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Q&A
What are the blood pressure requirements to pass the DOT physical?
Can I get a DOT medical card if I have hypertension?
What if I’m on blood pressure medication?
What if I don’t normally have high blood pressure, but I have “white coat syndrome”?
What are the blood pressure requirements to pass the DOT physical?
Here are the medical guidelines according to the Federal Motor Carrier Safety Regulations (FMCSRs). Note that employers are allowed to impose more stringent medical requirements.
- A driver with a BP of less than 140 / 90 may be medically certified to drive for a two-year period.
- A driver with a BP of 140 – 159 systolic and /or a BP of 90-99 diastolic, has stage 1 hypertension, and may be medically certified to drive for a one-year period. Certification examinations should be done annually thereafter and should be at or less than 140/90.
- A driver with a a BP of 160-179 systolic and/or a BP of 100-109 diastolic, has stage 2 hypertension, and is a candidate for antihypertensive drug therapy. The driver is given a one-time certification of three months to reduce his or her blood pressure to less than or equal to 140/90. Provided treatment is well tolerated and the driver demonstrates a BP value of 140/90 or less, he or she may be re-certified for one year from the date of the initial exam. The driver is certified annually thereafter.
- A driver with a BP at or greater than 180 systolic and / or 110 diastolic has stage 3 hypertension and is disqualified. The driver may not be qualified, even temporarily, until blood pressure is reduced to equal to or less than 140/90 and treatment is well tolerated. The driver may be certified for 6 months and biannually (every 6 months) thereafter if at recheck BP is equal to or less than 140/90.
Drivers with Type 1 or Type 2 diabetes, or kidney disease require treatment if their blood pressure rises above 130/80, since they already have a high risk of heart disease.
Can I get a DOT medical card if I have hypertension?
See blood pressure requirements for stages of hypertension. The medical examiner may require clearance from your treating physician before you can be considered for certification.
What if I’m on blood pressure medication?
Taking blood pressure medications will reduce your DOT medical certificate to one year. Your blood pressure must be controlled and be below 140 / 90 at the time of your DOT examination.
Also, it is very helpful, if you have a note from your treating physician that states that your condition is being treated and that the treatment has been shown to be effective, safe and your condition is stable. This information helps the DOT examiner determine if you are medically fit to operate a commercial motor vehicle for the designated time frame of your DOT medical certificate.
What if I don’t normally have high blood pressure, but I have “white coat syndrome”?
First off, we understand that this is a very real concern for some drivers. If you have “white coat syndrome”, tell the examiner, and ask to have multiple BP’s taken. He should be taking 2-3 readings anyhow, especially if you say so up front.
Look for certified medical examiners on this website. Each medical examiner here has a page describing their office and services. Find one who you would feel comfortable with. This should help reduce your “white coat syndrome”.
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A friend just called asking if the FMCSA was going to lower the BP requirements to 135/80 AND have a new BMI rule that no driver can have a BMI above 35. Any new rule making we should be aware about?
On Monday the American medical association reduced BP readings from 140/90 to 130/80 adding millions more people to so called high BP sufferers. Does this change the DOT regulations about BP for the DOT Physical?
I have white coat my blood pressure goes up when I think I can loose my job I know so many with this problem and now you lower it to 130 over 80 you people have no ideal how many school bus drivers will be off the road we just want to some day be able to retire but we need insurance and be able to pay bills your not helping us you are destroying lives
Exactly
I have been a full time OTR Professional driver for 32 years. In 2005 diagnosed with hypotension. Started with BP medicine and have never been denied a medical card with a constant BP of 130/70.
Ten days ago had my physical and medical card updated by a clinical Dr arranged by the company. He gave me a two year card.
My company is saying it should be a one year card.
Can the DR revolk (cancell) the current card before getting me a corrected card?
Steve I’m in same boat but your company is right. Below is the rule…
A driver with a BP of 140 – 159 systolic and /or a BP of 90-99 diastolic, has stage 1 hypertension, and may be medically certified to drive for a one-year period. Certification examinations should be done annually thereafter and should be at or less than 140/90
He probably won’t. That makes him look untrustworthy. . Like he doesn’t know what he’s doing. He could become unregistered.At that point, everyone that he passed would have to do their physical over again. I’ve seen it done.
