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 have a bp of 143/90 can I still pass and if so will I got a 3 month or a year
@ Antonio
DOT/FMCSA guidelines 140/90 or less. Blood pressure varies moment to moment, so work on being relaxed with some simple, easy, deep breathing and you should pass without any issues. Other wise you may get a 90 day card to get your bp under control. That 90 day card is a one time only card.
I went to renew my DOT but my pressure was too high. So that physician recommended I make an appointment that same day with my primary care doctor that day which I did. The receptionists also gave me paperwork stating that if I can show that I’m on medication that I can just bring the paper back with his signature and meds I’m taking but my primary doctor refuses to sign it until I get my pressure normal. I’ve lived with this issue since my early 20s. I’ve told him that also I get a little nervous when getting checked out. I’ve even been checking at home and it’s normal. Even wrote down every number. Can he go based on my word?
@ Louis
DOT/FMCSA regulations require you to be on your bp meds for at least thirty days and your blood pressure has to be 140/90 or less before he can issue a valid medical card. Once on the meds, your card will be limited to one year at the time. As far as taking your word for your bp readings, it would become very questionable and places the CME in a risky situation.
My blood pressure was 158 0ver 82, how come I only got 3 months on my card. I check the requirements and I should have given at least one year.
@ Raf R
Without all of the available information from your examination findings, it is difficult to answer your question. We suspect the examiner wants to monitor your blood pressure reading more frequently. It is up to the CME to determine the overall length of your medical card and he must take into consideration all possible risk factors.
Can any doctor do the BP recheck or does it needs to be the treating Dr.
@ Anne T
If you were given a short term medical certification (3 month) then the treating CME will need to do the recheck. If all comes out OK, then he can extend your medical cards expiration date. Or, you can get a new DOT/FMCSA medical examination and go from there.
Doc I had a TIA eight years ago and have been certified each year one year at a time in the past year my blood pressure has moved up just a little now running 146/90 if I get on pressure Meds will this give me a disqualification? Thanks for your help Jim
@ Jim
No. Blood pressure meds will need to be supported by your prescribing doctor with a medical release form. You will need to be on your meds for a few months before taking your next DOT medical certification examination.
Hey doctor i was just recently diagnosed with hypertension.. and placed on a combo bp meds……..when i check my readings at home im under 140/90….but im worried about white coat syndrome…..how many attempts do you get in a year to pass the dot test.
@ James D W
Your CME should work with you to overcome the white coat syndrome. They can take as many reading as they choose to in a single setting. Also, you may be able to use your doctors readings, if there are questions regarding your bp anxiety. That will be up to the CME to make those decisions.
I am apply for a Chauffeur license with the state of Michigan, do I need to have a medical certificate to apply for the test and or to have the license once I pass the written test.
@ Mike
This question will need to be answered by your local drivers license department.
I am a CME. I have a driver who I gave a 3 month certificate to in March for hypertension. On the recheck, his blood pressure was still quite elevated. I know I can’t give him another 3 month card. How does he get his medical card back at this point since he is now disqualified? I have read about “temporary disqualification” but I don’t see how to note that on the form.
@ Sarah V
Just perform a new DOT medical certification examination and if the BP is within normal limits, with or without meds, then he should be good to go. You may choose to issue a one year card so that you can continue to monitor his condition.
The 3 month temporary certification is to allow the blood pressure to be brought under control with medications as is is Stage II.
If the driver never received medicinal treatment and failed to qualify after the 3 months why does that driver not have to wait another 3 months if now receiving medication to demonstrate appropriate treatment.
If a temporary 3 month card is issued and then they disqualify this implies that they can be re-examined at any time and not wait 3 more months.
Granted they could go somewhere else but that just avoids the issue and does not address the point.
A Stage III is disqualified but apparently can be re-examined at any point and given a six month certificate. Is this the supporting argument to issue a 1 year certificate to a Stage II htn driver once they are also disqualified but later have the blood pressure under 140/90 at any time following disqualification?
@ David P
The 3 month medical card is not a waiting period, it is a 90 day window of opportunity for the driver to get his bp under control. If he fails after the 90 days then he must have his bp below 140/90 before he can be medically certified.
I tested 154/86 and was issued a 3 month certificate. I wasn’t impressed with either the doctor nor the aide who administered the BP test. I made an appointment with a well regarded doctor 2 months later to take the DOT test again. After filling out the paperwork I was informed by the nurse that since I had failed the BP test at the other clinic I would have to return to that clinic to have my blood pressure tested again. I maintained that I was entitled to a second opinion and had no obligation to return to that clinic. Was I correct?
@ K P
You are correct in getting a second opinion. You would have had to take a new DOT/FMCSA medical exam at the old facility also.