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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 am 19 and live in NC. I need to get my CDL permit for Lineman course. I take vyvanse and have for years. Will this prevent me from getting my CDL?
@ Caroline D
Your cdl is state issued and falls under the states requirements. not DOT/FMCSA. Either way, you should be able to pass the medical certification examination. You may need a medical release form from your prescribing doctor, for the medical examination. Most states are not very strict regarding your particular medication, especially if you have been on then for a suitable/prolonged period of time.
Hello, First let me say that I finally made it through all the questions and commentary. This has been somewhat helpful to my situation BUT I am still unclear about a couple of things. I have a valid class A license in MA. I currently have a valid MA DOT med card. I recently graduated driving school and have basically no driving experience. It has been difficult to find a local job without at least 6-12 mos. of driving experience. So I have been filling out apps with the larger OTR companies that offer training programs for new drivers. So far I have been given multiple “conditional” offers of employment only to have the offer rescinded once I am open about being in recovery from opiate addiction and being prescribed suboxone. I currently take the lowest dose of 2-4 mg a day as needed. When I share this openly I am refused employment before I even get to take the pre enrollment DOT physical/screening etc. I’m open about it because I don’t want to chance taking a test only to fail and have the results reported to the Clearing House. I can pass a urine test without any problem but it seems almost every company is doing hair testing now which presents an issue aside from me shaving my entire body before going. My questions are:
1) you mention numerous times in your replies that it is important to use a CME that understands the FMCSA regs…how do you go about determine if the CME does indeed understand them and what if I’m at the mercy of the CME that the company uses?
2) you also mention that it’s important to provide proper medical documentation from my prescribing doctor describing the condition and reason for Suboxone. What verbiage exactly should be used by my doctor that would be acceptable by a CME to explain my suboxone prescription?
3) I saw in an earlier comment that Naloxone is an acceptable drug and will not cause a test failure. Would you recommend that I speak with my doctor and request that the prescription be changed to Naloxone? Would this be a remedy to my situation?
I’ve worked VERY hard to get where I am at and have overcome too many obstacles in my recovery to only be shot down by every company because I am managing my recovery properly and under a doctors care. I got my CDL because I LOVE to drive big rigs and heavy equipment and it is the only way to make enough $ to support my wife and 3 year old son. Any advice you can provide would be greatly appreciated.
@ Fred
Your situation is different than the answers you quote. Suboxone for opiate addiction is very different. It is the medication and the reasons for which you take these meds that all CME’s are going to question and most likely disqualify you. There is no verbiage that over-rides the addiction factors. You may look into intra-state only for a time while you get clean. ( and we applaud your efforts in a tough situation) Intra-state only places you in the states guidelines and variances, (not FMCSA) which you may get through. The change in medications will make little difference due to the nature of the prescription.
Thank you for the reply and the advice. It has been difficult finding an intrastate company willing to hire a driver with no experience. May I ask another question. I am at the point in my recovery where I can taper off/discontinue taking the suboxone. If I discontinue taking it and wait long enough for it to clear my system before seeing a CME do I still need to inform the CME that I was prescribed suboxone in the past year? Are CME’s able to view prescription history even if I choose (take the chance) not to list it? As long as it doesn’t show up in a hair or urine screening will I be in the clear? Or am I screwed for the time being because the CME can access a data base showing all my prescriptions and history of having them filled?
@ Fred
Once you discontinue your meds, you still need a medical release form from your prescribing doctor and your substance abuse counselor. Denying appropriate information on the medical intake form could cost you in the long run. ? is it worth it?
I have a class B cdl.I drive a bus. My doctor prescribed zolpidem for insomnia. Can I take this medication and still drive the bus?
@ Pam
You are a class B driver and should fall under your states guidelines and variances, not DOT/FMCSA. Your medication would be in serious question if you had a class A interstate drivers license. Make sure your medical examiner knows the difference between your states guidelines and the class A DOT guidelines.
Stop sharing that personal info. They have to test specifically for that. Keep those things your business in regard to that.
If you filled out your medical card before receiving your prescription, when and who is supposed to fill the new info out on the long medical card? The doctor or the driver? I went to my D.O.T Medical exam and the doctor ran blood work on me, before giving my certificate. She prescribed medication after I filled out the part to list ALL MEDS. Who is supposed to fill in the new info, the doc or me?
@ Edwina
DOT medical examiners are not supposed to perform any diagnostic testing or prescription handouts at the time of the DOT/FMCSA medical certification examination. We believe it should fall on the medical examiner to complete the proper paperwork in this case.
My dot medical examiner disqualified me because I use to be prescribed suboxone I even went as far as to get a letter stating that I am no longer under the prescribers care and was told by the medical examiner that I could never have a medical card again unless I went to rehab
@ Rodney W
Go get a second opinion, your last examiner may be over reading the FMCSA guidelines. Yes you need supporting documentation and a medical release form from your prescribing doctors, but with information in hand you could be OK.
Will Kratom make me fail a dot drug test?
@ Drew
You may fail since Kratom does have opioid characteristics.
If a driver is prescribed a pain medication by their doctor, are they required to report that information to their supervisor or medical examiner?
@ Tim
If you have pain or illness which has taken you out of driving or places a risk factor, both to yourself or the public at large, then it would be best to inform your supervisor. And you would need to have a new DOT/FMCSA medical examination, so yes you would need to inform the medical examiner.
I have already taken a DOT drug screen but after I got home I realized I didn’t take in my medication bottles with me. Now I’m afraid I will fail my drug test. I am taking Metoprol just 25mg twice a day for a mitral valve problem. Is that medicine going to make me get a false positive?
@ Brian
If you did a DOT drug screen and it comes back positive, then the medical review officer for the drug testing company will contact you and ask for a copy of your medication prescription. Just be prepared to supply the information to him.
I have my Class B and I drive a school bus. I also have severe RLS and my neurologist wants to prescribe Gabapentin. Will this medication preclude me from driving?
@ Lisa
Class B license holder fall under the states variances and guidelines. Check with your local drivers license department for the best answer.
I am not truck driving right now but do have a CDL and my health card needs to be renewed. My doctor has me on Trazadone and Fluoxetine for sleep and anxiety. I am okay when I take them and once my body got used to them I had no side effects Will this keep me from getting my health card?.
@ Manuel M
Your medications and health conditions will raise questions, but with proper documentation you may be cleared.