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Q&A
Does the DOT physical include a drug test?
What drugs are tested for, if a DOT drug test is requested?
What if the DOT drug screen tests positive?
Why do I have to have a urine test for my DOT physical?
Is protein in the urine a disqualifier?
Is sugar in the urine a disqualifier?
Is blood in the urine a disqualifier?
Can I get a medical certificate if I’m being treated for a medical condition by my doctor?
What if I take insulin by injection and my diabetes is under control?
My doctor put me on Metformin. Can I still drive truck?
What medications disqualify me from getting a medical card?
Can I be qualified if I have a prescription for medical marijuana?
What if I take nitroglycerine for angina?
Can I still drive if I take prescription Paxil, Imitrex, and Zonisamide?
Can I take Xanax and still drive truck? My doctor put me on it and I don’t want to lose my job.
Can I still drive if I take a blood thinner?
Can I still drive while taking Provigil (Modafinil)?
Does the DOT physical include a drug test?
The DOT physical exam to get your medical card, does not include a drug test. This does not mean that any Company you want to work for, will not request a pre-employment drug test — they most likely will. But the DOT physical exam requirements do not include a drug test.
What drugs are tested for, if a DOT drug test is requested?
The 5 Panel drug test analyzes urine for the following drugs:
- Marijuana (THC metabolite)
- Cocaine
- Amphetamines
- Opiates (including heroin)
- Phencyclidine (PCP)
What if the DOT drug screen tests positive?
The DOT drug screen is looking for illegal or non-prescription drugs. Yet, sometimes normal prescription medications can trip a positive test.
If the urinalysis is positive for one or more of the drugs on the 5 panel drug test, then the driver will be contacted in person by the Medical Review Officer. The MRO will interview the driver to determine if there is an alternative medical explanation for the drugs found in the urine specimen. If the driver provides appropriate documentation from a prescribing physician, a confirmation test with a split sample is performed for each identified drug. Confirmation ensures that over-the-counter medications or preparations are not reported as positive results. If the MRO determines that it is a legitimate medical use of the prohibited drug, the drug test result is reported as negative to the employer. Otherwise the drug test will be reported as positive.
Why do I have to have a urine test for my DOT physical?
The urine test is just a kidney screen to test for sugar and protein. It’s done to determine that there is no early onset of conditions like high blood pressure breaking down the kidneys, or early signs of diabetes, or kidney infection.
Is protein in the urine a disqualifier?
No, not necessarily. Protein in the urine may indicate kidney disease. The medical examiner will make a decision based on the amount of protein in the urine. The medical examiner may certify, time limit your certification or temporarily disqualify your medical certificate while you have the condition checked by a specialist.
Is sugar in the urine a disqualifier?
Yes, it is an indicator of the onset of diabetes or already a diabetic that does not have the condition under control. The driver would be disqualified until the condition is under control, either with medications or diet.
Is blood in the urine a disqualifier?
No, not necessarily. If the medical examiner believes that the blood in the urine may indicate a condition that affects the ability of the commercial driver to safely, the driver may be referred to a primary care physician or specialist for further evaluation. The medical examiner may certify, time limit your certification or temporarily disqualify your medical certificate while you have the condition checked by a specialist.
Can I get a medical certificate if I’m being treated for a medical condition by my doctor?
Depending on the risk posed by the condition and treatment, the medical examiner may require documentation from your doctor. To assist in the preparation of the documentation, you can get more information here, courtesy of Trucker Docs. Even though your prescribing physician may be of the opinion that your condition and treatment is safe to drive, the decision to certify still rests with the medical examiner.
If you have non-insulin treated diabetes the medical examiner will check that your diabetes is adequately controlled. If it is controlled, you will get a time-limited certification and most likely need to re-certify annually.
If your diabetes is treated with insulin, you will be disqualified for inter-state driving. You may be able to drive intra-state.
The DOT does have a few, very stable insulin dependent drivers testing on insulin waivers, but you would have to check with the FMCSA on this issue.
What if I take insulin by injection and my diabetes is under control?
Without a DOT Diabetes exemption waiver the answer is No, not for interstate driving, even if your condition is stable.
You may be able to drive intra-state. Each state has its own rules.
What are the requirements for blood sugar limits? I just found a job driving school bus. I am a diabetic, non-insulin dependent. When I took the test my blood sugar was 350, but in the past few days I’ve gotten it down to about 170. I have never had a low or high blood sugar blackout. Will I have to get an exemption?
