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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 was recently denied a medical card for listing cannibis oil as an over the counter medication on my DOT physical questionnaire. Oil is legal in the state where I received the exam and can be purchased at any health store. Was my physician justified in making this decision?
@Joann
DOT medical certificates for interstate drivers is a federal issue. So for a federal medical card, yes your medical examiner is justified in making this decision.
Your ability to purchase and use oils of the cannabis plants are a state level issue and falls under different rulings.
I plan to get re-certified to obtain my cdl. I am Pre-diabetic and has been prescribed Metformin, which is keeping my blood sugar to safe levels. I’m am on two medications for blood pressure: am lodi pine Besyate. For indigestion it’s Ranitidine. My question is am I qualifyed to operate a tractor trailer?
@Rock
Make sure you take a medical release form from your prescribing doctor explaining your medications and their usage. If all else checks out, you should be good to go.
I was denied my medical card for taking nitrostat. I got a stress test and passed. Why did the doctor denied my medical card.
@Eric
You should have been asked to provide additional information to the CME, so he can make a better judgement call regarding your present condition. Get a medical release form from your prescribing doctor explaining your situation and medical needs. Take that information with you and go get a second opinion from another CME.
I UNDERWENT A COUPLE OF HERNIA SURGERIES AND HAVE BEEN RELEASED BY MY DOCTOR. I WAS ON MY LAST DAY OF PRESCRIBED PAIN MEDS. THE MEDICAL EXAMINER STATED I HAD TO GET A DOCUMENT SIGNED (THEIR FORM) FROM MY DOCTOR SIGNING OFF. MY DOCTOR COMPLETED THE FORM. THEN THE EXAMINER WAS SHOCKED THAT HE SIGNED OFF AND SAID SHE WILL NOT ISSUE IT AND WILL MANDATE 30 DAYS OFF BEFORE I CAN RETEST BECAUSE SHE IS SKEPTICAL THAT HE WON’T PRESCRIBE MORE. IS THIS LEGAL??? IF I WAIT A COUPLE OF DAY UNTIL IT IS OUT OF MY SYSTEM AND I TEST NEGATIVE HOW CAN SHE HAVE THE AUTHORITY TO NOT GIVE ME MY MEDICAL CARD (ALL OTHER ASPECTS OF THE PHYSICAL PASSED)
@Gregg
Well since there is no drug testing on the DOT physical and your CME has ask for your primary to sign off and he has, I am not sure where she is getting her authority from. Yes you need to be off your pain medication so you can qualify as fit for duty. She is to determine fit for duty, end of subject.
You wrote: <>
With due respect, you are not correct here. I have held my Diabetes Mellitus Exemption, issued by the FMCSA, since 2008. They implemented that program shortly before 2008. This allows me to drive interstate with no restrictions. I always like to reassure hesitant employers by showing them my Dexcom continuous glucose monitor, which beeps to alert me when my blood glucose level *starts* to get too high or too low.
As for the state of California, they restricted me to not driving passengers or hazmat, but that was reversed after I complained to the Governor about that practice.
Will taking tramadol with a prescription disqualified m ?
@Ricardo
You will need a medical release form from your prescribing doctor so the medical examiner can make a more informed decision. The final decision still rests with the medical examiner.
Is degenerative disc disease a disqualifying condition? My pcp put me on gabapintine for the pain as needed, but also Aleve for the inflammation. I’m not really sure if I would pass a physical because of the medication and the reason for it.
@Robert
The medications would cause questions, but you also need to be able to perform the duties of a CMV operator. So the CME is looking to determine medical fitness for duty before he will pass you.
It sounds like you may have difficulty doing the physical aspects of the job. If you can do the job then make sure you take a medical release form from your doctor to explain your medication usage and needs. It helps the CME make a more informed decision regarding your situation.
In Alabama,beside a church bus,what else am i legal to drive with cdl-A class but no physicle card in alabama only?
@Tandy
This is not a medical certification related question. You’ll need to ask your local drivers license department.
Can you please explain why methadone automatically disqualifies one for medical when much stronger pain meds dont. It works wonders and does not affect my mental like oxycotin and oxycodone. I understand the bad reputation because it also used to treat substance abuse in clinics which is partly run by federal government (where they do profit) while subutex and suboxone is allowed and treatment is all they are used for. Afterall they use methadone do get off prolong use of those allowed pain meds… it just doesn’t make sense to me at all. You can get clearance from Dr for the pain meds as well as medications that ONLY treat abuse… but not one that helps with that AND pain and is prescribed for pain. Please enlighten me???
1. Baewert A, Gombas W, Schindler S, et.al., Influence of peak and trough levels of opioid maintenance therapy on driving aptitude, European Addiction Research 2007, 13(3),127-135. This study shows that methadone patients aren’t impaired at either peak or trough levels of methadone.
2. Bernard JP, Morland J et. al. Methadone and impairment in apprehended drivers. Addiction 2009; 104(3) 457-464. This is a study of 635 people who were apprehended for impaired driving who were found to have methadone in their system. Of the 635, only 10 had only methadone in their system. The degree of impairment didn’t correlate with methadone blood levels. Most people on methadone who had impaired driving were using more than just methadone.
3.Cheser G, Lemon J, Gomel M, Murphy G; Are the driving-related skills of clients in a methadone program affected by methadone? National Drug and Alcohol Research Centre, University of New South Wales, 30 Goodhope St., Paddington NSW 2010, Australia. This study compared results of skill performance tests and concluded that methadone clients aren’t impaired in their ability to perform complex tasks.
