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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 just went for a DOT physical and was only given a 3 month medical permit based on the bipolar condition my medications revealed. I was told the rules are now different and that even with the note from the treating doctor I could only possibly be issued a 1 year medical card in any case. I guess I have 2 questions, is this true, and should I consider finding a different line of work as these tightening restrictions could edge me out at any time.
@Nick
The one year medical certificate is a truism. FMCSA wants all CME to monitor your progression every year. And all you should need is a medical release form from your doctor explaining your condition and his prognosis.
There are no new rules regarding a condition like yours, just a need to understand what the guidelines say. Try a different CME next time.
Thanks for the response. I have been driving for a while and found this response alarming. Most of the big companies I know of won’t take you if you don’t qualify for 2yrs . The CME even said the release form was good for 2 years so I will defiantly get a second opinion as I have little reason to believe I can’t do my job for only a year.
I had a medical marijuana card that will be expired for two years in April. Will this keep me from obtaining my school bus license? Should I let the CHP officer know before I start my testing there?
@Jacquie
You are in a state that has an allowance for marijuana, so you will fall under the states laws here. Not sure what your needs are going to be to acquire a drivers license to transport children in your state with your medical permit. Check with the state first and see what they have to say. Just ask questions.
I HAVE BEEN CLEAN OF DRUGS FOR TEN YEARS, CAN I DRIVE A SCHOOL BUS
@Charlotte
If you can perform the duties of a driver and pass the physical, then you should not have any issues.
You may want to check with your local drivers license department to make sure they do not have any surprise in store for you though.
I am prescribed Xanax which I take 1mg at bedtime. I am also prescribed Oxymorphone ER 30mg one pill twice a day for my chronic pain. I have a class A CDL and am about to start a new job as I am a new driver. Will my medication I am prescribed to disqualify me from a job?
@Cory
A lot will depend on the length of time that you have been on these meds. Get a medical release form from your prescribing doctor explaining the length of time and the need for the meds. That will help the CME with his decision making process.
Have Medical Marijuana card and going for CDL (didn’t realize couldn’t have). Doctor is stating I need to attend rehab and get letter of completion before she can give me physical. Can I just test clean and be done with it. Do I really have to attend rehab for a doctor prescribed medication, can’t I just stop?
@Ralph
If you test clean, because you have discontinued using, then you should be just fine. If you go back to the same examiner they will want to see what they ask for. As a driver you are going to be tested randomly through out your driving career, that happens to every driver. Drug and alcohol testing is mandatory for all drivers.
My fiance was recently prescribed ritalin. Will he pass the DOT physical while taking it, or does he need to get the medical release form?
@Sue
He will need to be on these medications for a period to determine how he will react to the drugs. So he will have a short waiting period and then he will need a medical release form from his prescribing doctor explaining why he has been placed on these meds. The CME is going to have questions and you want to have the answers before hand so things go smoothly.
I been driving for 4 years. I take Suboxone 8mg strips. Been taking them for 4 years. My first physical I had to get a note from my doctor stating it was ok for me to take suboxone & drive a truck. That was no problem. Well I went to get my 2 year physical done a few days ago and the lady told me that I could no longer drive a truck and take suboxone, I had to chose which one I wanted more basically. So even if I have a note from my doctor saying it’s ok, i still can’t get my health card?
@Nathan
You will need to support the requirements for the meds you are taking with documentation from your prescribing doctor. If you have been taking this medication for years and driving, you need to have your prescribing doctor complete a medical release form for you, explain what you need these meds for, and your condition, and that you have been on them for an extended period of time without incidence. Some examiners are very strict on this and won’t budge, but there are examiners that truly understand the situation. You may have to search around to find an examiner that does understand, but they are out there. Good Luck
Wow, I just experienced the SAME exact thing. I think it is a new rule.
I use a suboxone, but don’t have a prescription. I was completely off of suboxone and doing fine, but recently, feeling the need to use, I bought some suboxone and started taking the dose my doc used to prescribe.
I’m afraid if I get a prescription now, I’ll lose my job. I know I’ve put the cart before the horse, but suboxone does not impact my driving and it’s better than falling back into addition. What should I do?
my “new” Dr the one i been seeing for decades moved up to management.
are these two meds ok with the dot?
SERTRALINE 25 mg tablet.
TRAZODONE 50 mg tablet.
given to me case i am having trouble’s sleeping and getting proper rest. then falling asleep during my work shift. also general fatigue. (getting very hard to work more then two/three days).
the report pages read like a scary novel.
i do not get it both meds have the side effect is not being able to sleep?
as well as a couple others that scare me.
should i worry? not take these?
@Tom
You will need a doctors medical release form to explain your need for these meds. Both of these medications are going to cause questions. If you have been on these for some time, you will just need the doctors medical release. But if you are just starting them, then you will need to go through a waiting period that allows the doctor to see what the other effects of this medication are and how you re-act to them.