BP was 160/90, and they gave me 30 day period to come back for DOT retest. Just started BP meds….Can I take more than one test during that period ? What if I fail next one in 2 weeks ?
Q: Is there an option for those of us with naturally HBP and high Cholesterol? I can eat a box of donuts and not gain a pound. I can still run a triathlon or 10K… I don’t get it. My arteries are clean, all the way up into the carotid and that’s after an MR angiography.
My BP is normally high. After a trip to a special testing office for my CDL physical, it was high by about 50 points on each side. I am otherwise in good health and shape. No gut, etc…. So the doctor gave me a 30 day certificate to get my permit, but I missed the timing mark. My BP is now down to the borderline- below if I go all Zen-like before the test.
Having had HBP all of my life, I still don’t understand why people like us, also with naturally high cholesterol, THIN (especially by today’s GMO, Walmart-life-style induced “era of girth”), have to be under the same standards as those with average body chemistry.
I failed my first Dot physical due to high BP. The DOT Doctor sent a form with me to take to my doctor. He said when my BP is under control, that my Doctor should fax the form saying my BP is good. The DOT Doctor said he was putting my Medcial card on hold for 45 days. My BP is good now since taking medication. It’s been good for 2weeks. My Doctor is faxing the form from the DOT Doctor with my BP being good now do I still have to wait the 45 days to get my card.
@Mary
The medical examiner would like to see your BP stable for 30 days before issuing a medical card.
You have 45 days to change a “determination pending” to an actual medical certificate. If you show back up at the DOT examiner more than 45 days after the first exam they MUST do a complete new exam.
My husband has normal BP but his heart rate ranges 37-51. Will he pass a DOT physical?
@Autumn
Depends on body type and medical fitness or issues. It will be up to the CME to make the final determination.
I have high blood pressure and I take 3 medications to control said problem. I was told the other day at my DOT Physical that due to the number of medications that I take for my blood pressure requires me to do a sleep study test. The doctor stated that the rules changed 2 months ago.
I can not find this change any where. Is this true or only this doctors opinion.
Please help me
@Cheryl
There has always been a mulitude of issues that could warrant a sleep study. To our knowledge, there were no new rule changes with the FMCSA and the examiner can request a study if he feels that there is a question of risk. You could go for a second opinion elsewhere.
My blood pressure was 140/80, The Dr. Would only give me a 3 months med card. I’ve never had any issue before. Why is that?
@Ron
140/90 is the cut off, but we suspect that with a BP of 140/80 that the examiner is wanting to make sure that you can get your blood pressure down, with or without medications. Thus the three month card. The CME is just trying to cover their behind. A blood pressure of 140/90 or below, without medications, should pass, but you really want to have a BP closer to 120/80.
140/80 is low for me! I’m half asleep when it drops that low.
This is bs he was in the guidelines this is all a scam if you are in the guidelines you should receive your card they send you in at the worst time of day to do your physical do it in the morning or early afternoon not after someone gets off of work what a scam as my doctor has told me blood pressure rises during the day stress work eating what a big scam another way to pick on drivers
Just went to my own Doctor and failed due to high blood pressure. I have been diagnosed with White Coat Syndrome. Even after relaxing, it remained high. The issue with me is not the fear of doctors but the fear of failing and not having a job. It’s the YOU HAVE TO PASS mentality that gets me. Took my blood pressure 2 hours after leaving the office with my 3 mo certification and it was 133/79. When are regulators really going to acknowledge this problem and come up with an alternative testing method??
I have same problem i run at about 134over around 77 pulse perfect go to renew i can go up to 150 or higher cant figure it out go to my doc im fine called dot no help dont care
@Dennis & Ryan
Here are some tips to manage your blood pressure and have it measure as low as possible during the exam. These can help you to get a ‘normal’ reading.
When I suspect white coat syndrome and the patient cannot get their blood pressure down after several readings, I will send them to their primary care doc to have their blood pressure taken. I have the doctor then fax me the results and if it’s under 140/90, I certify the driver.
A lot of times, it’s not so much “white coat syndrome” as it is “you-have-to-pass-this-test-because-your-lively-hood-depends-on-it syndrome” as Ryan described, and as soon as they leave my office, their no drops to normal.
I will typically take quite a few blood pressure readings if necessary. If I really needs to, I’ll put the patient in a quiet dark room with relaxing music and a glass of water to sip on to calm them down.
