not if the examiner understands the difference between FMCSA guidelines and the states variances. That’s the hard part. Too many of the CME’s think all drivers must comply with the FMCSA guidelines, when the state may have differing guidelines based on different drivers license class’s.
I received a three month med card because my blog sugar was high. Can I see a doctor get my diabetes under control and get a new med card or do I have to wait till my three month card expires?
@ Dustin T
Get your blood sugar under control and then retake the medical examination.
I have a question. I have a 2 year DOT from a Maryland doctor – for the company I work for. I know that I must have a physical every year living in Pennsylvania. My 1 year expires on 1-28-19…however, my actual DOT expires on 1-28-20. I went to the DOT Dr for my annual physical and was told the BP meds I was just placed on have not kicked in yet and he could not give me a DOT Card on this day.
My question is…How long until my “S” endoresement is downgraded and What can I do to get my “S” endorsement back?
Thank you,
Frustrated
@ Wanetha M
You will need to check with your local driver license department for the best answer.
If medical exspiration date is 11/10/19 does it exspire at 12 am on that or at 12 am on 11/11/19
@ Ken
12:01 a.m. 11/11/19
Went to a doc in the box for my dot they said my pressure way so high I could have a stroke and should go straight to the er and they didnt even do the rest of the physical they just disqualified me. Went straight to the er my pressure was 128/88 ekgs normal They recommended I go somewhere else. So I did my blood pressure was normal at that facility and they gave me a 2 year card never had high blood pressure before dont take any medication. Is this correct
@ Darin
Doc in a box said it all, $ $ $.
AS one of the doc in a box you are referring to, If we wanted $$$ why send to an ER, we would have passed and kept the patient happy…to come back again another time…
Offensive.
@ Lamanuel D
Not all box type facilities are on the $$ grab. Unfortunately, some of them are. The doctors do not perform the testing, or even get involved with the driver/patient. Staff do the examination and follow the doctors recommendations, whether it is correct or not. The DOT/ FMCSA guidelines were established for the big rig, over the road, long haul drivers and not the local drivers, or lesser class drivers license. It is important to keep in mind that our jobs are to present ourselves as professional medical providers, with understanding of the FMCSA guidelines and the states variances within our given state. If you felt the need for the driver to go to the ER, then you did the right thing.
Is there any recourse for getting disqualified by a CME who screwed up the BP test? A buddy of mine recently went to school for his CDL and was going to come work for me once he had gotten it and finished his time with the company he got it through, he has no history of high BP, never had white coat syndrome, and his doctor just checked his BP again(it was 120/80 which is what he normally gets except from the CME at the school) when he went in for a check up before going over the road, the CME at the school only gave him a 3 mo the card citing high blood pressure and the results he claimed were ridiculously high to the point that if they were the actual readings my buddy would have been in the middle of a heart attack to get his numbers that high. Is there anyway for him to get a 2 year card from someone else now or is he stuck since the first doc gave him a 3 month and said he needed blood pressure meds.
@ Jman
Go get a second opinion from another CME elsewhere
I have controlled blood pressure by blood pressure is normal every time I go to get my D.O.T done the doctor told me that if I get my sleep apnea test done and it comes back normal he will give me my 2 yrs d.o.t card.I went today for a physical and everything came back normal he only gave me 1 yr again. I would like to report this doctor because I believe he is singling me out this is not the first time I go to him he made me come back every 6 months since I started this job and I been here more than a year. I want to know how to go ahead and make a report on this doctor.
@ Samuel V
If your blood pressure is being controlled with a blood pressure medication, then the Dr. is only following the FMCSA guidelines. You can always ask the Dr. for an explanation of his decisions.
I ‘ve read that if your blood pressure is under 159 over 99 you have type 1 hypertension and you can pass with a 1 year cert. Is that true
@ Steve k
FMCSA, 120/80 for normal, can go to 140/90 for a one year card, if on blood pressure meds. 159/99 is not stage one hypertension.
So could he still get a one year certification if its over 140?
@ Donny
For a class A driver to pass the DOT/FMCSA medical his pressure reading must be 140/90 or lower. If the readings are high on the examination the CME can issue a ‘one time’ short medical card to allow the driver to get his pressure under control. After the one time short card, the driver must have a bp reading below 140/90. If it remains above those numbers then he will not qualify until he gets it down under the FMCSA requirements.