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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Question:
I got my two year card this February 2014 and and at my yearly family doctor physical my bp was up and I was put on medication in October 2014. So do I have to report this immediately to my DOT work Doctor?
@ Cindy
No, it will come up at the time of your next DOT examination and you will be limited to a one year medical certificate.
Will bee stings raise your BP ? Readings at home were great got stung that evening by 4 wasps and next morning my appointment was at 8:30 . BP was up and the doctor said bee stings would not make any difference so I did not pass . Also it was red and puffy ? Doctor wanted to change to more BP medicine. I said no was I right in this ?
@Eva
I believe you made the best choice. Any time pain is involved, then BP has a tendency to elevate.
One you have healed from the bites, then check your pressure and it should be back to its normal. Good Luck
i am currently on two blood pressure meds. My reading was 150/88. how can I get a 1 year card? I go to my regular DR. and it is controlled by the meds and I have also lost 17 pounds since I started this new job, do I have to get a letter from my DR. or am I out in the world looking for a new job? What is the difference between the recertification and the regular dot exam? Because if I am looking at the numbers correctly it says ( reading of 140-159/90-99 stage 1 / 1 year but recertification is 1 year if less then 140/90, or a 3 month if 141/159/91-99. why is there a difference to these numbers ?
@Curt
1. If you are taking blood pressure medication, your blood pressure must be below 140/ 90, no questions asked, and you get a one year card, period.
2. If you are taking blood pressure medication and your blood pressure is above 140 /90 then you get a 3 month card and you MUST have your blood pressure below 140 /90 before you can get the rest of the one year card.
3. You are reading into the FMCSA’s rules and regulations what you want them to say, not what they really say. So by understanding the rules, then you must have your blood pressure under 140 /90 and all you get is a one year medical card and you will need to bring a copy of your medical release form completed by your primary doctor.
I am on bp medicine and control it well and my reading was high the first time due to being nervous . I got a 3 month card . The next time my reading was 138/ 85 . I was not passed and told by the doctor that until a couple more reading and appointments he would not give me my cdl . This seems wrong after reading the rules also I was told it didn’t count if its not an appointment just a walk in. I can not find that in any of the rules ?
Thanks
@Eva
You are correct, it is B.S. Go somewhere else when it’s time to get your next appointment.
Thank you so much, do I need to wait 30 days before using a different doctor as my appointment falls 30 days short ?
@Eva
The thirty day thing is the FMCSA’s attempt to stop the “doc shopping” thing.
But if you disagree with the first CME and you go else where, after a short period, then you should not have a problem.
I am amused by the stop “doc shopping”… Stop what? Since these docs only do DOT, shouldn’t all results be the same? And if not, shouldn’t the lime light be on the DOCTORS and the traing/GUIDELINES they follow? Seems to me to be fair, the agency that oversees these doctors should be sending a “scout” into several different places to see for themselves what differences/discrepancy may be there, then CLEAN IT UP…… again… This messes with people earning their living,and as far as I see, many people end up out of work,or have additional costs that burden the average worker, all over what “might happen”….. Let’s face it…all kinds of drivers out there are MORE of a risk, but that goes unchecked …….
I have two questions plz
1-I work for a city as a cdl driver we are not required to have a dot medical card or physical …I’m trying to get another job that does require a medical card/physical if for some reason I fail the physical will that stop me from being able to drive at my current job ??
2-if I take blood pressure medicine for high BP and it’s under control will this make me fail on my physical?
@Brenda
Every single state that I know of has to have a medical certificate to operate a commercial motor vehicle, so I’m not sure about your not needing a medical card.
If you live in some state that does not require such a thing then your first question is basically self answering.
Your second question is, if taking blood pressure medication, your pressure must be below 140 / 90, and your medical card will be good for one year at the time.
If it is above 140/90 and not under control then you will need to get it controlled as soon as possible. Usually that means a 90 day card to work with your primary physician and get it under control.
The dot dr said because I take 2 or more medicines that I have to go for a sleep study test. I had a letter from my Dr saying my hypertension and diabetes were under control. Why would this be?
@Jerry
It is a bit of a guideline, not a ruling.
I would have your doctor check you out to determine if you need a sleep study. If not, then take a note from your primary doctor back to the examiner. If the examiner is still stuck on the sleep study, then go somewhere else to get your medical card.
For more information, and to better understand this sleep apnea issue, see our blog posts on Sleep Apnea.
I failed for high bp went back and my numbers were better but he switched meds. Went back before my 3 month period and was high again. He said let’s go back to the previous med and failed me. Can I go to another DOT examiner?
@Linda
After a 30 day wait, then you can go elsewhere.
FMCSA is trying to stop the “doc shopping.”
There have been some issues with the new CME’s not fully understanding their roles, so FMCSA stated that once you have gone to a doctor and, for what-ever -reason you are having problems, wait 30 days and go elsewhere.
I have type two diabetes that I control with Diet and exercise, without meds my sugar runs about 150 to 170. However I have started checking my blood pressure lately at those self service ones at Pharmacists and it is running around 125 to 135 over 90 to 96. It varies a bit but that is the range. Will either of these affect me for getting a two year or one year card.
@Robert
Both will effect your DOT medical certificate. BP must be below 140/90 and your diabetes must also be under control.
And even with both controlled, you may be limited to a one year medical certificate.
Both of these conditions are progressive in nature and should be monitored closely, thus the one year card.
I have my pressure down to the low 120’s over mid 80’s. My sugar which I am controlling completely by diet is around 170. I don’t mind getting a one year card. Will I pass for a one year card with these readings.
@Robert
Yes. You will not have any difficulty with these numbers.