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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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So, I work with a CME. After a stage 2 3 month card, at the end of the 3 months if the pressure is not managed, he is disqualified, but for how long? Pt did his 90 days and the pressure is still over a little (148/82). Not qualified. Went back to PMD for medication adjustment, does he have to wait another 90 days before he can be examined again?
@ Ray H
No, once his pressure is stable and below 140/90 he can be retested. The 90 days is not a waiting period, but an opportunity to get his bp under control, without taking him off the road and putting him out of work.
Do the company have pay full for a f another physical, the driver is given the remainder of year, if not it make the driver or company pay twice, which is not fair
So after 90 if you’re blood pressure is still high, is there a 45 day grace period you have to get it down?,and is this law a California law also?
@ Bil A
If you are a class A driver and were given a 90 day medical certificate to allow you to get your blood pressure below 140/90, it is a one time 90 day card. From DOT/FMCSA, as a class A driver, after a 90 day card you must get your bp below 140/90 before you can return to driving. Lesser class drivers fall under the states rules and regulations and you would need to confirm with your states DLD.
So Yesterday i go for my DOT physical, the nurse is performing the initial test all is well except BP 1st attempt at 160/100 , a few minutes later she tries again same 160/100 ( in fact she mumbled that it went higher, and i should relax). She said she will have the dr. try later. So we go through entire porcess , dr comes in wheels in a manual machine with larger cuff , result is the same 160/100 give or take. After researching here’s the issue , i was sitting at the edge of the bed, feet dangling, no back support, and my arm was not elevated.
Today my wife takes my blood pressure 3 different times , sitting on a chair with back support , feet squarely planted, arm resting on top of the kitchen table and i am at 135/85 give or take all under 140/90.
What should i do, i was told to go see my primary and get on medication, I have 45 days and then she would give me a one year card. No job is worth , needlessly getting on medication , I would prefer to diet and exercise my way down.
I was given a form for my primary to complete , and return to CME.
@ Rich
You could go for a second opinion, somewhere else, before going through with the family doctor and med routine.
I’m on 1year card for 5 years now. No more meds . And hypertension is no longer an issue . Naturally controlled with exercise and diet . Can I return to a 2year medical card ? And wife so where do I look to find the required process? Thank you .
@ Constance F
Ultimately, it is the CME’s call. The wording on the intake form is ‘any history of HBP?’ If the examiner feels, with some supporting medical documentation from your primary physician, that your situation is completely under control, then he may extend to a two year card.
Blood pressure was 144/84. The medical place used a machine not manually checking blood pressure. I asked for another reading and was refused. Is it ok for the medical testing site to do that? Use a machine and refusing to do another reading?
@ Gina
You should be able to request 3 different reading and they should comply. Go elsewhere and get a second opinion.
I have a bp of 143/90 can I still pass and if so will I got a 3 month or a year
@ Antonio
DOT/FMCSA guidelines 140/90 or less. Blood pressure varies moment to moment, so work on being relaxed with some simple, easy, deep breathing and you should pass without any issues. Other wise you may get a 90 day card to get your bp under control. That 90 day card is a one time only card.
I went to renew my DOT but my pressure was too high. So that physician recommended I make an appointment that same day with my primary care doctor that day which I did. The receptionists also gave me paperwork stating that if I can show that I’m on medication that I can just bring the paper back with his signature and meds I’m taking but my primary doctor refuses to sign it until I get my pressure normal. I’ve lived with this issue since my early 20s. I’ve told him that also I get a little nervous when getting checked out. I’ve even been checking at home and it’s normal. Even wrote down every number. Can he go based on my word?
@ Louis
DOT/FMCSA regulations require you to be on your bp meds for at least thirty days and your blood pressure has to be 140/90 or less before he can issue a valid medical card. Once on the meds, your card will be limited to one year at the time. As far as taking your word for your bp readings, it would become very questionable and places the CME in a risky situation.
My blood pressure was 158 0ver 82, how come I only got 3 months on my card. I check the requirements and I should have given at least one year.
@ Raf R
Without all of the available information from your examination findings, it is difficult to answer your question. We suspect the examiner wants to monitor your blood pressure reading more frequently. It is up to the CME to determine the overall length of your medical card and he must take into consideration all possible risk factors.
Can any doctor do the BP recheck or does it needs to be the treating Dr.
@ Anne T
If you were given a short term medical certification (3 month) then the treating CME will need to do the recheck. If all comes out OK, then he can extend your medical cards expiration date. Or, you can get a new DOT/FMCSA medical examination and go from there.
Doc I had a TIA eight years ago and have been certified each year one year at a time in the past year my blood pressure has moved up just a little now running 146/90 if I get on pressure Meds will this give me a disqualification? Thanks for your help Jim
@ Jim
No. Blood pressure meds will need to be supported by your prescribing doctor with a medical release form. You will need to be on your meds for a few months before taking your next DOT medical certification examination.