That doesn’t work they tried that with me. Instead of going down it was going up more.
I am in the same Boat! My BP is fine at home but the minute I go to the Company Doc it goes out the roof! And I am going this back this monday.This whole certified Doc thing is a load of crap.How can a DOT certified doc know more than my family doc and cardiologist both of which I have been seeing over ten years and both say I am fine.What happened to electronic sharing of medical records? Why can’t the DOT just get our history electronically from our docs? That would just make too much sense,now wouldn’t it! But then the money would stop for Dot Docs and they wouldn’t want that too happen!!!
Why does dot say if you have had stents put in you have to have a stress test when you’re heart doc says no i think your heart doc should know more about that than those people
@ Dwayne
You’ll need to take that one up with the FMCSA portion of the DOT.
I think there should be not DOT physicals. This way the dot examiner can’t play dr. Trying to say or do fmcsa rules is unfair. I don’t need a medical dot tell if I can or can’t drive. Due to there lack of knowing the driver medical history. The driver and primary care k owe more than them!!!
What length of time do you have to submit a recirtification from the Dot exam to the MVD if not driving? Ex.. I took my dot Monday planning on going back to work friday,swinging by MVD prior to working on Friday…is this acceptable?
@Scott
Depends! Depends if your previous medical card has expired and how long ago. Depends on the state, each state treats the downgrade process differently.
Just get to MVD and work it out with them. If your previous medical card had not expired you will be okay.
we had a driver fail his DOT physical for high blood pressure and he does not want medicine so we will not let him drive our commercial vehicles but should/can we permit him to drive our non commercial units such as a cargo van/ pick-up?
@Mike
In most states, not sure which state you are in, any vehicle that has the name of the company on it has to have a driver with a valid medical card. Not a cdl, but a medical card. Check with your local drivers license department to confirm.
Went last year got physical my blood pressure was 155 /90 got a year physical. Have go here in a couple months what does my blood pressure have to be get a one year physical. Not on any blood pressure medication. Have white coat syndrome got to my doctor blood always fine. What should I do.
@Tony
140/90 or less is the magic number. Anything lower is a plus. You should have your blood pressure lower and see if you can bypass the white coat syndrome http://dotphysicaldoctor.com/blood-pressure-tips-during-the-dot-physical-exam/. The CME is looking for safety related conditions and is not trying to put you out of work. So relax, take your chill pill, find your Yoda moment and have them take a few readings if you are right on the border. But it is better if the BP is a bit closer to normal, say 130/84.
Hello. I have High blood pressure. I get recertified every year because of it. I went today and my BP was 140/82, and thought I was good for a 1 year card. The doctor took it again and was 150/90. I got a 3 month pass. Should I have received my 1 year card with the initial reading or no?
@Corey
You got a one time three month medical card because you are taking a medication and your blood pressure was above FMCSA guidelines. And if your blood pressure is not below 140/90 at the next examination, in 3 months, you could be disqualified until you do get it below FMCSA requirements.
I was told by a doctor that they can give out more than one 3 month DOT card for a driver back to back but can’t locate that on the federal site. Is this true?
@Aimee
It depends what medical issue the 3 month card was issued to correct.
I have high blood pressure which is controlled with medication. My normal daily readings are usually in the 130s/80s as long as I take my medications. Will I still pass for a 2 year with my history of high blood pressure or will I just get the 1 year?
@Amanda
Yes – one year, because you are maintaining your blood pressure with meds.
So if start taking bp meds, it’s possible I can get a new medical card.
@ Armetheus V J
If you start bp medication right now, you will need to be on them for at least thirty days before you can take a new medical examination and you will need a medical release form from your prescribing doctor.
At my 1st medical card re issuing after 2 year initial card, my BP was taken 3 times, 152/102 – 150/107 & reportedly (though I did not see it personally) 180/110 in that order. I have never been on BP medication but the DOT certifier said I was disqualified. Now, unless I’m misreading DOT regulations, I should have been given a 3 month card with the expectation that I (and my PCP) get it under 140/90 within that period, correct?
@Steve
The 180/110 would be the disqualifier, and the lower numbers put you in a stage 2 hypertension category.
But ultimately it falls to the CME’S level of comfort and decision making as to whether he feels that there is a potential safety issue brewing. He can read the guidelines and interpret them as he sees fit.
Have someone check your blood pressure now that you are away from the clinic, a real blood pressure check not the freebies at WallyWorld.
