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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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I was told my blood pressure had to be 120 over 80 and not above 80 or I would not pass the DOT physical is that correct?
@ Betsy
Not so for FMCSA. 120 over 80 to 140 over 90 are considered normal. Approaching the 140/90 mark is a good indicator for high blood pressure, you would like to keep your pressure is the 120’s over low 80’s.
Hi, I had received a temporary three month Dot medical card. It expires in a couple of days. I went for an annual check up on a different mater, and was told my blood pressure was 180/90 today. I’m very nervous I will be disqualified. Will I loose my job on the spot?
@ Regina
In most cases you are going to be medically disqualified until you get your blood pressure under control. As for your job, you need to talk with the HR department of your company.
Will I loose my job, if I am disqualified for the second time of my dot medical card
@ Regina
You have to ask the company this question. Each company has different policies, so check with your company’s Human Resources department.
wellllll YEAH you’ll lose your job-if your required to have a DOT Physical/Medical Card and cant pass it ie: get a card your disqualified ie: no longer have a valid Class A (requiring a Medical Card) so yeah if your job requires it then…bad news!
I’m in antibiotics for a infection and my BP is fluctuating between 135/80 and 140/80 is this a cause for concern at dot physical?
@ Jason 2
There will be questions regarding the extent of infection and your prognosis. A note from your primary about the bp fluctuations would be helpful also.
Initial Medical Examination resulted in a 3 month card being issued. Went back at the 3 months, was eligible for the one year card. ME gave new card with an expiration of 1 year from the original exam date but only gave a new card (form 5876), did not complete a new long form (form 5875). Is the ME required to complete a new long form or can they just issue a new card to the original long form?
@ Mindi
A lot depends on the issues which warranted the first 3 month card. Also, most examiners would do a full new DOT examination.
If you were asked to come back in 3 months then something such as blood pressure was not within limits. At your initial visit the completed exam was done, but you did were not qualified due to “something”. Once you followed up your results were evidently within limits and you then qualified. A completed exam is not to be done again at all follow ups. The additional info will be viewed and your certificate will reflect the date of your exam, not your follow up.
ON SEPT 7 2018,HAD DOT EXAM, BP WAS145/90, WAS GIVEN A 90 DAY CARD, ON DEC 5 2018 DOT EXAM BP WAS 140/92, DOCTOR DISQUALIFIED ME, ON DEC 18 2018, BP WAS 130/80, I WAS GIVEN ANOTHER 90 DAY CARD. WHEN I ASKED DOT DOCTOR WHY WASNT GIVEN A 1 YEAR CARD? HER REPLY WAS THAT SHE WASNT SATISFIED WITH THE WAY MY PERSONAL PHYCIAN IS TREATING MY HYPERTENTION.I TAKE BP MEDICINE EVERYDAY,HAD MY DOCTOR WRITE A NOTE EXPLAINING THAT HES BEEN TREATING ME FOR HYPERTENTION.THIS. WHAT GIVES HER THE RIGHT TO QUESTION MY PERSONAL DOCTORS TREATMENT PLAN? I PASSED DOT REQUIREMENTS FOR BP AND WAS ONLY GIVEN A 90 DAY CARD. WHY WASNT I GIVEN A 1 YEAR CARD?
@ Jim
Registered CME’s have the right to continue a basic monitoring process for cdl drivers, especially when there has been a change like yours. They do not have the right to questions your doctors treatment plan, only monitor. That being said, they have the right to limit the card to 90 days until they are happy with the findings. Then you’ll get the one year card.
ok thank you, jim
Guessing you went to a Doc in the Box…Mine Questioned my Cardiologist Letter…so the Nurse Practitioner is Smarter then my Cardiologist??? Feel that these Doc in the Boxes are only giving 3-6 month cards now and no more…my BP That day was 128/86…and she want to give me a 3 month card…Went to my Other DOT doctor and Passed…We should be able to Pick our Doctors..as long as their DOT CERTIFIDE. and stop using these nurse practitioner and doctors tgat can only get a job at a Doc in the Box
Hi Doc,
On Friday my BP for a required physical by my employer was 186/94… then 10 minutes later it was 156/94. I was forced to do this with a year left on my current physical because I had a high spike in my BP prior to it. I’m on meds and the doctors through testing determined my hypertension is weight based. Everything looked good per the doctors yet the new physician who did my DOT only gave me a 3 month certificatcation. Am I correct in believing I should have received a 1 year and not a 3 month? What are the newest guidelines per FMCSA regarding hypertension and what we’re allowed on time on our medical cards?
Thank You
Ken H
@ Kenneth H
The CME is correct, your blood pressure is not completely under control. They issued you a 3 month card to give you time to get your BP below 140/90. That’s a long standing FMCSA guideline.
Hi Doc-
Getting on a bus tomorrow to go to a CDL school, and am worried about the blood pressure reading.
When Im being “good”, my blood pressure is pretty normal on medication. I take Indipamide 1.25mg and Almdipimine 10MG. My concern is that the Amlidipine will disqualify me to to the side effects of “dizziness, use caution when operating a motor vehicle” even though I have never experienced any of these side effects. Do I have a reason to be concerned?
