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 Â may be medically certified to drive for a two-year period.
First time BP elevated:
Stage 1:
A driver with a BP of 140 â 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. Â 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 BPâs 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. Â 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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i went to get my physical cpl days ago my blood pressure was a cpl points hi 142/84 they cked twice and failed me no 90 day card 1 ye etc told me to see my doc get my blood pressure readjusted and have him fill out form to ok me to work he adjusted meds but refuses to fill form out can i retake my physical elsewhere i have 11 days before my present card expires
@Roger
Yes you can go elsewhere, just make sure that your blood pressure is under control.
If you are already on medications for HBP then your BP must be below 140 / 90. And you still need to have your medical doctor complete your medical release form for you. He may not understand that all that is being ask of him is that your medications are effective and safe and that they have your BP under control.
I have type 2diabetes what are my requirements
@Randy
You need to be on your medications and watching your diet to control your sugar. You need a medical release form completed by your primary doctor for your condition and take that with you when you go for the DOT examination. That’s about it.
I check my bp before going to see examiner and it was 125/82….but when the examiner took my bp, it was 142/84. I asked them to retake but they refused.He gave me 1yr card. My question is, can I go to another examiner to check it out there cos all I need is a two card. Another question is, can a company terminate my job if I have just one yr card ?
@Dickson
The CME should have taken at least three reading for your blood pressure, so you should have been given more reading to determine the need for a one or two year card. as far as the company goes, that may be a company policy, but I know of no company which does such a thing.
My brother had an accident in a company vehicle, the driver of the car was injured and had to be taken to the hospital, my brother said the driver of the car was treated and released the same day. My brother took a mandatory drug test and said he also had to re-do his DOT physical which he is having a hard time passing due to high blood pressure. He went to his Dr. a few days ago and said his BP was 150/85, and said the Dr. told him if it was the same the next day he would pass him-of course it wasn’t so he continues to go back to the Dr. at least every other day to have his BP checked. All of this sounds incredibly suspect to me! According to my bro, since he’s had high bp for quiet some time he doesn’t qualify for a 3 month pass.
@Karen
B/P’s have to be below 140/90. And if he is on blood pressure medications already then he has to have the condition under control before he will pass another DOT physical.
I am going to a company cdl school in two weeks so a quick reply would calm me down. Thanks in advance . My bp is all over the place. I recently had alot of dental work. It would vary from 122/75 to 140/85 with no rhyme or reason . I went to the doctor’s and it was 174/??. I went to get some meds. as a prophylactic so I would be good on the bp. I smoke. She gave me 20 mg of lisinopril. Do I need to tell the m.e. that I am on this and if I didnt would he know? I need this job. I’m homeless and desperate.
@Brian
First and foremost, lying or leaving out vital information on a federal form will cost extensively, if caught. Go for a walk before you go in for the physical, it may elevate your heart rate, but should lower your blood pressure. Your numbers are not that far off. If you are taking a blood pressure medication, then tell the CME during the examination and answer the question on the medical form. They should take 3-4 reading. And if you do really need medication, thenyou can go and get the meds. Good Luck
Hello, I have been a school bus driver for ten years and love my job. 2 years ago, I had elevated blood pressure at my DOT physical and the doctor put the fear of losing my livelihood into me so I developed “white coat syndrome” as a result and it has affected me since. My numbers are wicked high during the exam. Because of this, I got a three month card the last time even though I explained the above: Situational anxiety. I have had bad reactions to any blood pressure medication I have tried, six different ones, and I don’t mean dry mouth. I am on my third Primary Care physician. My medical card is up in Feb. 2015. If I don’t pass, I will not only loose my job but my home and my car since I am my sole support. I really need some advice here because how can I NOT worry? Thanks, Annie
@Annie
Well the regulations regarding blood pressures are below 140/90.
If you are on medications, it must be below 140/90 or you get a one time 3 month card. When you return it must be below regulation numbers.
Also, the examiner is expected to take a multitude of readings. So if it’s high in the first couple of readings and you explain your concerns, then they should allow you to rest and settle down before taking any more readings.
But no matter what you tell them, the readings have to be 140/90 or below. Try taking a long walk before you blood pressure check. It may raise your pulse rate and lower your blood pressure. It’s worth a try before you go for your next exam. Good Luck
Thank you for your reply.
Update: I did not pass. The doctor would not take into account “White coat hypertension” as a reason for elevated blood pressure at the DOT appointment, even with an explanation letter.
Are you limited as to how many drugs you can take to reduce your blood pressure? I heard that it was a maximum of 3.
@Steven
A completed medical form from your primary may answer the CME’s questions.
FMCSA just wants all the examiners to look closely at each driver and their medications. Your primary can answer many of the questions with the medical release form.
I value reading all of the questions and answers here, but Truckerdocs, too many times I Read your response to some of these facilities, that seem to not being doing things correctly, you tell the person to “go elsewhere”… While that’s a exceptable suggestion, I feel you should incourage them to report these facilities to DOT,or another appropriate place, maybe a medical division of the state…they should be held accountable if they in fact, are NOT operating in the clients best interest, especially when something like this, that effects one employment–most other medical issues DONT effect how we all earn a living, at least not to the point someone can take away your state license over something that MANY people have had, and continued for many years, with no problems…..I wonder why a DRUG test is not involved in a CDL physical to be “qualified “…… .??
@George
You are correct in your position.
When you find the area on the FMCSA’s website to report these abuses, please write back to us so we can give everyone who is having issues with their examiner a place to report it. I know that it is there because I have had drivers use the conflict resolution phase of the FMCSA website. BUT, FMCSA has buried this section so that it is hard to find, because, according to FMCSA, they would be completely overwhelmed with conflicts that they are having with the new CMEs.