The medical examiner needs to see your blood sugar levels below 120. That is the level for blood sugar spillover into the urine. The concern is not whether you have ever had a blood sugar blackout, it’s – Could you have a blood sugar blackout while driving a bus full of little people? Safety first for you, the driver, and for the public at large.
My doctor put me on Metformin. Can I still drive truck?
The Metformin is to control your blood sugar as a borderline diabetic. It will limit your DOT medical certificate to one year at a time.
I’m a CDL driver. I had to start insulin for my diabetes. My medical card expires in a month. Will the doctor know I’m taking insulin when he does my tests?
It does not matter whether he knows or not. On the DOT medical examination form that you fill out, it will ask if you are a diabetic and also how you control the condition. So you are the one who is going to tell him about the insulin.
Your examining doctor should ask quite a few questions regarding your insulin usage to help determine your options.
What medications disqualify me from getting a medical card?
Any habit forming drug; methadone; anti-seizure medication, is disqualifying.
The medical examiner will review every medication – prescription, non-prescription, and supplement to determine if its use will adversely affect the safe operation of a commercial vehicle. The medical examiner may require documentation from your prescribing physician. In this case the medical examiner may, but is not required to grant you a medical card.
Can I be qualified if I have a prescription for medical marijuana?
No. Marijuana is a disqualifier, even if you have a prescription.
A CMV driver cannot be qualified if on Methadone. There are exceptions to the rule regarding other drugs prescribed by a physician, but this does NOT apply to Methadone.
What if I take nitroglycerine for angina?
Nitroglycerine use is not disqualifying. The medical examiner may require an evaluation by your Cardiologist to make sure that your angina condition is stable.
Can I still drive if I take prescription Paxil, Imitrex, and Zonisamide?
These three drugs are going to be a red flag for any examiner. You should bring with you a letter from your prescribing physician, explaining the need for the medications and their possible side effects. All three are listed with side effects of drowsiness, weakness, dizziness, and should not be used while driving or using machinery. You are going to have to explain to the medical examiner why and how much if any of these medications you are taking and the basic circumstances for their needs.
Can I take Xanax and still drive truck? My doctor put me on it and I don’t want to lose my job.
One of the best ways for a driver to answer a question about whether a medication may be a disqualifier or not, is to read about the side effects of that medication.
Lets take a look at some of the side effects of Xanax which include: “Drowsiness, light-headedness, headache, tiredness, dizziness, irritability, talkativeness, difficulty concentrating, dry mouth, increased salivation, changes in sex drive or ability, nausea, constipation, changes in appetite, weight changes, difficulty urinating, and joint pain. Some other side effects can be serious. The following symptoms are uncommon, but if you experience any of them, call your doctor immediately: shortness of breath, seizures, seeing things or hearing voices that do not exist (hallucinating), severe skin rash, yellowing of the skin or eyes, depression, memory problems, confusion, problems with speech, unusual changes in behavior or mood, thinking about harming or killing yourself or trying to do so, and problems with coordination or balance.”
As you can see, some of these issues can be unsafe for you and the public. It will cause any medical examiner to question your reaction to this medication. Talk with your prescribing doctor and ask questions with regards to driving while using any medication.
I take Prozac for anxiety and I no longer have anxiety attacks. Will this be a problem for my DOT physical?
If the anxiety disorder is controlled with the medication, then there is no real problem. Just make sure you inform the medical examiner about your condition and the medications you are taking for it.
I have been diagnosed with panic attacks. I don’t have them often but I do take Lorazepam for them on a PRN basis. Can this disqualify me from driving a school bus?
The side effects of the medication could be a disqualifier from driving a bus. I would bring a note from your physician stating how long and how often you use this medication.
A bus-load of kids could be stressful and may trigger your need to medicate. So the medical examiner would be concerned about the side effects of the medication. The big concern here is for your safety and the safety of the children.
I want to keep my CDL but I have anxiety and need to get on some medication. I don’t want to lose my license. What anti-anxiety medication in okay to take and still be safe to drive?
Talk with your MD and explain that you are a commercial OTR driver. That way the doctor can work out which, out of dozens of medications, will work best and not interfere with your ability to operate a commercial motor vehicle. Most of the anxiety meds do not run positive for drug testing. They usually have side-effects that cause drowsiness and that is the main problem. So give the provider as much information as possible and go from there.
You will need to get documentation from your MD stating that no side effects are present that will impact your ability to safely operate a commercial vehicle.
Can I still drive if I take a blood thinner?
Yes, you may still drive. You will need to get documentation from your treating physician as to when the condition started, what was the diagnosis, what has the treatment consisted of, what medication are you on, and is the condition stable. All of these things are to help the medical examiner determine whether you are medically fit to operate a CMV safely.
