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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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My husband is a diesel mechanic and holds Class B CDL. He does not drive a truck on the highway at all. He is diabetic and medications are not controlling his levels so he going to need to go on insulin. Will he need to get an insulin exemption in order to get a new medical card? We live in Georgia, and he works in Tennessee.
@ Stefanie W
He is a class B and will fall under the states variances. So check with his local drivers license department for the best answer.
How long does it typically take for the medical examiner to contact you if you test positive for any non-prescription drugs?
@ Nick
It is not the doctors responsibility to contact you for this. He would report to the authority that request the drug screen. That usually would happen within a few days.
I’m getting ready to start a Weight loss program with a DOT approved doctor is there any known medication that I might be able to take to assist weight loss and not be disqualified from driving
@ John
Your DOT approved doctor will know what is acceptable and what isn’t.
Hello, I’m currently a Limo driver in NYC. My company has asked me to get my B CDL so I can drive the limo bus. I had a brain injury over 15 years ago and since have been on citalopram 20mg once a day for anxiety/ depression from the injury that’s now and has been controlled for many years and a very small dose (as needed) of alprazolam .5mg. I also take metoprolol 100 mg once a day to slow down my heart( I have SVT, not heart disease). I have been on all of these for 10 years plus. Do you see anything that would immediately disqualify me? Is it worth even trying or am I wasting my time?
Regards
@ Christopher G
Have medical release forms from your doctors in hand and you should do fine.
I am a certified family nurse practitioner and am working in addiction medicine. I have read many comments about Suboxone, Subutex and Methadone but did not see Vivitrol. I know that Suboxone and Subutex show as Buprenorphine in a urine screen. Since Vivitrol injection only contains the Naltroxone and does not have an opiate component would it disqualify patients from receiving a CDL license? Would it show in a CDL urine screen? Would the CME immediately disqualify the person for being on this injection? Would a medical release and 30 day usage period be enough to allow the person to receive a CDL? If the patient is in a medication assisted treatment program and receives medication at that facility do they need to list Subutex, Suboxone or Vivetrol as prescriptions? Since this is a MAT program the medications do not show on an OAARS report when it is run so does the person need to report them as prescribed? Thank you for your assistance.
@ Tracy J
First are we asking questions about a cld license or a DOT medical card. All medications are to be listed on the drivers intake for a DOT medical card. They would need releases from any prescribing doctor. And a patient or client that is in an active rehab program would not qualify to take a DOT medical certification examination.
I have been on oxycodone for the last ten years, I had my DOT physical and received my 2yr med card. I both tested for and received my class A permit. I was cleared by the company’s MRO and was subsequently medically disqualified by the company safety dept. I was attending the company driving school and had 2 days left before I could test. To make a long story and potential lawsuit short….the company decided for whatever reason that they would not work with me on prescriptions at all. I have since received spinal steroid injections and am weaning off oxycodone for the first time in 11yrs.
My question is would the rest of my pain management regime disqualify me. Once I’m off of the oxycodone in a couple more weeks I will still be on Lyrics, Robaxin, and Diclofenac. I had several med releases that clearly stated these drugs in conjunction with the oxy would not effect my driving abilities at all. So should I maintain any hope of being qualified medically to drive it while taking these meds?
@ Sean J. B
All the meds are going to raise questions, but if you have proper documentation and medical releases from your prescribing doctors, then you still may have a chance. FMCSA is looking for safety issues in its guidelines and the CMS’s are to take all the available information into consideration. Good Luck
I ran into that once with the pain med. Went tto the companies driving class. Etc then they popped a random on everyone mine came up positive for hydrocodone i had all proper release from doctors. It even showed up on initial preemployment. Nothing was said. On application it asked no where about current meds i was escorted out by security. Called attorney and was able to sue them under the Americans with disability act. After i did this many others sued them as they went threw same thing at that time had had my cdl for 15 years never even so much as a over weight ticket. Alot of these companies are getting sneaky as how they do things.
A driver at our location that has a DOT Medical Card is asking if she can take a prescribed medication of Saxenda.
@ Carol B
She would need to be on the medication for thirty days to determine if there are any adverse side effects. Once clear that there are no side effects that would influence her ability to operate a cmv safely, then she could return to driving. A new DOT physical would be required and proper documentation with a doctors release form from her prescribing doctor also.
Driving a medical card 14,000 lb truck in NH. Vt. Can I take cyclobenzaprine 5mg up to three times a day, with no side effects, neck injury, feb 18 accident.
I m looking for an answer on this and can not find out anywhere.
@ Donald B
Your DOT medical examiner will have to answer this question because you fall under your states variances and not the federal guidelines.
I do. Same dose. 3x/day. Never been brought up in drug screening.