As far as drug testing for drivers, every new driver is drug tested before he/she is hired, so not sure what the advantage would be. Pre-employment and random drug testing is the responsibility, and routine, for Companies.
Thanks for your response….I understand that companies do upon hire, and random drug tests, but it just seems to me that since the DOT MEDICAL physical is to determine one’s condition to operate a vehicle safely, a drug test should be included… Seems blood pressure is the biggest thing looked at in these physicals…. But when hired by a company, only drugs are at the top of the list….. We all know if you have an accident, you are tested for drugs….next, they will be slapping a BP cuff on you, and the insurance companies will want to deny coverage based an “elevated BP reading”
So I return to the same place I used last year for my DOT physical…The doctor gave me one year card then because my BP was elevated…. This time, Imy BP was under 140/90, and this time he gives me a 6month card, stating that I am overweight! I was pissed and said that I did not see this on the official site as something a DOT doctor could do….. I returned to read this:
QUOTE:
“Being overweight is not a restriction to passing the DOT physical exam. It is the medical conditions that being overweight eventually leads to, such as high blood pressure, heart disease and kidney disease, that may affect your ability to safely drive a commercial vehicle. That is what the DOT Physical exam will determine â whether you have any of these restrictive medical conditions. Getting healthy and staying healthy is your best guarantee for your life and your livelihood.” UNQUOTE
While that’s all fine and dandy, and I do understand the risks of being overweight, but that paragraph clearly says :
“That is what the DOT Physical exam will determine â whether you have any of these restrictive medical conditions ” WHICH IS HIGH BLOOD PRESSURE, HEART DISEASE, KIDNEY DISEASE”
…I HAVE NONE OF THESE, being overweight CAN lead to these things, but, I DONT HAVE THEM… so, in your opinion, does this doctor have the right? I think he is jumping the gun since I DONT have those conditions, “it CAN EVENTUALLY lead to” I think he’s penalizing me ahead of time, with no merit
I believe this is the perfect example of what I referred to earlier, about these places not always acting correctly with some of us….. If a regular doc talks with you about being overweight, he’s NOT messing with how you earn your living,he will tell you where it EVENTUALLY will lead.. He doesn’t take anything from you…but these docs in some cases, go over the line……..
@George
Very true. Too many of the new CME’s really have no idea of what their role is in the process.
Just try to find a Driver Friendly CME. Their job is to know the rules and regulations, but they are working to keep the drivers in the truck. Good Luck.
When I went for the physical my b p was high but I qualified for the 90 day card. But they told me to try and get it lower then come back. I went back a week later and it was lower but still in the 90 day range. Then they told me I couldn’t get that card because it was only for the first time ever getting a medical card. When I brought up the regulations on my phone and showed them they were wrong they still refused to give me the card and also put me on medical hold. I don’t have medical card so my cdl isn’t any good pm I lost my job along with insurance. I’m in a real bad spot here. No job, no insurance, no licence. I’ve been a driver for 30 years and never came close to losing my licence. Is there any way I can fix this?
@Keith
If you get your blood pressure below 140 / 90 and can keep it there, with thirty days if possible before you try again, then go somewhere else and get a new medical card. Your blood pressure must be below 140/90 with or without medication. Good Luck!
I feel that a medical card should not be required to have a cdl. CME do not know every driver situation or health history. My opinion is that the PCP should be doing the dot that way it’s done correctly. Plus if the driver is at his or her PCP while doing the dot examine It can be corrected and noted plus being monitored as well. Plus treated right away. FMCSA would like to see more PCP become NRME it builds a better relationship plus it makes the driver less nervous. There are PCP who are also on the NRME To do medical examines. This is just my thoughts and opinion.
I have a ? For someone, if you have blood pressure controlled an diabetes control do u have to do a sleep apnea test to keep your cdl
@Harold
As a general statement NO. If there are other indicators, other than BMI or neck measurements, it may be needed, but in general No.
See our articles on Sleep Apnea Screening.
i have a dot medical card till 11-1-15 . my pre hire company wanted me to get a dot exam for them and would not use my current card . the exam came back with i had high blood presure and only gave me a 3 month card . is my card till 11-1- 15 still good to use .thanks jerry
@Gerald
Yes, your 11-1-15 medical card is still good. That’s the one your state Drivers License Department will/should have on file because you are personally responsible to get a copy to them when your last medical card expired.
I had this exact same thing just happen to me today. Im on bp meds and its been controlled for well over a year now. I am consistently at about 125-135/75-85, just recently received a 1 year card. Hiring requirements for my current company that I just began training with included another dot physical. After sitting for 6 hours waiting inline to be examined, I finally got seen and my bp spiked at 150/116. They took a few more readings within about a total of 10 minutes time, and my bp was dropping with each read, it still wasn’t low enough n I received a 3 month card, and was told that the 3 month card trumps my 1 year card. Is this true and/or is my 1 year card still valid? 1 year card is on record at the dmv, will this medical examiner send the 3 month card to my states dmv which would in turn, trump the 1 year card? Thankyou much for any input.
@Sam
You all need to have a completed medical release form in hand before you go for your DOT examinations.
With that release form in hand, you already answer most of the CME questions. The CME is not your primary and does not have anything to go on other than the facts facing him right then and there.
Also DMV is different that FMCSA. One is state and the other is Fed. So on one hand the 3 month card trumps the FMCSA, but, at present, does not trump the state DMV. But if you do the right things first, then there are no hassles.
Thankyou very much for the reply, definately made this abit clearer for me. I’ll talk to my doc about a medical release form. Thanks again