If a driver has been taking Trazodone for a few years in the evenings to help with sleep (no history of depression), if they have a medical release from their primary, how long will they be able to get a certification for? Assuming everything else in their health history is clear.
@Emily
More than likely one year at the time. The CME will want to have a medical release form from the prescribing doctor and will want to continue to monitor the drivers condition with the help of the prescribing doctor’s input.
I’m taking prozac, can i still drive a truck.
@Peter
Make sure you have a medical release form from your prescribing doctor and an explanation for the prescription. With that information in hand, you should be OK.
I’ve been driving for 19+ yrs. Now i’m on Kidney Dialysis. Will this Disqulify me to Drive?
@Dennis
Interstate yes, intra-state only, you want to check with your local drivers license department to determine what paper work they will need to qualify you to drive in state only.
I recently tested positive for a random drug test at my place of employment. As a result I was terminated from my job. I am due for my DOT physical and recertification. what is the status of my CDL license?
Can you take hydrocodone at night and still get a medical card ?
@Bob
Do you have a valid prescription and how would you pass a random drug screen?
So the answer could be yes, with proper documentation; or no without it.
I am an independent owner operator and I had neck surgery in September and went back to work in December cause I couldn’t find a competent driver, I take a low dose Percocet at night, with a prescription from my doctor, do I have to get a release from my doctor should I get stopped or heaven forbid an accident, and can a DPS call for a drug test during a DOT inspection as when I’m out on the road I take them with me???
@Chillimaru
You want to have a copy of the prescription available to you at all times. Also you will want a medical release form from your doctor. And yes the DPS can call for a random drug screen anytime he feels the need.
@Tim
Medical certificate is one thing and the cdl is another.
Check with your state drivers license department and ask them this question.
I have a CDL and work for a major parcel company that does random drug testing. After doing my UA I was contacted by the MRO and was told I tested positive for amphetamines (Vyvanse) which is prescribed to me. I also take a prescription pain medication (Hydrocodone) which did not come up in the test. Unfortunately when asked what medications I was taking, I told them about the Norco. Even though there was no positive for opiates, they’re telling me because I mentioned it to them that I was taking it, now I have to get a doctor’s note to submit to the company cause the company is aware of it now. In reading the language DOT Rule 49 CFR Part 40 Section 40.139
(3) To be the basis of a verified positive result for opiates, the clinical evidence you find must concern a drug that the laboratory found in the specimen. (For example, if the test confirmed the presence of codeine, and the employee admits to unauthorized use of hydrocodone, you do not have grounds for verifying the test positive. The admission must be for the substance that was found).
If there is no positive result for opiates, is the MRO allowed by law to disclose this information to the company?
@John
The MRO is looking for a properly prescribed medication to rule out a positive test result. That was all he needed. You gave him more information then he needed and it is his responsibility to report that, even if there was no positive testing. He has no idea if you have been taking this medication for a long time or just starting. Either way a note from the prescribing doctor for both of the medications will clear up things.
I was put on a low dose high blood pressure medicine ( lisinopril 10mg) during a high pressure time in my life. I am since off it and have made life changes, eat better, no salt/sugar, and I exercise. My blood pressure is good (120’s/70’s). I’m due for a CDL physical. My question is; due I need to report this on my medical long form?
@ Todd
Just make sure you get a note from your previous prescribing doctor indicating that you no longer need the medications. With that info in hand you should do just fine.
I want to know if the new diabetes medication trulicity or victosa although injectable non insulin can be used while maintaining a medical card for a CDL?
@Peggy
You would need to be on these medications for a period of time to see how you respond to them. But as long as they can control your condition and you have normal A1c’s and the doctors release form, you should be OK.
I started driving a year ago. I went today for renewal of my fed med card. Went to my family dr office. One of my dr’s associates did the exam. After I paid and did parts of the exam, he told me he would not renew due to the medications I am on. I explained that there have been no changes in meds, I am able to get a letter from the prescribing Doctor as I did last year when this same dr office approved my card. This associate still would not renew my card. i am on adderall and some anxiety meds. The only change in medication from when this same office approved my last card was that I no longer take a pain medication that was prescribed to me. Has anyone ever been approved, had no changes and then been denied? I feel they basically ripped me off of the $100 charge because this dr told me he had no plans to renew because of medications. Now I’m going for another opinion tomorrow (I explained to this examiner the whole situation). He sees there is no reason that dr had to deny me, especially if I have a letter from my psychiatrist deeming me safe to drive. Has anyone ever had this type of issue before?
@WI driver
Yup, you got ripped off by your doctors ASSociates. With proper documentation, you should have done just fine. Good idea to go for a second opinion. Just make sure you go with all the documentation in hand when you go for the examination.
This new examiner told me to bring in the do mutation so he can keep it on file as well. Told me if I cannot get it tomorrow just to call when I do have it in hand had he will get me in on the same day! He told me straight out that some docs read too much between the lines and really aren’t educated on what the actual guidelines are. This ASSociate told me straight out he had to go back and review the DOT guidelines. So he knew before they even took my $ that I was gonna be denied! Worst part….this is family physicians office!
