Please read through the Q&A before posting a question. This will help everyone to not have duplicate questions. Thank you!
If you still can’t find a related answer, then you are welcome to ask your question in the comments section below.
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.
Can’t Find An Answer For Your Question?
If you have a question that you feel has not been answered, scroll down to the Questions and Comments box and post your question.
- Before posting, please make sure you are on the appropriate Category page, so that relevant questions and answers can be found by other drivers too.
- To save us all from zombie spammers, your question will not appear on this page until it has been approved.
- Trucker Docs™ will answer your question as soon as possible.
- Visit this page again soon to see our response.
P.S. Your email address will not be published.
Your comments are also welcome.
I got into an accident in my personal vehicle in aug. 2014, have been written off work since then. I have had 1 surgery (disc arthroplasty) and still have 2 herniated disc in my cervical spine, and 3 bulging disc in my thoracic area, because of this I am in pain management program and currently prescribed oxycodone, my med card is going to expire soon but I dont want to loose my cdl as i still have hope that i will be able to go back to work one day after the surgeries and meds are done. Will they give me another med card, even though i am prescribed oxycodone since i am also written off work??? I know i cant work while i am prescribed this med, but can i still get a new card so my cdl doesnt expire (ect)… for when i don’t have to take the med anymore?
@jesi
Well your medical card was invalidated on the date of your auto accident, so you will need to get a new medical certificate before returning to work. If we read everything correctly now, you can not qualify as a fit for duty driver, so you can’t qualify for a new medical certificate. You will need a medical release form from your doctor before any CME is going to do a new examination.
Right now you need to talk to the drivers license department in your state and explain your situation. They should have a policy that helps you keep your CDL while you are in recovery. Once fully recovered and you have a medical release form in hand, then you can go for the new medical card.
I’m a cancer paitient who has over 2 million chargeable accident free Istopped driving a truck for a living in 2013
I take pain medication for a medical neccasary reason. I renewed my DOT medical card in 2011. While at the location of my physical , a nurse practitioner did my test. He noticed my fentanyl patch and immediately said I had failed my physical
I informed him that according to the DOT regulations, all class a narcotics are strictly FORBIDDEN UNLESS THE DRIVERS DOCTOR CLEARS HIM TO DRIVE. MY oncologist of over 12 years at that time understood and agreed that since I’d been on these medications for years , I was fully functional in every sense to operate a commercial vehicle . I’ve become acclimated to this medication that it does not affect my cognitive abilities whatsoever. He had me tested by another Dr who specialized in the mental cognitive testing. He cleared me also
So after I informed the nurse practitioner of this, he said it doesn’t matter I was to be disqualified! I then asked him to bring in an actual lisenced Doctor and the Dot book and I’ll show them the allowed exception that I legally was entitled to
He took my Drs phone number and was gone for like 45 minutes!
He and the head doctor then came into my room an handed me a 1 year medical card
This is 100% true. Like I said I no longer drive. After fighting cancer from 8/98 until 2012 with 6 relapses. Multiple chemo treatments radiation therapy until the level I cannot have anymore radiation therapy
Enough was enough took my Drs advice stopped working and was approved in 6 months for permanent SSDI I lost over 60k a year by not working. That hurts bad life is now $$ very difficult
But just hope this helps someone out there
Hagar
@Hagar
Thank you for taking the time to share your experience, that persistence and knowing the rules pays, especially when others are not going to take the time to help you.
We wish you blessings on your new path in life.
My prostate cancer has reappeared. Can the disqualify me as a school bus driver?
@Lynn
As an intra-state only driver you should check with your local drivers license department. As long as you can perform the duties of a driver and are under ongoing care you may be fine. But check with the DLD for final confirmation.
I have been on Time release Xanax for 7-8 years I do not have any side effects and can not even tell when I take 1, I take I a day. can I still drive a commercial vehicle?
@Stephen
Get a medical release form from your prescribing doctor explaining his findings and results and you should be good to go.
I am going for a DoT medical card, not for CDL just to save company on insurance thru new thi g they’re doing. I currently take suboxone and valium prescrobed by my physician. I have no issue from drugs and am on a low dose. Should/can I ommit these things since they are not tested for and skip possibly loosing my job? Thanks
Drive a regular truck under my standard licence. Have been on meds for years and never had any accidents before or since on them.
