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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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I just went for a DOT physical and was only given a 3 month medical permit based on the bipolar condition my medications revealed. I was told the rules are now different and that even with the note from the treating doctor I could only possibly be issued a 1 year medical card in any case. I guess I have 2 questions, is this true, and should I consider finding a different line of work as these tightening restrictions could edge me out at any time.
@Nick
The one year medical certificate is a truism. FMCSA wants all CME to monitor your progression every year. And all you should need is a medical release form from your doctor explaining your condition and his prognosis.
There are no new rules regarding a condition like yours, just a need to understand what the guidelines say. Try a different CME next time.
Thanks for the response. I have been driving for a while and found this response alarming. Most of the big companies I know of won’t take you if you don’t qualify for 2yrs . The CME even said the release form was good for 2 years so I will defiantly get a second opinion as I have little reason to believe I can’t do my job for only a year.
I had a medical marijuana card that will be expired for two years in April. Will this keep me from obtaining my school bus license? Should I let the CHP officer know before I start my testing there?
@Jacquie
You are in a state that has an allowance for marijuana, so you will fall under the states laws here. Not sure what your needs are going to be to acquire a drivers license to transport children in your state with your medical permit. Check with the state first and see what they have to say. Just ask questions.
I HAVE BEEN CLEAN OF DRUGS FOR TEN YEARS, CAN I DRIVE A SCHOOL BUS
@Charlotte
If you can perform the duties of a driver and pass the physical, then you should not have any issues.
You may want to check with your local drivers license department to make sure they do not have any surprise in store for you though.
I am prescribed Xanax which I take 1mg at bedtime. I am also prescribed Oxymorphone ER 30mg one pill twice a day for my chronic pain. I have a class A CDL and am about to start a new job as I am a new driver. Will my medication I am prescribed to disqualify me from a job?
@Cory
A lot will depend on the length of time that you have been on these meds. Get a medical release form from your prescribing doctor explaining the length of time and the need for the meds. That will help the CME with his decision making process.
Have Medical Marijuana card and going for CDL (didn’t realize couldn’t have). Doctor is stating I need to attend rehab and get letter of completion before she can give me physical. Can I just test clean and be done with it. Do I really have to attend rehab for a doctor prescribed medication, can’t I just stop?
@Ralph
If you test clean, because you have discontinued using, then you should be just fine. If you go back to the same examiner they will want to see what they ask for. As a driver you are going to be tested randomly through out your driving career, that happens to every driver. Drug and alcohol testing is mandatory for all drivers.
My fiance was recently prescribed ritalin. Will he pass the DOT physical while taking it, or does he need to get the medical release form?
@Sue
He will need to be on these medications for a period to determine how he will react to the drugs. So he will have a short waiting period and then he will need a medical release form from his prescribing doctor explaining why he has been placed on these meds. The CME is going to have questions and you want to have the answers before hand so things go smoothly.
I been driving for 4 years. I take Suboxone 8mg strips. Been taking them for 4 years. My first physical I had to get a note from my doctor stating it was ok for me to take suboxone & drive a truck. That was no problem. Well I went to get my 2 year physical done a few days ago and the lady told me that I could no longer drive a truck and take suboxone, I had to chose which one I wanted more basically. So even if I have a note from my doctor saying it’s ok, i still can’t get my health card?
@Nathan
You will need to support the requirements for the meds you are taking with documentation from your prescribing doctor. If you have been taking this medication for years and driving, you need to have your prescribing doctor complete a medical release form for you, explain what you need these meds for, and your condition, and that you have been on them for an extended period of time without incidence. Some examiners are very strict on this and won’t budge, but there are examiners that truly understand the situation. You may have to search around to find an examiner that does understand, but they are out there. Good Luck
Wow, I just experienced the SAME exact thing. I think it is a new rule.
I use a suboxone, but don’t have a prescription. I was completely off of suboxone and doing fine, but recently, feeling the need to use, I bought some suboxone and started taking the dose my doc used to prescribe.
I’m afraid if I get a prescription now, I’ll lose my job. I know I’ve put the cart before the horse, but suboxone does not impact my driving and it’s better than falling back into addition. What should I do?
my “new” Dr the one i been seeing for decades moved up to management.
are these two meds ok with the dot?
SERTRALINE 25 mg tablet.
TRAZODONE 50 mg tablet.
given to me case i am having trouble’s sleeping and getting proper rest. then falling asleep during my work shift. also general fatigue. (getting very hard to work more then two/three days).
the report pages read like a scary novel.
i do not get it both meds have the side effect is not being able to sleep?
as well as a couple others that scare me.
should i worry? not take these?
@Tom
You will need a doctors medical release form to explain your need for these meds. Both of these medications are going to cause questions. If you have been on these for some time, you will just need the doctors medical release. But if you are just starting them, then you will need to go through a waiting period that allows the doctor to see what the other effects of this medication are and how you re-act to them.
If a driver has been taking Trazodone for a few years in the evenings to help with sleep (no history of depression), if they have a medical release from their primary, how long will they be able to get a certification for? Assuming everything else in their health history is clear.
@Emily
More than likely one year at the time. The CME will want to have a medical release form from the prescribing doctor and will want to continue to monitor the drivers condition with the help of the prescribing doctor’s input.
I’m taking prozac, can i still drive a truck.
@Peter
Make sure you have a medical release form from your prescribing doctor and an explanation for the prescription. With that information in hand, you should be OK.
I’ve been driving for 19+ yrs. Now i’m on Kidney Dialysis. Will this Disqulify me to Drive?
@Dennis
Interstate yes, intra-state only, you want to check with your local drivers license department to determine what paper work they will need to qualify you to drive in state only.