Im really looking into becoming a driver. But im on medication thats so controversy for the medical card. I become disabled 20 yrs ago. My right arm and wrist were broke in 3 places. I have 3 plates and 15 screw in it. My left arm was broke in 17 places and has 17 plates and 50 screws in it. My left heel and ankle were crushed into many pieces. So many they couldnt count em they nust fussed it back together. I have tried all the pain meds they are, all prescribed! But im finally on a low dose of suboxone. I take 3,2.5mgs of it daily. And sumtimes not even all 3. I know that suboxone has a bad name cause it also used for addiction. Would this be considered a disqualified? What do i need to do on my part to prepare for the physical? (paper work). Who does the physicals? My doc? Or theirs? Anything you can throw my way would greatly be appreciated. Thank you in advanced!
@Gannon
Like we have said in the past. You need a medical release form from your prescribing doctor explaining the need for this medication and an explanation regarding your usage and how long you have been on the medication. If there is proper documentation and there have been no adverse effects then the CME can take all of the available information into consideration before making his final decision.
As far as examiners, you will need to find an examiner that is on the NRCME registry that can be found on the DOT website.
Or look for a local examiner on DOTPhysicalDOCTORS.
I understand that this is a redundant question but a answerer would be much appreciated. I was recently disqualified for my CDL medical certificate. When I filled out the required form I disclosed prescription hydrocodone use. This was voluntary and never expected a problem. I have been taking the prescribed meds for 12 years and disclosed them to every doctor that has done my certification. The certifying doctor was also my primary physician and prescribing doctor. The CME was a real jerk and would not even advise me what to do next. He simply told me that I was not certified and walked out of the room. Do I have to see him again or can I find another examiner? Does he report the failure to the proper authorities. What should be my next step for certification? Thanks for your time
@Greg
Medical release form from your prescribing doctor explaining your usage and how long you have used this medication.
Then go somewhere else for a second opinion. It may be listed on the FMCSA data base as a failed test, but not why the test was failed. A second examination that sees you are fit for duty would then over-ride the failed test results. And again, it may not have even been entered if the examiner did not finish the testing.
Can I take prescription amphetamines for weight loss and still be qualified to drive?
@Pat
Not without a doctors release stating that you are safe to drive and have had no ill effects. You will test positive on your drug test so make sure you have a copy of the prescription with you.
Can a person legally hold a cdl while taking Xanax, lexapro, and pain killers.
@Danielle
You will definitely want to have a medical release form available when you go for your next DOT examination. You are taking meds that will cause a multitude of questions and a medical release is going to be required. Make sure that your doctor explains his reasoning for the meds that you are taking and whether he feels that you would be safe to drive a CMV.
what if I took an expired prescription and I test positive for a drug screen
@Warren
That would now come to a decision between you and the MRO. He will tell you what he needs and you will need to comply with his request.
I have arthritis and expect to have a hip replacement surgery. Currently, I am taking an opiod medication, but I’m not currently employed as a driver (physically I could, but I don’t because of the medication). My health cert expires this month. All I want is to keep up my CDL in case I want to go back on the road after surgery. Will I have trouble getting my medical card? I have a regular appt with my doc tomorrow – should I have her fill out anything for the examiner? Think I’ll pass?
@Lady Luck
Yes, have her fill out a medical release form for you, so when you go for the DOT examination you have the information you need to give to the CME at that time. Also explain your situation and be prepared to answer a bunch of questions. Remember the CME is looking for medical fitness for duty and without proper information, you may have some difficulty.
I had a medical disorder called TTP. It isn’t listed as anything that should cause me a problem but. . during my most severe episode 6 years ago I had 3 TIA strokes, one of which provoked a seizure. While I was in the ICU at one hospital I was started on Keppra. I have had at least 2 EEGs since then and have shown no signs of seizure activity and have shown no adversity in 6 years of being on the medication. Now I have moved and decided that I wanted to get my CDL. I talked to my PCPs nursing practitioner and she informed me that I should have been weaned off Keppra 5 years ago, show no signs of epilepsy and was put on the Medicine as a precaution pending a test. My old PCP never weaned me off, never tested me for anything and has just been refilling meds for 5 years. Is my situation hopeless?
@Jim
Not hopeless, but you will have to be off the medications for quite a while before you could apply for an interstate CDL. Check with your local drivers license department and see what they have to say about going intra-state only. That gets you started while you are getting through your waiting period. Good Luck
I am officially off (well on a 2 week wean) the Keppra and have a medical release stating the situation, does that make a difference? This is a new development since my last post.
@Jim
Since your medication is used as an anti-epileptic med, you will need to be off this medication for quite a while before any CME is going to move past the wait period. The note from the doctor will be a help, so make sure he gives, as complete as possible, all the available information regarding you, this medication and how it has been being used.