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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My husband has a current two year dot card. He started a new job and had to go for a dot exam. At his last exam when he received his two year card his blood pressure was 135/79. He had just lost his job of 20 years and was beyond stressed out as well as he suffers from white coat syndrome. When he went for the new exam his blood pressure was 150/80 he told the Dr. it is not normally high and he would not listen he only did the one reading and told my husband he only qualified for a 3 month card. My question is he is not on any blood pressure medicines and does not normally have high blood pressure so shouldn’t he have received a one year card. The doctor doing the exam is a chiropractor and seemed unsure of the rules he went and printed some information off the computer and insisted he only qualified for a 3 month card. Am I misunderstanding the information. Also if he does not agree with this doctor can he seek a second opinion from another examiner and does he have to tell that examiner about the three month card or can he just let the examiner form their own opinion on if he should have a one year card if the reading is still high.
@steve
Without taking any medications, your hubby should have received a one year card to let things settle down. You can seek a second opinion and have another examination done in a few months. That should give everybody a chance to get things back to normal. The three month card was already input to the FMCSA data-base, so it does not matter if there are any questions with the next exam. Simply explain the situation and go from there.
I am a certified medical examiner but have some confusion on the certification period for drivers with controlled hypertension on medication. Do they get a one year certificate or two?
@Kimberly
On medication and a medical release form from their primary, as long as the pressure is below 140/90, they would get a one year card if all else is within normal limits.
Can a person with a controlled blood pressure but has a stage 4 kidney disease still drive a commercial truck.. both cases are being treated by doctors..
@ Andrew
It will depend on the degree of limitations. Controlled blood pressure is not the issue, it will be the kidney disease. If you have a medical release form from your doctor and he can explain how your condition is progressing, then you may gat a short window card. But it would be unlikely that you would pass the DOT examination without a doctors release. Your condition is a progressive one and would be seen as a safety issue.
I had high blood pressure when going to first exam for med certificate so got 3 month extension. I went to my primary care physician, have meds and my blood pressure has gone down to 148/108 – but not yet there. My primary has adjusted my meds and I expect to have bp below the 140/90 very soon. Do I go get another medical or do I have to go through the written and driving testing all over again? Thanks.
Sue
@Sue
Just the medical certificate portion of the examination should be all you need, once the bp is below 140/90. Be aware that your medical card will be good for one year at the time while you are on bp medication.
Are heart transplant recipients possibly eligible for a medical certificate?
@Kelly
Possibly. You will need plenty of information and doctors releases to start with. From there you will need reports from your cardiologist and stress test results. That should be enough to get you started with. Then when you see the CME he may request further information. Good Luck
If you fail your dot physical is your current medical card any good
@William
Nope.
I failed my CDL physical from high BP 146/86 and was issued a 3 month extension. I am working with my PCP to get it lowered. I was already on 2 BP meds and my PCP has given me 1 additional medication. I haven’t returned to have BP checked at the place the denied me medical card yet and I have 2 questions. I realize if I don’t pass I don’t get another 3 month extension, but am I able to have the Medical Examiner check me multiple times while I am working with my PCP to get it lowered before my 3 month extension expires? The next question is IF I don’t pass, will I ever get to try again or is that it for my driving career?
@Birdman
You can have your BP checked as often as you like by any one you want, just make sure they know what they are doing.
And if you fail now you can still retake the physical exam at a later date, once your BP is under control.
Be aware that once your medical card expires, your state may downgrade your CDL. If this is going to occur, check with your local driver’s license department about the process for getting your CDL reinstated.
i am on BP meds, what if my BP is above 140/90 will I still be able to be qualified for 6 or 3 months till my doc can get my meds adjusted?
@Chris
If you are on blood pressure medication, you may get one three month card to get your medications dialed in. You will not get a second three month card. So from this point on you want your BP below 140/90.
So in the three months if I get my BP under control will I be able to go back to a one year card? Thanks doc
@Chris
Once you get your BP under control, then you would get a one year card from the date of the examination.
What if someone who is on BP meds has a reading over 160/100? Is there a cut-off reading for the 3 month certificate? Say 165/110?
@Justin
All depends on BP reading and CME findings. 140/90 is the cut off. If you are above those numbers for the very first time, then you may be issued a one time three month card. After that you are disqualified until you can get your numbers under the 140/90 and there are no more three month card after the first one.