@Bob
Do not omit. You have a properly prescribed medication that is being given by an attending physician. All you would need is a medical release form and a copy of the script. If you omit, it’s considered lying and isn’t worth it.
Is hair follicle testing going to become mandatory for DOT and do they tezt for same meds as regular 5 panal DOT test just farther back
@Kevin
Hair will not, at present, be part of the DOT urine testing. Yes, they look for the same things as the basic 5 panel.
Can you get your CDLs and take Suboxone?
@Richard
It will raise lots of questions and is difficult to substantiate. Get a medical release form from your doctor explaining your condition and the reasoning behind this particular drug usage. It may be doable, but don’t hold your breath on it.
Been on this medicine for 12 years and my doc would be happy to send a medical release. Hope it is okay.
Richard,let us know how it turns out because I’m in the same boat.
I got my CDL and DOT med card while on suboxone. Nobody asked me for anything other than the company for a letter from my Doctor stating that it would not affect my driving capabilities
Let me know how it goes for you cause mine runs out in 2 and a half months and I have to redo it so I hope I dont run into any problems this time as I am also prescribed klonopin now. But either way if w.e medication you are PRESCRIBED excluding marijuana if you have stability with the medications you should have no problems as long as your doctor is willing to write a letter for you stating again that their is no problem for (name) to drive under (medications) being prescribed ASLONG as they are taken as PRESCRIBED. Hope this helps and hope the world has not become shit because if your a good dam driver and your stopped from it because of a medication that does NOT affect your driving capabilities then the trucking industry is turning into shit cause i see people flipped over all the time crappy drivers killing people and its rarely very RARELY based on any type of medication the driver was prescribed so if they want safety they need to see a driver is truly capable of driving and thats it.
If a driver is taking Addrell, does this disqualify him for a CDL ?
@Michele
It would depend on the reasoning and the length of time that the driver has been on these medications.
It would mostly test positive on a DOT drug screen, so make sure you have the prescription available for the MRO.
My husband wants to begin taking adipex (a prescribed weight loss medicine). It is a phentamine. Will this affect him having his CDLs?
@Kelsey
Unknown. It needs to be used for a period of thirty days to determine its effect and side effects, if any. He should not be driving until this information is known. If it is prescribed, make sure you keep copy of the prescription on hand in case he is drug tested and it comes up positive.
Can I get a DOT medical card to drive a vehicle (10,000 to 26,000 lb) if I use insulin for diabetes even though the vehicle does not require a CDL? I am not sure I am asking the right question.
@Stephen
If you are going to be an intra-state only driver, you should need the correct information from your state drivers license department. Their rules are a bit different from the FMCSA.
You may not need a CDL, but each state is different with insulin dependent drivers, so check with them for sure.
I take Pioglitazone, will that keep me from getting my dot med card?
@lloyd
If you have been on the medication for any length of time, then make sure you have a medical release form from your doctor and a copy of your last A1c. That should provide the information that the CME is going to be looking for.
Can a person taking muscle relaxers for a back issue and having a weight restriction of only being able to lift 20lbs be able to drive Semi in Michigan and still be safe for themselves and the other people on the road according to DOT standards??..
@Bob
No, you could not qualify as medically fit for duty. And at present your medical card should be invalid, until you can pass the DOT medical certification examination.
Looking into getting my CDL but I take a high dose of Gabapentin (Neurontin) for some nerve pain in my legs & to level out my mental illness. It’s working great but I’m concerned I’ll have to overhaul my meds routine if I start driving. Can you drive while taking Gabapentin?
@Jenn
This medication is going to cause a ton of questions before you ever get started.
Best bet is to get a medical release from your doctor explaining why you take these medications and how you have responded to them. With that information in hand you have answered many of the questions that the CME is going to have. But it is not a guarantee that he will see fit to pass you on the medical certification examination without further information.
Will victoza show up in a random drug test.
@Sophia
This medication is for diabetes, so why are you worried about it in a drug test. The short answer is no and they are not looking for it.
If I fail my drug test, is there a grace period in which I must wait to try and take the drug test again?
@Josh
No grace period that we are aware of. You can retest as soon as you can pass the test.
Will a prescription of Carbamazepine XR 300 BID make me ineligible to get a DOT physical card?
