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 may be medically certified to drive for a two-year period.
First time BP elevated:
Stage 1:
A driver with a BP of 140 – 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. 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 BP’s 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. 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”.
Please read through some of the questions and answers posted below. This will help everyone to not have duplicate questions. Thank you!
If you still can’t find a related answer, then you are welcome to ask your question in the comments section below.
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I had a BP reading of 165/102 and was given a 3 month card. I was referred to a cardiologist and 2 days later my BP was still high (146/91) but not as high as at my DOT exam. Since then I have lost 15 lbs, and started walking. My blood pressure has improved, but if it is still high (146/91) can I be given another 3 month card until I can get it to the less than or equal to requirement of 140/90?
@Scott
That falls into the examiner’s realm and he may or may not.
But a blood pressure in the 140’s/90’s range should allow you a one year card, unless you are already on high blood pressure meds. If you are on meds then the answer is usually no, until you get it under control.
Hi,
I went to the doctor to have a physical done for a new driving job. My blood pressure was a little up, but still would qualify me for a 1 year card. He looked at my history (this is MedExpress, NOT my family doctor) and found I was there back in September of 2013. I was sick as a dog, and felt as though i got hit by a truck… My blood pressure was obviously higher at that point because I was sick. That visit in September of 2013 was NOT for a DOT physical. Soon afterwards, I went to my family doctor and was put on Lisinopril, and then in November of 2013, I passed a DOT Physical for work, and was granted a one year card.
The new job requires me to have a new physical, and he didn’t even take that prior DOT (after the sick visit) physical under consideration in the least, and instead used that sick visit to not issue me a card. I do not believe that is correct, since I am on medication and it IS in fact controlled, even though he says it is running wild. I do not think he has any idea what he is doing…
I took several readings today, and these were the numbers…I used a Home machine, which gave pretty much the same readings I got at the my doctors yesterday. She also felt he should have issued a 1 year card because it is controlled
8/19/2014
1PM – 138/76 pulse 80
7pm – 131/82 pulse 78
I feel he should have issued me a 1 year card. Am I correct?
What would you suggest?
@Shawn
If the information you have provided is true, then you should have received a one year medical card.
Have your primary doctor complete a medical release form for you and take it back to the examiner and get your card. Good Luck.
My initial BP that the Doctor wrote on my 649-F form was 144/94, after 3 seperate tests over a 3 week period my average was about 130/85. He would only issue me a 3 month certificate. Why cant he issue a 1 year cert. On the form649-F Item 5. it states for “Recerification” one time cert for 3 months, but in the definitions 391.41(b)(6) it indicates that a 1 year cert should be issued ? What is the difference ?
@CM Liston
You are correct. If the examiner has a multiple reading of 140/90 and below, then he should issue a one year card.
If you are recently on blood pressure medication, he may want to monitor for the three months first, before issuing a card for the remaining nine months.
My BP was 140/95 and I was issued a 3 month card well above what it normally is can I ever go back to a two year card if I can get it under control with diet and exercise or am I stuck going every year?
@Adam
If you get it under control without meds, and you can demonstrate over time that it’s under control, then yes you can go back to a 2-year card.
But please be aware that this is usually a progressive condition and your examiner may want to keep an eye on you for a while.
That’s the best way to go – to get a health challenge under control. Good plan. Good luck.
I WAS DENIED A MEDICAL CARD BECAUSE MY BP WAS 150/100.. DOT REGULATION SAY THAT I CAN GET A 3 MONTH CARD BUT THE DOCTOR DENIED ME ANYWAY. WHAT CAN I DO OR WHO DO I CALL TO REPORT THIS FAULTY ACTION AGAINST ME?
@Herman
More questions than answers, on this one.
A BP of 150/100 with no history of high blood pressure, is three months to get it under control, the first time.
BP of 150/100 and on BP meds, a one-time three month card to get it below 140/90.
150/100 and on BP meds and not under control, no card until below 140/90.
Now if you feel that you have been wrongly denied, then check with FMCSA and find the conflict resolution committee on the FMCSA website. Good Luck.
I have been a driver for years, I take B/P Medicine and it is controlled and falls under the guidelines, also I’m a Type 2 Diabetic and take meds., to control along with diet. My question is the DOT Doctor gave me a 6 month DOT card saying I have to bring into him a 6 month log of daily checks of both B/P and Sugar. Both are controlled and fall under the guidelines, so is this legal for them to ask for 6 month logs when I go every 3 months to my own Physician for Bloodwork and gave DOT my numbers from my last test which showed under control? I truly feel this is not right, when he has seen its under control. Your response will be very appreciated on these issues.
@Dave
The examiner may have the right, but it’s overkill.
I would get a medical release form filled out by your primary healthcare provider and take it to the DOT examiner. That release lets the DOT doctor know that you follow your primary’s instructions and that there is no need for you to keep this log.
I had a light stroke May 25, 2013 my neurologist has giving me the ok to go back to work. I pass the physical. Do I qualify for a new medical card under the new DOT policy ?
@Tony
As long as you are passed the one year waiting period and your neurologist understands what you will be doing as an OTR driver, then you should have no problems.
Make sure you get a letter from your primary healthcare provider indicating he understands your type of work and what, if any, restriction / limitations you have. The better information you can provide the DOT examiner, the better off you are.
i just flunked a DOT medical exam for a pre hire out of state although i have a current valid Dot card good for 20 more months from my home state.. this is the only part of the exam i failed….will the dot find out i flunked a pre hire exam and render my current 2 year card thats 4 months old invalid?
@Mike
You did not specify what part of the DOT examination you failed and the details of the condition that failed you.
I am also not sure why you would have had to have a new medical card if the one you have now is still very valid.
So fill me on on what is going on and I will try to answer any of your questions.