Thanks so much.
@ Mary
With proper documentation and a medical release form from your doctor indicating the length of time on your present medication regime, you may be OK’ed for a one year certificate.
Can I still driver wow being on dialysis
@ Colby G
Not as a class A driver.
What about a school bus driver being on dialysis?
@ Mike
This will be a state related question and will be best answered by your local drivers license department.
Can I get back the 2 year certification again if my BP is normal from the Stage I hypertension without taking medication?
@ Eric
FMCSA reads it like this: is or has there been a history of high blood pressure. With your doctor’s note of compliance and a healthy life style, it may be possible. But give it some time.
I went to renew my dot fed med card 2.5 months ago. I get a little nervous when i’m there which causes my blood pressure to go up. I was given a 3 month temp card and a form for my doctor to fill out to evaluate my bp. I went back to the dot place for a follow up on my bp. the lady at the counter said the I had to do my physical all over again. she stated that was the new dot rule any body that gets a 3 month card has to do another physical again. Is this true or is she just confused about the rules.
@ Mark
FMCSA has requested and required that a new physical be performed to make a valid determination regarding the drivers fitness for duty.
If I fail a second D.O.T medical exam for HBP what happens to my Class A license
@ Brian V
Most states require a valid medical card to maintain a valid class A license. But you should have enough time to get with your doctor and get your BP under control.
I just started hemodialysis. MY dot certificate expires in November. Does being on dialysis disqualify me for getting my certificate renewed?
@ Brooke
Your DOT medical card became in-valid the moment you started hemodialysis. Once you are released to return to full normal work duty you will need a new DOT medical certificate. Make sure you bring a medical release form from your doctor and your latest test results.
I took my dot physical and was told i have high blood pressure. Was given a one year card. But felt they got me nervous asking all these questions. I went to my doctor and he said my blood presure was normal. Will i always have a one year cert. From now on
I have anxiety and have had for the last two years. I have been getting my DOT physical at the same location for two years. I went to get my recent DOT physical and the doctor said they needed a letter from my primary care doctor stating that I’m compliant with treatment and not abusing medicine. Is this something that sounds to be correct?
@ Patricia A
It is correct, the examiner is requesting additional information to aid in his decision making process.
I have had my CDL for 3 years now. I have been issued a one year certification due to my blood pressure being controlled by medications. However, my last DOT exam I was issued a 2 year certification even when I disclosed my medication AND the fact that I have been issued a card for less than 2 years on the form. Will I run into a legal ramification with this or is it simply up to the discretion of the examining doctor?
@ Kimberly J K
Your examiner does not understand the FMCSA regulations and as you stated should have issued a one year card only. This was not your error. We recommend that you continue with the one year re-examination and make sure you find an examiner that understands the FMCSA guidelines.
Does having anxiety disqualify someone from driving a CMV?
@ Dawn
If you are taking med for the condition, then make sure you have a medical release form from your prescribing physician.
I suffer from chronic pain for which there is no viable cure or treatment other than medications that would prevent me from passing the drug screen testing. My PCP says although I am being treated for high blood pressure he believes that 90% of my problem of the higher BP is due to the chronic pain and 10% to being overweight. He’s found no evidence of heart disease. I’m already on a one year schedule for physicals. My PCP is not DOT certified. How do I continue to qualify?
@ Terry A
You should continue with the process that you have been using. Apparently you have continued to qualify for a one year card, so keep doing what you have been doing.
For the past three one year certificates I have submitted a letter from ENT for CPAP compliance and another letter from my Internal Medicine Doctor certifying “no diagnosis of hypertension” with weeks worth of BP readings averaging 130/70. I have “white coat” and always read high like 150 to 175 for Systolic. Diastolic always lower than 80. I have still been given a one year. This time I got a 3 month even with the repeated proof and documentation. I don’t trust anyone any more. Thought Medical Registry imposed some level of standardization but different facilities still apply disparate standards in dealing with special situations.
I am a combat veteran and when I don’t trust people or the system my anxiety and stress rockets up. My job is on the at every exam. Never know what to expect…..
did you notice you never get an ansaw when your bp goes up and down for mood change because this whole physical is a scam. i want to know how many drivers had accidents back before you was required to take a physical what about driving cars you have more cars on the road then trucks why take a mans lively hood away because of high bp do we live in a free country or not try makeing people who drive cars have to take physicals i dont think that would work out for them to well. i used to be very athletic in my younger years I ran 5 miles a day my bp went up and down 130/90- 140/80 some times 145/90 I am now 60yrs old and my bp is still the same depending on my mood so depending on my mood i should loose my cdl and starve my family because of my mood that day its ridiculous i watched a man loose his work and was scared to death he was not going to pay his bills he cried like a baby he didnt know how to explain to his wife they may be evicted if he cant get his med card soon I payed his rent for him until he got it its so hard to watch this beautiful country go down this way but if the country had an emergency they would suspend that rule in a minute the hypocrites
I have never taken medications for HBP. I went and got a 90 day because my BP was high. I am seeing my DR to try and get it under control. What happens if I can not get it under control with in the 90 day window? It has me very concerned because I can not afford to lose my job. Can I get another extension while I work on it with my doctor, if I show I am working on getting it regulated? Thanks
@Chriss
It may be possible, but don’t count on it. Most cases the CME wants to see it under control before giving you a new medical card.
