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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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The new Medical Examiner’s Certificate asks about illegal drug use back 2 years. One of my driver applicants answered truthfully that he had used marijuana within that 2 year look-back period. He is not currently using and has passed a pre-employment drug test. The Medical examiner flagged his application as not qualified and indicated that he needed to see a SAP before continuing his application. I can’t find any indication that past (but not current) illegal drug use is a disqualifying condition. Any ideas on what to do next for this driver?
@D.E.
Get a second opinion from someone else. The examiner may be over-reading the guidelines and may be testing at the class A interstate level.
Also the new forms ask about any use and the examiner may only be looking for a solid confirmation from a SAP that there is no usage, but in the end it will fall to you to make the final hiring decision.
Hello Big Rig driving peeps!
I’m currently on 1mg dose of Suboxone daily!
And where I work the Boss asked me to get Class A Cdl license and start my own crew !
Since I’m on a low dose should I
A. Keep it to myself and not tell the MRO. I mean how could this be found that I’m prescribed it!
B. Get a note from prescribing Dr explaining how I’m doing with it and why!
C. Quit taking meds soon!
All honest opionions welcome !
Thank you and God bless you!????????
if you take lyrica can you still drive
@Robert
Not without proper documentation from your primary prescribing doctor.
Is Ritalin a disqualified and is it tested for on the 5 panel test used now for drivers
@Duane
You want a medical release form from your prescribing doctor explaining your need for the medications and the length of time that you have been on them.
Not tested for on the DOT 5 panel, but needs to be disclosed during the DOT examination. Having the medical release form in hand before you start is a huge help and answers many questions before you ever start.
I have a Class A CDL. I take 10 mgs of Ritalin a day and got my DOT medical card renewed today. (For one year, not 2 years because of the medication) Ritalin is a stimulant and not not an amphetamine and is considered a class 2 medication. Adderall is a class 1 medication because it is an amphetamine. You cannot get a DOT medical card if you take amphetamines. (That is what I was told by the Doctor) If you take Ritalin for ADHD, have the prescribing doctor write and sign a statement to the doctor that does your DOT physical. That is all I needed to do. Whether a company will hire a driver who takes Ritalin is another question. The drug will show up on a urinalysis.
I got into an accident in my personal vehicle in aug. 2014, have been written off work since then. I have had 1 surgery (disc arthroplasty) and still have 2 herniated disc in my cervical spine, and 3 bulging disc in my thoracic area, because of this I am in pain management program and currently prescribed oxycodone, my med card is going to expire soon but I dont want to loose my cdl as i still have hope that i will be able to go back to work one day after the surgeries and meds are done. Will they give me another med card, even though i am prescribed oxycodone since i am also written off work??? I know i cant work while i am prescribed this med, but can i still get a new card so my cdl doesnt expire (ect)… for when i don’t have to take the med anymore?
@jesi
Well your medical card was invalidated on the date of your auto accident, so you will need to get a new medical certificate before returning to work. If we read everything correctly now, you can not qualify as a fit for duty driver, so you can’t qualify for a new medical certificate. You will need a medical release form from your doctor before any CME is going to do a new examination.
Right now you need to talk to the drivers license department in your state and explain your situation. They should have a policy that helps you keep your CDL while you are in recovery. Once fully recovered and you have a medical release form in hand, then you can go for the new medical card.
I’m a cancer paitient who has over 2 million chargeable accident free Istopped driving a truck for a living in 2013
I take pain medication for a medical neccasary reason. I renewed my DOT medical card in 2011. While at the location of my physical , a nurse practitioner did my test. He noticed my fentanyl patch and immediately said I had failed my physical
I informed him that according to the DOT regulations, all class a narcotics are strictly FORBIDDEN UNLESS THE DRIVERS DOCTOR CLEARS HIM TO DRIVE. MY oncologist of over 12 years at that time understood and agreed that since I’d been on these medications for years , I was fully functional in every sense to operate a commercial vehicle . I’ve become acclimated to this medication that it does not affect my cognitive abilities whatsoever. He had me tested by another Dr who specialized in the mental cognitive testing. He cleared me also
So after I informed the nurse practitioner of this, he said it doesn’t matter I was to be disqualified! I then asked him to bring in an actual lisenced Doctor and the Dot book and I’ll show them the allowed exception that I legally was entitled to
He took my Drs phone number and was gone for like 45 minutes!
He and the head doctor then came into my room an handed me a 1 year medical card
This is 100% true. Like I said I no longer drive. After fighting cancer from 8/98 until 2012 with 6 relapses. Multiple chemo treatments radiation therapy until the level I cannot have anymore radiation therapy
Enough was enough took my Drs advice stopped working and was approved in 6 months for permanent SSDI I lost over 60k a year by not working. That hurts bad life is now $$ very difficult
But just hope this helps someone out there
Hagar
@Hagar
Thank you for taking the time to share your experience, that persistence and knowing the rules pays, especially when others are not going to take the time to help you.
We wish you blessings on your new path in life.
My prostate cancer has reappeared. Can the disqualify me as a school bus driver?
@Lynn
As an intra-state only driver you should check with your local drivers license department. As long as you can perform the duties of a driver and are under ongoing care you may be fine. But check with the DLD for final confirmation.
I have been on Time release Xanax for 7-8 years I do not have any side effects and can not even tell when I take 1, I take I a day. can I still drive a commercial vehicle?
@Stephen
Get a medical release form from your prescribing doctor explaining his findings and results and you should be good to go.
I am going for a DoT medical card, not for CDL just to save company on insurance thru new thi g they’re doing. I currently take suboxone and valium prescrobed by my physician. I have no issue from drugs and am on a low dose. Should/can I ommit these things since they are not tested for and skip possibly loosing my job? Thanks
Drive a regular truck under my standard licence. Have been on meds for years and never had any accidents before or since on them.
@Bob
Do not omit. You have a properly prescribed medication that is being given by an attending physician. All you would need is a medical release form and a copy of the script. If you omit, it’s considered lying and isn’t worth it.