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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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Is victoza DOT approved?
@Todd
It is very similar to an injectible that has been approved by the DOT. You will need to be on this medication for a while to make sure of its effectiveness and to rule out any potential side effects. (which there are a few – including some that would be seen as a safety issue). Also, make sure you get a medical release form from your prescribing doctor explaining its usage and how you have responded to the medication. You might want to take a recent A1c with you to support your treatment results.
does the DOT physical urinalysis detect prescribed drugs. or do i tell the doctor if i am on a prescription?
@Cal
Nope, the urinalysis is looking for proper kidney function and screens for blood, sugar, and protein.
And — You are required to complete your health history in your medical form, which includes medications.
thanks !
I failed a drug test at my work awhile ago and lost my dot license, i had to see a sap to be evaluated and take a couple classes and report back to him after i was done i took my return to duty drug test passed and resumed normal operations, 3 months later i failed another drug test, does anyone know if i have to go through the same process to get my dot license back? BTW im no longer with this company.
@Aphotic
You will need to check with your local drivers license department and see what they will require for you to redo your cdl. Since the cdl comes from the state that is the place to start.
Thanks for the reply, its not a cdl just a medical card basically to drive a dot certified vehicle.
@Aphotic
That falls within your local state regulations.
I have a Class B license with P and S endorsements. I currently drive a school bus. I have a really bad case of ‘white coat syndrom’ when my blood pressure is checked. My question is: can I take a Xanax prior to my DOT physical to help calm me down for the BP check? I don’t use Xanax regularly.
@Dave
Do you plan on telling the examiner that you are taking a non-prescribed medication to overcome your white coat syndrome? Probably not the best choice.
The examiners know that this is an issue, so explain your situation and go from there. They should be willing to take a multitude of readings over time to get you calmed down. It isn’t based on a single reading.
The Xanax is a prescribed medication by my PCP. He prescribed it for when I go to blood drives and to the the dentist. I thought if I use it before going for my DOT physical and explained to the DOT doctor that I took it to calm my white coat syndrom and that I don’t need it or use it regularly. Your thoughts?
I appreciate your advice. Regards.
@Dave
Most CME’s are going to have questions about your need to take a prescribed anti-anxiety medication to pass a medical certificate examination. Even with your medical doctor filling out a medical release form explaining the situation is going to cause questions. And taking a medication that is going to cause that many questions? Not sure what will happen in this case. What do you do to get through a visit with your own medical doctor? And if that works, why not try that with the DOT examination.
I take citalipram for depression. How long must I be on it and be stable to get my CDL health card?
@Craig
You would need to be on this medication for at least 90 days or longer to determine how you will act and possibly react to the medication. After that you will want to get a medical release form from your prescribing doctor explaining your situation and how you and your condition have responded to the medication.
My husband currently holds a CDL license and has now been prescribed adderall by his doctor. How does he get this approved in order to keep his license?
@Lynn
More questions than answers here. Why was he prescribed this medication, how long has he been on the medication, is he stable with its usage? There are lots of variables here and more information would be needed. Your best bet is to have your primary prescribing doctor fill out a medical release form and take it to a local CME to see what else in the way of information would be needed before he would pass a DOT examination.
My husband was just given Depakote DR 125mg for migraines. Is this approved by DOT? Will they allow him to drive?
@Lydia
Since this drug was just prescribed, your hubby now has an invalid medical certificate due to the facts that he has a condition that has required a new medication that is used for seizures. I know that it is being given for the headaches, but no-one knows how he is going to react to the medication and it has some serious safety issues attached to it. He will need to be on the medication for at least thirty days and when he starts driving again, he will need a new medical certificate. He should also take a medical release form from his prescribing doctor explaining the effects of the medications on the driver and why he is using this medication. That will go a long ways in helping the CME to make the proper decision regarding the driver and his medical fitness for duty status.
Can I take amitriptyline while operating with a CDL license or is it a drug banned by the DOT?
I don’t see an answer to the question about taking amitriptalene. Is this a banned medication for a truck driver
@Matt
It isn’t on a banned list, yet it will cause a lot of questions because of its usages and side effects. So make sure you bring in a medical release form from your doctor explaining what and why you are taking this medication.