If the pressures are below 140/90 then you may try another facility for a second opinion. But there is no FMCSA requirements to give you a three month card, only a recommendation via the guideline.
I’m hoping that someone can help with a rather confusing situation. I am a truck driver and have stage 1. hypertension. I take med.s and have been recertifying for my DOT physical every year for several years with readings around 140-150/80s .
Took my physical last week and reading was 144/80 and Dr. would only certify for 3 mo.s. My company doesn’t even understand this. I guess my question is—if I go back within 3 mo.s to re-test and my readings are still 144/80 am I going to be disqualified. Given these readings and the circumstances, this seems like a gray area? Thx..
@Ron
FMCSA has set the standard at 140/90. You can get a one time three month medical certification. After that, if your readings are greater than 140/90 you will be disqualified until you do get a reading of 140/90 or lower. That is FMCSA guideline.
is there a time limit on when you have to have a reading of 140/90 should you still me high on the 2nd attempt after you were issued a 3 months card.
@ jf
The limit is the three month card. You get only one 3-month card to get your blood pressure under control so you really want to work at getting your blood pressure down within the 3 months.
Newbie question- My hubs took a DOT physical a few days ago in preparation for school (lets use 2/28 for example purposes). He got a three month card due to blood pressure being too high. We are working with his PCP to get the blood pressure under control. We are getting conflicting information on when he can go back and get retested. Understanding that when he does retest, the one year card will be valid from the date of the original test (2/28 in this example). At what point can he go retest?
@Riley
After a 30 + day period on the medications to make sure that there are no side effects and the blood pressure must be below 140 / 90.
Being given a one year card due to 140/90 bp. Can I get a 2 year next time? Or is a 1 year always going to stick? I really believe that white coat syndrome. I take it at home constantly. 132/83. 129/82. But when I get to the exam it goes up. The doctor told me no matter what it is, after a 1 year is issued. They all will be 1 year. True? Great informative site by the way
@Dokar
140/90 is at the very top of the acceptable levels, not sure why you only got a one year card. Unless the CME feels that this is an issue that you will not take seriously. Yes you do need to get it down below 140 / 90 and keep it there during the examination. You can also ask for more than one reading. If you do not take medications and you get your BP down to a more normal range, then there is not a FMCSA regulation that states you cannot go back to a two year card, but it is up to the CME to make the final call. The single most important thing you need to do is as much physical activity as you can during the day. I know, easier said than done, and the only person who can help keep you healthy is you. So make some type of simple plan that you can adhere to. Good Luck
Went today and got another 1 year. But nice to know i can get a 2 year still. Even showed the doctor a video i had taken in full duration with my amron machine getting a 127/ 71 reading that morning. She asked to bring the machine in next time. Maybe next time i will just go else where. Knowing a 2 year is within reach. Thank you for your reply. Great board
question: Had one of my drivers go 2 weeks ago to the Little Clinic to renew DOT physical. BP
was too high so was denied and told to see his Dr. Driver had been on new BP meds since this. Today he goes back to Little Clinic and Dr. gave him a 3 month medical card. BP still a little high 135/100 — Driver leaves with 3 month card and is getting in car when Dr. called him and told him to come back inside — when he did, she took his card and said he has to wait 2 months from the original denial (2 weeks ago) to attempt to get a new physical. I’ve never heard this before. Anyone else had this issue or know if this is a true statement from the Dr.?
@TinaB
140 / 90 is the highest that a blood pressure can be for a driver to get a valid medical card once on medications. FMCSA recommends that a driver be on medications for at least 30 days to make sure that they will not have any side effects and has the blood pressure under control. Not sure why one you would get a one time three month card and then try to cancel it before he gets out of the parking lot. So unless the doctor cancelled the three month card off the NRCME registry, then he may still have a valid medical card. Check with your local drivers license department to confirm or deny the existence of the medical certificate. If the card has been cancelled, then you should be in a thirty days waiting period from the original beginning date of the medications.
Had my treadmill stress test. All of my vitals were fine except i was only able to get my heart rate up to 75%. Can I still get certified?
@Cliff
If your cardiologist feels comfortable with the final results and will sign off on a medical release form, then you should be OK on this issue. So have a copy of your medical release form and a copy of your latest stress in hand when you go for the DOT examination and you should be in good shape.