@ Dennis B
This medication is going to raise a ton of questions, so be prepared for them. The main question will be, why do you take this medication? And you will need supporting documentation from your prescribing doctor before any CME is even going to start an examination.
i am a doctor who has a patient who has been on suboxone for five years. he has been compliant and committed for the entire time. he is currently tapering off the med. he recently went for a DOT physical card and was told that he did not qualify because of the suboxone. he lives in NY.
i consulted the federal web site and found that only methadone is an absolute disqualifier and that the
individual clinics within the individual states determine the guidelines. do you have any recommendations for my patient? he really needs his job. thanks
@ Lucinda
As you dig deeper you find that there are lots of gray areas in the guidelines. Ultimately it will fall to you for the final decision. If you feel that the driver has been compliant and is trustworthy and safe, then you can issue a medical certificate. You will want to issue for a year at the time to continue to monitor his progress and get a medical release form from his prescribing doctor to support your decision making process.
Does methadone come up on a dot phisical drug screen
@Mike
Yes.
Does taking adderall if prescribe by my doctor stop me from getting my medical card for class A
@ Shawn
No, it will require proper documentation from your prescribing doctor.
I am a 51 y.o. male who is wanting to train and get my CDL. I have had 2 back surgeries and take prescribed pain meds. My doctor will fill whatever form is necessary to clear me to drive. Will that be a major problem in obtaining my CDL from the medical examiner?
I am being treated for chronic pain because of a car accident. Since then I have been treated with everything from OxyContin (3-80mg a day), 4-5 Tylox a day & others. Now I take 3- 15mg morphine we pills a day and 1-15mg immediate release if needed. These doses make it possible for me to be able to get up and work by taking the edge off the pain. My boss said that I need a doctor to say I can drive while taking my medicine. Is this possible ?
@ Kenneth K
All depends on what class drivers license you carry. As a class A driver you have been disqualified since the accident and would have to pass a new medical certificate examination, which you won’t pass at this time. If yo are a class D driver in a small pickup truck, then your prescribing doctor may indicate that you are safe to drive. And he has prescription information for a positive drug screen. It would be very unlikely that any doctor is going to state that you are safe to drive anything on these medication, so until you are fully healed and off the meds, you probably should not be driving.
I was prescribed Wellbutrin Sr 150mg to help stop smoking. if taking this will it disqualify my medical card
@ Scott
You would need to be on this medication to determine its effect and side effects. After you have been on the medication for thirty day and with a doctors release form stating that you can perform the duties of a CMV operator without negative side effects. You should be alright.
I am a bus driver for about 14 years I have been a diabetic for six of those years just recently my doctor wanted to put me on insulin, because my diabetes is out of control I’m on the highest level of oral medication I could take. My question is can a bus driver in the state of California be on insulin at night would that affect my CDL license. I was told that a bus driver can not be on insulin but my position is that I won’t be at work I will be taking insulin at night at bedtime will that affect my medical cert.
@ Charles
You want to check with california state drivers license department on this. As a class A interstate, you would be disqualified, but as an intra-state driver within california, that would be a state question first.
Does Ritalin disqualify you from getting a medical card? Also-what about depression drugs like welbutrin (Bupoprion)
@Fred
You are going to need medical release forms from your primary prescribing doctors explaining your condition and situation. If everything is under control and your doctor feels that it would be safe, then you may be OK, with proper documentation.
i’m taking 300 mg of Gabapentin twice a day. Am I allowed to take this and drive? Would i pass a drug test?
@Digger
This would totally depend on the reasoning for taking these medication. Not enough info to give you a yes or no.
i take it for my back pain. its the only medication that works besides hydrocodone
@Digger
As long as it is properly prescribed by a physician and you have a copy of the prescription for the MRO when he ask for it, then you should be OK.
Had a tia on1/2016 med card was denied 8months later got medical release and received med card but my company would not accept it they wanted me to go back to there doctor and she insisted on 1 YEAR
@Andrew
FMCSA wants a one year post TIA to rule out the possibilities of stroke. That’s a FMCSA thing.
Not sure why any one would have cleared you before that, unless you presented them the supporting documentation for the CME to make a differential decision in respect to a FMCSA guideline.
I had all my documentation medical opinion reports stress test releases from neurologis and cardiologist
@Andrew
Sounds like your company is making sure everyone is safe, and they are sticking to the guidelines. Companies are allowed to have even stricter rules than the FMCSA recommendations. So this is now between you and your company.