Can I still drive while taking Provigil (Modafinil)?
The use of Provigil needs careful supervision. Drivers being prescribed Provigil should not be qualified until they have been monitored closely for at least 6 weeks while taking Provigil. The medical examiner will require documentation from your treating physician stating that the treatment is effective, and that no side effects are present that will impact your ability to safely operate a commercial vehicle.
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can you be cal certified taking suboxone
@Steve
All depends on the reasoning behind the prescription. A doctors medical release form will be a big help to the CME doing the examination. Have your doctor explain why you are taking the medication and what his prognosis is for getting off the medication, if at all possible.
Hi i’m in the same boat. I just went for my d.o.t physical and passed with flying colors but I was honest and and told him I was on suboxone and he automatically disqualified me also did a pre employment drug screen which today notified my employer but the thing that gets me is my employer told me he was going to notify the registry and they were going to take away my CDL.can he even do that?
@Nick
They can’t take your CDL away from you, only your medical certificate. Once you have resolved the medication malfunction, you can renew your medical certificate.
Will Invokana make it so I can’t pass the urine test on dot physical? or can I get a paper from my doctor so I can pass it.?
@Esther
For this medication you will need a medical release form from your doctor and your latest A1c. That helps the CME with his decision making process by having all the information when he starts the examination.
I HAVE TO TAKE LEVOTHROID OR SYNTHROID FOR HYPOTHYROIDISM. I HAVE A CDL AND AM A TRUCK DRIVER. CAN I DRIVE TAKING EITHER OF THESE MEDICATIONS?
@Steve
Make sure you take a medical release form from your prescribing doctor explaining your condition. With the release in hand at the time of the examination, you should not have any issues.
I have had two heart attacks,the first one in 2011 that required a quadruple bypass. the second one June 30th 2015.Here is the list of meds I currently take. Are there any that would be disqualifying, and Im I going to have problems keeping my medical card. thanks
Atorvastatin
Carvedilol
Plavix
Losartan
Nitroglycerin
@Phillip
Following a heart attack you need a healing period before you can sit for your next medical to return to work. Since you have had a second heart attack recently, you will need a stress test every two years and a medical release form completed by your cardiologist before you go for the DOT examination.
Then based on that information, the CME will make his recommendations. Your doctor needs to explain what and why you are on the medications that you take and what the potential safety issues that may arise from their usage. Based on the cardiologist findings and medical release form you will probably be limited to a one year card and a stress test every two years.
I’m taking trazodone 50 mg tab. Will it prevent me from passing my D.O.T physicol?
@Javier
If this medication is controlling your situation, then make sure you take a medical release form from your doctor explaining your needs and the other effects that you may experience while on these meds. With the proper information from your prescribing doctor, the CME can make a better and more informed decision regarding you driving and taking this medication.
Do vitamins and OTR ibuprofen violate DOT regulations? Do you have to have a script for them?
@Cantrell
If any medication, like ibuprofen, or OTC vitamins are being used then you may need an explanation for its use, but what the CME is most concerned about is the possible side effects. Is it safe, are there possible effects that could cause the driver to lose control of the CMV that he is operating, etc? If your doctor recommended a specific OTC medication or vitamin, then a note to the CME would simply help him make a better informed decision.
I was a otr driver for 12 years. In that time i was prescribed celexa 20mg a day. I got out of driving a semi for 5 years and am going back into driving a semi. My docter gave me the celexa for a slight conversation disorder? “Stress i belive”. Am i leagle to still take this medication? I have a d.o.t. drug screen and physical and am not sure what has changed in the past 5 years with medications. Thank you!! Again, celexa 20mg dayley for slight conversion disorder from i.u. medical centers of Indianapolis indiana.. one other question? Will the d.o.t. even test for this drug or will it even show up? Happy 4th of july doc!!
@Rod
Due to this medication’s potential side effects you are going to have to answer some questions. Get your primary prescribing doctor to fill out a medical release form for you. The release will answer most of the questions that a CME is going to have.
As far as drug testing, if you have a prescription and the MRO can get information from your primary, then you should not have any issues.
Happy 4th to All!
Will taking buspirone 10mg twice a day Keep me from getting my DOT card or passing my DOT examination? Thanks
@Herman
This medication will pose many questions for the DOT examiner. Start with a medical release form from your prescribing doctor, explaining your situation and how you have handled the medication. The side-effects and possible other effects may be in question. Also indicate how long you have been on this medication. All this information done before you get the examination will be a huge help before you get started on the DOT medical examination.