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”.
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Is it possible to get an extension until my blood pressure medication is back in stock and if so who do I call? Five in the state of Colorado.
What if Washington state won’t allow you to go to another Dr. If you’ve seen one already. I wanted another opinion because this Dr. Didn’t follow protocol in the exam so I didn’t pass without restrictions.
@ Lola L
You can have a class A DOT/FMCSA done any where in the USE as long as the CME is on the national registry. That’s federal, not state.
Hi,
I got my CDL A permit (CLP) which expires on 08/02/2022, but the doctor gave his medical card for 3 months (until Aptil 25th) because he saw a blood pressure problem. If I could’n get DOT exam in time am I gonna loose my permit? I am out of the country and I’ll be back after April 25th. Thank you.
@ Suleyman Y
Just get a new DOT physical when you return to the states.
Thank you.
My blood pressure has been significantly lower in the last 2 years my doctor took me off blood pressure medication what will DOT need to need to see In order to give me a 2 year card
@ Mark
A note from your doctor may be of help, but don’t count on it. DOT/FMCSA ask if you have ‘ever had a history’ of high blood pressure?
So, I work with a CME. After a stage 2 3 month card, at the end of the 3 months if the pressure is not managed, he is disqualified, but for how long? Pt did his 90 days and the pressure is still over a little (148/82). Not qualified. Went back to PMD for medication adjustment, does he have to wait another 90 days before he can be examined again?
@ Ray H
No, once his pressure is stable and below 140/90 he can be retested. The 90 days is not a waiting period, but an opportunity to get his bp under control, without taking him off the road and putting him out of work.
Do the company have pay full for a f another physical, the driver is given the remainder of year, if not it make the driver or company pay twice, which is not fair
So after 90 if you’re blood pressure is still high, is there a 45 day grace period you have to get it down?,and is this law a California law also?
@ Bil A
If you are a class A driver and were given a 90 day medical certificate to allow you to get your blood pressure below 140/90, it is a one time 90 day card. From DOT/FMCSA, as a class A driver, after a 90 day card you must get your bp below 140/90 before you can return to driving. Lesser class drivers fall under the states rules and regulations and you would need to confirm with your states DLD.
So Yesterday i go for my DOT physical, the nurse is performing the initial test all is well except BP 1st attempt at 160/100 , a few minutes later she tries again same 160/100 ( in fact she mumbled that it went higher, and i should relax). She said she will have the dr. try later. So we go through entire porcess , dr comes in wheels in a manual machine with larger cuff , result is the same 160/100 give or take. After researching here’s the issue , i was sitting at the edge of the bed, feet dangling, no back support, and my arm was not elevated.
Today my wife takes my blood pressure 3 different times , sitting on a chair with back support , feet squarely planted, arm resting on top of the kitchen table and i am at 135/85 give or take all under 140/90.
What should i do, i was told to go see my primary and get on medication, I have 45 days and then she would give me a one year card. No job is worth , needlessly getting on medication , I would prefer to diet and exercise my way down.
I was given a form for my primary to complete , and return to CME.
@ Rich
You could go for a second opinion, somewhere else, before going through with the family doctor and med routine.
I’m on 1year card for 5 years now. No more meds . And hypertension is no longer an issue . Naturally controlled with exercise and diet . Can I return to a 2year medical card ? And wife so where do I look to find the required process? Thank you .
@ Constance F
Ultimately, it is the CME’s call. The wording on the intake form is ‘any history of HBP?’ If the examiner feels, with some supporting medical documentation from your primary physician, that your situation is completely under control, then he may extend to a two year card.
Blood pressure was 144/84. The medical place used a machine not manually checking blood pressure. I asked for another reading and was refused. Is it ok for the medical testing site to do that? Use a machine and refusing to do another reading?
@ Gina
You should be able to request 3 different reading and they should comply. Go elsewhere and get a second opinion.