4.Dittert S, Naber D, Soyka M., Methadone substitution and ability to drive. Results of an experimental study. Nervenartz 1999; 70: 457-462. Patients on methadone substitution therapy did not show impaired driving ability.
5.Lenne MG, Dietze P, Rumbold GR, et.al. The effects of the opioid pharmacotherapies methadone, LAAM and buprenorphine, alone and in combination with alcohol on simulated driving. Drug Alcohol Dependence 2003; 72(3):271-278. This study found driving reaction times of patients on methadone and buprenorphine don’t differ significantly from non-medicated drivers; however, adding even a small amount of alcohol (.05%) did cause impairment.
It has a bad reputation but NO science backing it… just bad stigma
so why has,nt anyone had methadone taken off the d.o.t disqualification spec.s ??? How can I do it, As ones know that take it, It does nothing to your driving abilities, Theres many far worse drugs out there that should ban a driver,This law needs to be changed pronto because many good drivers are losing their jobs over this,If you know how we that care can help or get this law changed please reply.
@Kevin
Basically it should fall under the same guidelines and understanding as all of the pain relieving medications.
But that being said, too many CMEs never understood the relationship between the drugs, time and the drivers. So they just ass-u-me that this medication is a total disqualifier.
Since FMCSA has no new guidelines for the new DOT examination and have left the examiners without some level of guidance, you are going to see more good drivers being disqualified due to possible risk factors, so the examiners will be very leery of any medication that a driver may be taking.
If suboxine is allowed, how about Fentinyl patches? I’ve been on it for 6 years, no MV accidents or alcohol incidents in 20 yrs. I had a CDL, but let it expire, now I want to go back and drive class A. Please send me an email ,Thank You!
@Paul
Make sure you have a medical release form from your prescribing doctor explaining what medications you take and why. The CME needs as much information as possible to make the best possible decision in your case.
Sorry friend fentanyl is an opioid medicine and automatic dq. It is a hundred times stronger than heroin . I know, I was on it for 18 years and it never affected my judgement of driving my car or 32ft rv. I was on it for an injury I received when rearended by semi driver who was impaired. I have permanent damage to my back and neck from it. I can guarantee as so as the MRO sees fentanyl on your list, you’ll be dq’d. Sorry to bear the bad news and I am in no way trying to be rude just truthful. I had to surrender my Oregon CDL that I held for 20 years when I was out on Fentanyl.
Hello,
I just went for a Physical. I filled out the paperwork. I wrote down that I had taken a prescribed 1 mg film of Suboxen about a week ago but can no longer take it because it causes me to vomit. The nurse said when the Dr saw that I wrote down suboxen, he immediately disqualified me BUT will give me an opportunity to get tested (which they did not do on that day) by my primary dr to see levels of Suboxen in my system.
The reason I am telling you this is 3 fold. Had I NOT mentioned the Suboxen and went ahead and did a Urine, had it been found, I would have gone through a lengthy review, which I would have been successful in BUT it takes DAYS/maybe even WEEKS to accomplish
#2 Since I mentioned it on the form asking what meds I was taking, the dr rejected me immediately.
#3 Because he rejected me immediately, he gave ME the opportunity to go to my primary dr and get tested, which will be almost immediate. If the result is NEGATIVE for Suboxen, then I can immediately go back to the DOT exam and take the Urine test (with results from primary in hand of course)
I am not too worried about being restricted concerning Suboxen because it does cause me to get pretty sick right away. I did take it about a week ago because I had nothing else and I was in a lot of pain.
I, once again, did NOT realize that Suboxen was given to people who are drug addicts. The reputation of a drug WILL follow YOU into the office, forcing YOU to explain that YOU are not a drug addict.
I went through the same thing when I was given methadone as a supplement for pain.
As a side note: I did NOT know that Methadone will totally screw up your teeth so I am suffereing from the side effects of Methadone. I have chipped teeth (2) and one tooth that fell out in the back. DAMMIT!
Now I need to find out WHAT the hell I CAN TAKE and pass a physical and THEN find a DR who will prescribe it! I am in MA and the only people in this state that has pain medications are the drug addicts, drug dealers and the RICH! (We KNOW that THEY will NOT BE DENIED, if THEY are in PAIN. We LITTLE people have to suffer, jump through hoops because of the ridiculous laws they have put in effect!
Why don’t they just enforce the original laws on the books and clean up the DRUGGIES and their DEALERS?? No, I guess punishing the people who are really IN PAIN IS THE ANSWER!! UGH!
I went to renew my medical card, and it was put on hold do to me being on subutex even tho they gave it to me 2 years ago being on the same med. I don’t drive a semi it’s a maintenance truck over the 10,001 requirement. I’m in the process of doing the waiver. So my question is with my Dr’s approval and note saying I’m very competent on the medication and has no adverse affect on me. Do I even stand a chance on getting my card. Also they said I have to pull my medical records but how far back do I need to go. It’s all I can do to get any answers. Thanks
I am trying to find out what medication is dot certified for quit smoking thank u
@Mennie
The list is much shorter to find out which ones are not qualified.
Any medication that has the ability to alter a drivers ability to safely operate a CMV is on that list. So if the side effects on the box indicate that you may have difficulty do your job safely, then it will be a disqualifier.
@Josh
Someone is testing you outside of the state variances that you need to be tested under. Explain to the examiner that you are a local driver and fall under the states guidelines and not in the class A federal guidelines.
You should do fine, especially if you have a medical release form from your prescribing doctor. You may need to check with your local drivers license department for final clarification.