Sorry. Could not find a good place to stic” this question in here. I was put on bp meds a few years back and given the 1 year cert. I have not taken any meds for bp or anyother now in two years, i have my diet and bp all under control, yet the concentra nurse tells me its virtuallt impossible to go back to a 2 year cert and will not tell me the process to doing so. Of course they want that annual dollar for my physical but i want my 2 year cert back. How do i go about doing that. Our company only uses a certain facility so my options are null so far as going to a different examiner.
4got to give u my numbers. Just got through with a long walk and doing excersises. tested half hour and my bp was 110/73 pulse 71 on right arm and 111/73 pulse 71 on left arm. so my bp is well under control.
@ William
Sorry to say but the nurse is pretty much correct. FMCSA has set a guideline that indicates once on bp meds monitor yearly.
Blood pressure is a scam, the numbers are created AND lowered by big pharma companies because it’s a huge money maker. I’ve had the same BP my whole life, it’s always 140-150 over 85-95, I run and eat healthy, I’m not over weight at all. I don’t drink or smoke. I was put on Lisinipril because of the ridiculous DOT requirement, and it didn’t even make a difference, just made me really tired. Some people just have higher BP than others, the whole “silent killer” is a bunch of bull. My friend eats fast food everyday, never works out and has a gut from drinking beer every night, his BP is 120/70, so it’s all bullshit
You are absolutely correct!
You are correct. There is plenty of disagreement in the medical “profession” about that, so just because the ones who claim BP (taken in a stressful situation like a job-threatening hostile exam) has to be exactly under 140-90 for everyone then we are forced to “submit.” This FMCSA system is unethical. If they have a question about your BP they should then direct you to get an opinion from a real doctor and have that determine whether you pass or not.
I been on HP meds for three yrs and been getting a 1yr card when I went to get my physical done it was 133/90 and the doc side I was good for 2 yrs and I said I was on HPMeds and he said it under control and good for a 2 yr card is this right or should I have gotten a 1 yr card
@ Doug
FMCSA guidelines recommend a one year card for individuals on high blood pressure medications. You should have received a one year card.
Had much the same here. However I have been off my bp medication 5 months
I went back to receiving a 2 year card.
The Dr said since i was off the med , and stable i could go back to a 2yr card. Is this correct
@ Robert
It is up to the CME’s discretion, but in most cases you would need a medical release form from your primary doctor stating that he removed you from the prescription and the CME may hold you to a one year card to continue monitoring your bp. FMCSA writes it vaguely as “ever been on bp meds”.
I think the medical card is a scam. Trying to push Bp med just fmcsa has a low stand guidelines.
If I had a 3 month certification because of blood pressure but thought it was 6 months so haven’t seen physician yet and went back to get tested and haven’t improved/got worse would I get disqualified? Even if I’m scheduled to see my physician in the next upcoming days because of the misunderstanding
@ JJ
Your medical card became invalid three months ago. You only get one 90 day card and then, if no improvement, you are disqualified until bp is in the correct range.
just went and took DOT physical. The nurse went and took my BP over top of my hooded sweatshirt and said it was 152/90. Was sat in a room for 5 mins DR walked in and I explained how she took my BP and he re-took BP with cuff on my skin like your supposed to and got a 136/86. Why did he only give me a 6 month card????!!!!!
I received a 30 day temporary DOT medical card can I go and try to get recertified somewhere else this was due to a blood pressure reading that was too high or do I have to go back to the same ?
@Dave
You can goes else where for a second opinion. Multiple blood pressure readings should be taken during the DOT examination, if there is any questions. But you need to have your blood pressure under control, it is one of the silent killers.
Once they’ve threatened your retirement, livelihood and ability to survive and have a home (basically equivalent to waving a loaded gun in your face) by telling you the BP is 140/90, how do you think that affects the subsequent BP tests? This “physical” is a travesty and someone needs to protect innocent people from this abuse of power.
Someone needs to force the FMCSA to permit us to submit proof of low blood pressure from a reputable medical professional. It is immoral to have someone’s life depending on one or two or even three BP measurements during an exam in a hostile environment. And, furthermore, it is KNOWN by the medical profession that the diastolic reading is often inaccurate. If they’re going to use their measurements over those done over time by other practitioners, then they should be forced to prove the accuracy of the instruments they use and it should be done with a digital bp monitor where human error or deliberate malice cannot determine the outcome!
You should be aware that electronic blood pressure monitors are commonly 10% or more inaccurate in their readings. This is why EMT’s and Paramedics are taught to never use them.
I am a retired truck driver and I had nothing but trouble with my BP I was on BP meds. I hated every dot phy I took for my last 20 years of driving. So after I retired and got out of the truck. I lost 35 lbs it took a year. Before my wait lost my BP was 165/95 without meds now after weight loss my BP is 125/ 80 and no meds and I am 70 years old. So drivers lose weight and I know it’s hard with working the hours you guy do.