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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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Your comments are also welcome.
I am interested in obtaining a CDL. If I used to take Prozac for depression is this generally disqualifying?
@ Hunter
The CME may ask questions or request some additional information, but this should not be an issue.
Please advise if taking Paxil can a driver get one or two years?
@ Lee
It will be up to the CME to make that decision. He will request additional documentation regarding your condition and use it in his decision making process.
Im taking suboxone my doctor sent a letter to the medical exam doctor he was told it doesn’t interfere with my driving at all. I was cleared to drive a school bus I was on methodone a few months ago it is not same at all suboxone is totally different since I’m cleared to drive I need to know we I be cleared by the dot and 19A
@ Tim Mc
You are a class cdl driver that is under your states requirements and regulations, not federal DOT/FMCSA. Check with your local drivers license department.
My doctor is offering me a chance to put in a morphine pain pump to ease my pain associated with nerve and muscle pain from Guillain barre syndrome that is not being helped by my infusions every 3 weeks. Will I be able to return to work driving on my class A CDL? I had GBS before and we treated it with same infusion medication and got rid of it and I was able to return to work but 6 months later it came back and now it’s worse than first time and hasn’t responded to treatments and I just want to get back to work. Thanks
@ Brad
It may be difficult to get past a CME with this situation. But with proper documentation from your physicians, it may be possible.
Ok that’s what I needed to know.
I am prescribed trazadone to help me sleep at night. Will this disqualify me from getting my CDL?
@ Brian
For a lesser class cdl, it may not be an issue. For a class A, interstate cdl, it is going to raise questions because of its potential side effects. Not an automatic disqualification, but questions and supporting documentation from your prescribing physician may be needed.
Hi there. I’m a ups truck driver. I just found out I wasn’t aloud to be on subutex. That being said i got of from it. I am really hoping being the ups dot package car driver I am aloud to take vivitrol shot. Which it makes it if I ever tried using a drug or drinking alcohol I would get sick. Am I aloud to take and be on vivitrol? Also naltrexone is a pill form on vivitrol that does the same thing?
@ Aj
A lot will depend on the class CDL you hold. Class A is a federal medical card. Lesser class cdl’s are state regulated.
If I am just starting Coumadin for stroke risk with A Fib because I don’t have prescription coverage and Eliquis is too expensive will the medication transition be an issue for me getting my clearance?
@ Bill O
You should be fine. Need 30 days on new meds to watch for side effects. CME may request some additional documentation.
Hi there,
If you are taking a low dose of sertraline (25 mg) do you have to have a DOT physical every year or can it still be every 2 years. Thank you
@ Tanya
The CME will make that decision based on all the available information/documentation he has regarding your situation.
I’ve been on 50mg of serequel and 20mg of celexa for about 2 months, I have heard serequel is a disqualifying drug. My DOT physical is in about 10 days can I discontinue my serequel and pass my DOT physical.
@ Mark S
The medications will raise questions, but are not something that will disqualify you. You will, most likely, be ask to provide a medical release form from your prescribing doctor. The CME may ask for some additional documentation regarding your situation. He/she needs the info in their decision making process.
Only been taking medication for about 60 days and using an online physiatrist. Have a letter saying I’m safe to myself and public and the drugs I’m prescribed, is this going to be a problem.
@ Mark S
It should be, but it will depend on what the CME deems satisfactory for his/her decision making process.
Thak You for your answers
@ Mark S
You are welcome.
Can I get a 2 year card while taking Adderall? Also I have anxiety my doctor wants to prescribe Xanax or things similar, i have refused because I’m concerned it would disqualify me especially with the fact i take Adderall.
@ William R
Your meds are going to raise some questions and may require additional supporting documentation from your prescribing physician. The CME will need this data to aid him/her in their decision making process. The length of the card will be determined at that time.
Can I take adhd meds, and maintain a cdl
@ Robert
Yes, the CME may request some additional information, but you should be fine.
I’m looking into getting my CLP, what ADHD meds are ok? My doctor has me on Ritalin. If I decide to quit having it prescribed for me will I be ok? I’m not sure what to do, if I just wean myself off the stuff am I good or will there be a background check?
@ John
The CME may request additional information from your prescribing physician. The medications that you are taking right now are fine, the question will be for the physician as to how well you are doing on them. Just be prepared to request additional documentation from your doctor.
I have been taking Gabapentin and Tizanidine for my back for over a year and started taking Phentermine the last few months. I have not felt any side effects and my doctors (2) have signed off on the request that from the DOT Med Examiner. Last year I brought my medication to the DOT Med and he said I was good to go now this year he stated that last year was a mistake and he shouldn’t have past me. Now here is my question. What will happen next? Seems to me I would have to take time off and get the meds out of my system. I am not here to beat the system. I have tried to find out what meds I can take and what I can’t.
@ Rob
All of these medications are going to raise questions with any CME. The medications that you have been on for the past year should only require medical documentation from your prescribing physicians. Indicating no side effects and lowered risk factors. The new medication is also going to raise questions, because of its possible side effects. If you have been on this medication for 30 to 90 days, then get a medical release form from your prescribing doctor. Make sure that the doctors forms indicate the purpose for these medications. It will help with the CME’s decision making process.
I was diagnosed with Graves decease and prescribed Methimazole and Propranolol to help control it. Is that going to affect my chances to get Dot Medical Card renewed?
@ Daniel
These medications are going to raise questions with any CME. You will need to be on the meds for 30 to 90 days before taking a new medical certification examination. And you will need to provide medical documentation from your prescribing physician.