Hey doctor i was just recently diagnosed with hypertension.. and placed on a combo bp meds……..when i check my readings at home im under 140/90….but im worried about white coat syndrome…..how many attempts do you get in a year to pass the dot test.
@ James D W
Your CME should work with you to overcome the white coat syndrome. They can take as many reading as they choose to in a single setting. Also, you may be able to use your doctors readings, if there are questions regarding your bp anxiety. That will be up to the CME to make those decisions.
I am apply for a Chauffeur license with the state of Michigan, do I need to have a medical certificate to apply for the test and or to have the license once I pass the written test.
@ Mike
This question will need to be answered by your local drivers license department.
I am a CME. I have a driver who I gave a 3 month certificate to in March for hypertension. On the recheck, his blood pressure was still quite elevated. I know I can’t give him another 3 month card. How does he get his medical card back at this point since he is now disqualified? I have read about “temporary disqualification” but I don’t see how to note that on the form.
@ Sarah V
Just perform a new DOT medical certification examination and if the BP is within normal limits, with or without meds, then he should be good to go. You may choose to issue a one year card so that you can continue to monitor his condition.
The 3 month temporary certification is to allow the blood pressure to be brought under control with medications as is is Stage II.
If the driver never received medicinal treatment and failed to qualify after the 3 months why does that driver not have to wait another 3 months if now receiving medication to demonstrate appropriate treatment.
If a temporary 3 month card is issued and then they disqualify this implies that they can be re-examined at any time and not wait 3 more months.
Granted they could go somewhere else but that just avoids the issue and does not address the point.
A Stage III is disqualified but apparently can be re-examined at any point and given a six month certificate. Is this the supporting argument to issue a 1 year certificate to a Stage II htn driver once they are also disqualified but later have the blood pressure under 140/90 at any time following disqualification?
@ David P
The 3 month medical card is not a waiting period, it is a 90 day window of opportunity for the driver to get his bp under control. If he fails after the 90 days then he must have his bp below 140/90 before he can be medically certified.
I tested 154/86 and was issued a 3 month certificate. I wasn’t impressed with either the doctor nor the aide who administered the BP test. I made an appointment with a well regarded doctor 2 months later to take the DOT test again. After filling out the paperwork I was informed by the nurse that since I had failed the BP test at the other clinic I would have to return to that clinic to have my blood pressure tested again. I maintained that I was entitled to a second opinion and had no obligation to return to that clinic. Was I correct?
@ K P
You are correct in getting a second opinion. You would have had to take a new DOT/FMCSA medical exam at the old facility also.
I was recently diagnosed with non cirrhotic portal hypertension. I’m being treated for it. My blood pressure has always and still is 120/60. I do have a class A license. Will I have issues renewing my fedmed card?
@ Brian
Your situation will raise questions with the CME. He/She will want supporting medical documentation from your healthcare providers. They will also request a medical release form from your doctors.
165 /80. i am coming up to renew my 1year which then was 146/90. am i disqualified now? my weight was 246.6 and now i am at 201 at 6 ft. my pulse was 101and it is between 80 and 90 consistently now. i changed diet watch salt and am moderately active.
@ Brett W
DOT/FMCSA wants a 140 / 90 or less on your bp. If you are on bp medications, then you won’t qualify. If you are not on medication, then you may get a one time three month card to get your bp below 140/90. And good job on getting yourself back in shape.
If I got 3 month card but go somewhere else and get card will that work
@ Michael S
Depends on why you were given a three month card.
Can I be on more than one HBP medicine and still pass a DOT physical in Washington State
@ Ken
Your list of medications will be questioned, but with proper medical documentation you could be fine. Be prepared to answer questions about your condition and your meds.
Hi I was given a 3 month medical card due to hbp. I have since gone to my primary care doc and he has put me on hbp medication which has reduced my bp below the levels required. I am going to get the medical release opinion form filled out before I go back to get recertified. Do I have to have the complete physical done again since I just did the last one less than 3 months ago? Hbp was the only problem. I live in Ohio. Can’t find that answer anywhere. Thanks
@ Rich F
You will have to do a complete DOT/FMCSA medical certification examination. It’s a FMCSA requirement.
I am a little confused. I am a CME. I follow the recommendation of the 2002 cardiovascular conference report recommendation tables, page 55 for Hypertension. For high BP in ranges of BP greater than 140/90 but less than 180/100, it notes that at certification I can give a 1 time certification for 3 months, and if at recheck BP <= 140/90 can certify for 1 year from date of initial exam. Is this wrong, out of date? I do not find any new/different DOT/FMCSA recommendations.
Thanks!
@ Ron
To the best of our knowledge there have been no major updates. There was a draft issued in 2020, which can be found on the web. It is only a draft. DRAFT FMCSA Medical Examiner Handbook-4-23-2020.pdf.
I just had dot physical on blood pressure medication on 11/17/2021 doctor gave me 2yr card my reading 130/74MY COMPANY SAID THERES Discrepancy doctor told me new regulations in June 2021 if blood pressure under control you can have 2yr card who’s right
@ R m
One year for any drivers on bp medication. Your blood pressure must be under control, but with meds, only one year at the time.
