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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We had a driver issued a part 1 of 2 DOT CARD (good for 3 months) with a physical exam completed at this time. The driver went back (after 3 months) and received part 2 of his DOT Card which is good for more 9 months without any exam being done to receive part 2. Is this a valid DOT Card and acceptable without out a physical exam being completed to receive part 2 of his DOT Card?
@Jane
Your driver must have had to complete some portion of the examination or provided additional information to the CME at the time. So if that is correct, then the new card is valid.
The NP at the clinic my employer uses for DOT physicals stated that they cannot take multiple BP readings. A “one time” reading a that reading will be used. Is this true?
@CM in GA
That is outright BS. The FMCSA guides state specifically that a multiple reading is just fine.
Why can an airline transport pilot receive a class 1 medical with blood pressure as high as 155/95 who is wrong dot or the faa ?
I’m a type 2 diabetic. Went for my Dot physical in November of 2015. I received a 3 month card because my A1c was 8.3%. I’ve tried to find where it states at a certain level you only get a 3 month card. All I’ve been able to find is 7-10% should get you a year card. Any thoughts on this? Is there anywhere that states what is acceptable and what is not!! Thank you.
@Michael
FMCSA simply wants your diabetes under control, with no sugar spill-over in your urine. A medical release form from your doctor stating that your condition is under control and a list of your medications should suffice. A1c’s are usually needed when the diabetes medications are binding with your sugar and you are expelling them through your urine. So I would get a second opinion at another facility, with the doctor’s release form in hand.
I normally have low blood pressure, i.e. <100/70. I am physically fit, 5'11" and weigh 170. I am not on any medications for any condition. In the weeks leading up to my DOT physical, I begin worrying and get anxious. I am not afraid of the exam, I guess I am anxious of the ramifications if something is wrong. When I get my exam, my blood pressure reads high which is above the requirements. I don't want to lose my job!! If I go to my doctor, he will put me on blood pressure meds, which I do not need because my blood pressure is normally quite low. Any suggestions?
@Scott
Sit back, relax, do a little easy deep breathing. Most CME’s will take a few readings for blood pressure and help you get it down if it is a little high due to white coat syndrome. Don’t eat too much, stay away from the caffeine and smokes, if you smoke. If your blood pressure is normally in the numbers you mentioned, then you should not have any problems. Make sure that the examiner uses a blood pressure cuff and not an electronic cuff. The electronics need to be calibrate and most people do not do this often enough.
For more suggestions see: Blood Pressure Tips During the DOT Physical Exam
I, too, suffer from “White Coat Syndrome”.
I am 65 and for the first time my BP is 144/88. Usually it is around 125/80.
I took the exam today and was given a cert for 12 months.
My question is this, will all my future certs be for 12 months assuming my BP falls under 140/90 during subsequent exams?
My exam today was 140 bucks, so will I be shelling out that amount ever year from now on?
@Robert
If you can get your bp below 140/90 without the use of medications, then you may be able to return to a two year card, if all else is good. If you must go on medication to maintain your blood pressure below the 140/90, then your cards will always be for one year at the time.
I have a aortic aneurysm, I just Had a MRI, Im trying to find out if I can still drive cdl in connecticut. I cant find anything on ct.gov. I did find some info on fmcsa.dot.gov.
under their recomendations I can still Drive. CT is much tougher on a lot of things. can you direct me to the ct regulations?
Thank you.
@Rick
What you will need to do is to contact the local drivers license department and ask them. FMCSA has one set of rules and regulations, but every state has their own guidelines, and this sounds like a state question.
I’m curious , if my blood pressure is a little high for the first time , will i be given a year or 3 months , I’m not in any meds.starting a new job and they require a new physical. Also if only given a 1 year or 3 months I guess that will over ride my current physical which is still good for 1.5 years.
@Brian
New cards over-ride the old card. If your blood pressure is between 140 and 160 on the top and 90 to 100 on the bottom, you will probably receive a one year card to get your blood pressure under control.