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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why are bp from dot docs usually screwed up ?
137 at my doctor and an hour later 190 at dot doc ?
why did the British study which claimed that as many as 80% of BP readings are inaccurate ?
why does my EMT training manual say to use as a rule of thumb the male’s age plus 100 up
to 150 as a normal bp reading ?
why doesn’t the state’s medically disqualifying you from a job automatically qualify you for
social security disability benefits ?
@ Bill
Good questions.
I had my DOT Physical this morning they took my blood pressure with a wrist blood pressure monitor that barely fit my wrist the reading was very high so they tell me to wait ten min and they will take it again by this time im really nervous ten min goes by and they take it with an arm cuff and its just few points over 140/90 !!!! I guess my question is should they be using an arm cuff that fits my arm the correct way or is a wrist monitor acceptable?? The nurse even said that the wrist monitors always read high so now i have a three month card not sure what to do next any advice would help.Thanks
@ Mike
For the best and most honest blood pressure reading, they should be using a proper fitting arm cuff and a stethoscope. They can also do multiple reading while you are having your examination.
I have normal BP at home and high at the dot doc. My pcp has signed off in the past as just white coat. When I ho again and if it’s high and my doc signs off with a good reading doesn’t the dot doc have to abide by that? How can a dot doc diagnose a driver with just one visit?
@ Marc
The medical examiner should take more than one reading for your blood pressure. He is not in a position, by DOT/FMCSA regulations and guidelines, to diagnosis any condition. He can take your primary physicians informations into consideration, but is not mandated to accept it.
I have normal bp when I see my gp every 3 months but when I went to get my med card in CT I was denied because of high bp so I went back to my pc the same day and it was normal bp. I made an appointment with a different doctor for the dot card and my primary doctor sent a fax to the doctor saying that my bp has never been high and it is a white coat syndrome for me to see a different doctor. He still failed me for a med card. The doctor said that he can’t take the word of my primary care doctor. He said that he needs to see my low bp with his own eyes. Is there anything that I can do about this situation? Any help would be appreciated. Thank you in advance, Alan
@ Alan
It will fall to the medical examiner to make his final decision. BP’s that are high are potential risk hazards to all parties involved. Some CME’s will understand ‘white coat syndrome’ and others will not. Learn to relax ( gentle, slow nose breathing, without effort), no coffee or smokes before going in for the examination and take your ‘chill pill’, even if it’s imaginary. What you resist will persist.
Is a DOT doctor required to give you at least a one-year certification if your blood pressure is a little high if you’re being treated by a doctor
@ Marcos D
DOT/FMCSA regulations only allow for a one year, maximum, card if you are dealing with high blood pressure, even if being treated by a physician.
So they will no longer have a two-year certificate if your blood pressure drops below 140/90?
@ Manys
The kicker is ‘history of HBP. This will go for your nephew too.
I did not understand your answer but I ask again if you left with high blood pressure the first time and when you are going to renew it it is normal, it returns to 2 years or it will continue for a year, blessings doctor
@ Many’s
One year due to a history (last physicals readings) of high blood pressure.
Fmca are rules not law get a lawyer
How high was it? I thought they still issue a 1 year cert if it’s a little high . They flat out failed you ?! How high was it?
How are you so here is my take on this blood pressure test at the time of physical before I went for d o t physical my b p was 130 over there 86 I got to the clinic and in one 1hr my b p was 150 over 80 so i have to question if the docte r really don’t take my b p rite and so many of docters are stuck on sleep apena when I know and most drivers know that the government will fund them good money for that treatment
My friend claims to have a bp of 180 over 140 and the drs. In Ma. hasn’t revoked her drivers license. Is this normal or is my friend full of sh#@.
@ Ruth
Drivers license are a state issued document and do not require medical certification. A bp of 180/140 only means your friend is in serious trouble health wise.
On initial exam driver is Stage 1, i.e., has BP of 142/95, and is given a one year medical certificate. At next annual exam, he is again 142/95, i.e., continues to be Stage 1. Does he qualify for a medical certificate? For how long? What is the follow-up protocol. Confusing.
@ Susan S
A bp of 142/95 should have a three months medical cert to get bp under the 140/90. This card is a one time issue, until bp at 140/90 or less. If placed on bp meds, then medical card is one year at the time.
I only got a 1 year physical card last year. If my Bo is good this year will I get two year cert
@ Robert F
Bo ?