This matches what the practitioner told me when I went in. I received a 3 month, and was told to come back at that time and they would retest the blood pressure and if I passed, would be given a 1 year from the date of the initial exam (ie another 9 months).
@ Dina
That is correct.
I am trying to find the actual rule in the FMC regs where it says that a Doctor can give me a 3 month DOT ticket to get my BP under control…I just can’t find it, I have searched and searched, can you direct me directly to the rule so I can bring it with me to the Dr?
When I mentioned it to the girls that told me I had high BP, they were not aware of the rule and were telling me that they can only give me two weeks then fail me.
@ Bob J
# month card is a guideline not a regulation. When you determine certification for the driver with high BP in the ranges of stage 1 or stage 2 hypertension (BP greater than 140/90 but less than 180/100), consider these additional factors:
• Type of examination (certification or recertification).
• Current certification interval (1-2 years or 3 months).
• Treatment (lifestyle changes, use of medication).
• Severity of hypertension prior to treatment (particularly if history of stage 3 hypertension).
The purpose of the one-time, 3-month certificate is to allow the driver with high BP that is an absolute indication for antihypertensive drug therapy to continue to drive while taking steps to lower the elevated BP. It is not intended as a means to indefinitely extend driving privileges for a driver with a condition that is associated with long-term risks.
For the driver with high BP or hypertension to maintain continuous certification, the driver must demonstrate at examination BP at or less than 140/90.
NOTE: “One-time” means you cannot issue consecutive 3-month certificates for BP greater than 140/90. It does not mean once in a lifetime.
Thank you for the clarification.
@ Bob J
Glad to help, thank you.
I have been having blood pressure issues and can’t get it down below regulation. I am on a 150 mg of bpm and it is still running like 170/110. Can the doctor pull my Healy card since it’s been over 3 months now. Or how long do I have to get it down. I have to renew in December
@ Jeremy
The CME can issue only one 3 month medical card for you to get your bp within regulations. After that you must have a bp reading below 140/90 or better. You will not have a valid medical card until it is within normal limits. So it appears that you have some time to get it under control.
Yesterday at dot physical my pulse was around 120 blood pressure was 140/76 was told I have 45 days to go back for re check of pulse to get it under 100 in the cdl guidelines where does it say the pulse need to be a certain number . I’m going to my primary care Tomm for a check on it then have to bring results back to cdl doctor and make sure it’s under 120 my cdl expires December 31st is my cdl license still good for the 45 days she gave me to come back?
@ Stephen h
One, your cdl is state issued, so you would need to check with your state drivers license department to renew it. Two, a pulse rate of 120 is out of the normal range. Normal range is about 55 to 80 bpm. So it is not a DOT/FMCSA issue but a general health related question that the CME is evaluating.
So there isn’t a requirement on dot pulse rate that’s states your pulse has to be under 100? I live in Texas .
@ Bernice
Doctors and CME’s know that a normal heart rate is in the 60 to 75 bpm as normal. If your situation is as stated before, then a note from your primary physician indicating that your bpm is normally high, then the CME can take the available information into consideration.
My question is for my Husband . He took his DOT exam 2 years ago and for the first time failed it. He was given the 3 month card . now he has to do his physical every year .His blood pressure even with meds still has spikes every now and then we still can not figure out why. He is afraid he will fail A DOT exam when he goes in . Is he eligible for a 3 month certificate again if he fails or will he just be disqualified . We did not know if he could get another 3 month card after having one 2 years ago and being on blood pressure meds. Thank you for info you can give us .
@ Tina
FMCSA will allow a one time three month card for the driver to get his issue under control. If your husband is on high blood pressure medication, then his physical will be good for one year at the time. It is up to the examining CME as to whether he grants another three month card if he feels that the driver can have his situation under control within the time frame, but do not count on it. If he fails due to blood pressure, he is not disqualified. He simply needs to get his pressure under control and then re-take the examination.
I just had a quick question and couldn’t find an exact answer. My husband requires a DOL physical for his job even though he doesn’t need or have a CDL to drive his work vehicle. He was diagnosed with hypertension when he first got certified. His BP was 170/110 then. He also found out he has type 2 diabetes. He was originally certified for 3 months and then given the full year after he started treatment. He has been on medication and and his diabetes is well controlled he isn’t on insulin. His BP ranges any where from 155/90 to 135/80. With these readings would he be able to get recertified? We live in WA.
@ Rachel P
He will need a bp reading below 140 / 90. His diabetes will raise questions, but should only require proper documentation from his treating physicians. If all else checks out in the normal ranges he should do fine for a one year medical card. Also, he falls under the states variances and guidelines, not DOT/FMCSA. Some states adopted FMCSA guidelines and still have their own guidelines for non-cdl holders.
Thanks for the response. We still have 5 months before his recert is due so we have time to work on lower his BP even more.