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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 have a prescription for Phentermine 37.5mg for weight loss ..I have not begun taking it .I am not sure if it will disqualify me from renewing my CD. Please Help
@Angela
This will most likely get you disqualified until you get off the medication. Too many side effects that are not working for the drivers.
If you get a medical release form from the prescribing doctor and you have been on the medication for over thirty days, you may get by, maybe. Good Luck
Back in 05 I was taking Adderall for ADHD I was told by the company it was fine. By what I am now reading it’s no longer accepted, is that correct ? I was thinking about getting my CDL A back
@ trishim
It will need documentation from the prescribing doctor and a medical release form also.
Can an individual with a CDL license take medication called Victosa?
@Rhonda
Yes, just make sure you have a medical release form from your prescribing doctor explaining your condition and the length of time that you have been using the Rx.
will taking escitalopram stop me from driving class-A cdl. I have taking it for about 15 yrs and it helps very much and there are no drowsy effects.
that should be long enough time to get medical release
@wb
Make sure you have a medical release form from your primary prescribing doctor explaining your need for this medication. With that in hand you should be alright. If this has been a serious issue, then you may want to have your psychiatrist complete a medical release form also.
I have Type 2 diabetes, I am a Canadian CDL truck driver who travels into the United States on a regular basis. My diabetic doctor wants to put me on trulicity – which is a once a week non-insulin injection to help control my blood sugars. He feels this will help regulate me better than the oral medication I take now that has to be taken daily at certain times with meals and will fit into the schedule of a truck driver’s life. Will trulicity prevent me from driving into the US?
@Jacqueline
It should not be an issue. You will want your doctor to give you a medical release explaining the shift to an injectable and support the new findings with a recent a1c. It just requires that you have supporting documentation from the prescribing doctor.
i have been prescribed different pain meds by a family practitioner at the va. Tramadol, hydrocodone, Oxycodone. I do not take all of them at the same time, just putting all of them down that i have taken in the past 15 years. i only take one kind at a time. trying to find the one that works the best for chronic body pain. i have been diagnosed with Fibromyalsia and Chronic Pain. will it be possible to obtain a cdl. I am intending on going to school for truck driving, but dont want to pay all the money and go through the school if i cant get a medical card. Thank you for your time providing me with much needed information.
@Douglas
Your list of medications are going to cause plenty of questions. FMCSA and the CME are going to need supporting documentation regarding your needs and any side effects that these meds may cause. You want to have a medical release form in hand before you go for the DOT medical certification examination. Have your doctor explain your condition and the needs for the present medication protocol. That information will be a huge help to the examining doctor.
I have been diagnosed with Stage IIIc colon cancer. Already had surgery to remove tumor and lymph nodes. Doctor suggests I start adjuvent chemo. Can I drive while taking FOLFOX regimen?
@AV
Well if you have fully recovered from the surgery and the doctor has released you to return to work, then you need to take a new DOT medical certification examination before returning to driving. Get a medical release form from your doctor and take it with you for the DOT test. The CME will need this information before he can do the test and needs the information to help him determine your level of medical fitness for driving.
Yes, I was determined medically fit to drive after surgery. However, my question is: Can I legally drive while I am on a 6 month regimen of chemotherapy. I cannot seem to get a straight answer. FOLFOX is the regimen, and my ability to be able to work is a determining factor is I will take the therapy.
Thanks for your help!!!
@AV
OK, so who determined that you were medically fit to operate commercial motor vehicle?
Second are you going to be driving local or OTR?
And thirdly, given the medications side effects, it would be an unsafe issue for you to be behind the wheel of a vehicle for any period of time.
We know you are looking for a solid answer, but without a complete picture of the situation, the best you’ll get is a vague answer.
I had a new exam with a CME after recovering from surgery. I am a line haul driver covering 600 miles a day, 5 days a week (12 hour days). I am home every night with weekends off.
My concern as well is the possibility of side effects from the Chemo. I am aware that it affects everyone differently, but figured the possible side effects would disqualify me. I just want to be sure before I decide if I want the chemo or not. I suspect it is best to err on the side of caution, and not receive the chemo.
Thanks for your help!!!
I am 69 and in good health, no diabetes no high blood pressure. I have a Class A CDL that I wanted to keep. I have used a CPAP for the last three years and am in 95 – 100 per cent compliance. 6 months ago my Doctor at VA put me on Ropinirole HCL 0.5 Mg. for restless leg syndrome l- tab nightly. He also prescribed Zolpidem Tartrate 5 Mg l- tab nightly.
I took my yearly physical last week 12/20/16 and DOT Doctor said he can’t issue health certificate without a medical release letter from my VA Doctor. I have been to VA Doctor twice and refuses to issue letter for liability reasons.
My health certificate expires 12/29/16 some I’m in trouble.
I’m not presently driving but hate to lose my CDL in case l need to supplement my Social Security.
Any suggestions appreciated.
Signed. Depressed. Henry
@Henry
Your VA doctor is misunderstanding what is needed. He is not assuming any risk factors.
What the CME needs and the VA doctor should provide is a release for you to continue driving while using the prescription that he, the VA doctor, has prescribed.
It just helps the CME make a decision as to your ability to continue to operate a CMV safely. It also open a line of communication between the CME and the VA doctor. The final decision to qualify you rests with the CME.
I was certified for another year card in back in October and everything checked out for my diabetes and sleep apnea. I am a type 2 diabetic and I am on Victoza and Amaryl. Recently in my last endo appointment, my sugar has climbed to where the non insulin meds are not getting it done. The doctor wants to put me on long lasting insulin to help bring down the sugars.
What would I need to do since I’m already certified for another year with my state and the Federal DOT? Do I need to do a exemption waiver or should I hold off until next recert. I am a class B driver with air brakes.
@Matthew
There are a few medications that may support the direction that your doctor wants to go in. They support the treatment of diabetes without being insulin. Ask about them first.
You are a class B driver and do not fall under class A interstate driving standards, so also check with your local drivers license department and see what they will need for you to continue driving. Putting you on insulin invalidates your existing medical card and will, most likely, require a insulin waiver from the state.
Last year I got my DOT certificate and was honest about taking generic Xanax. My prescription is for only 10 pills at a time of 0.25 mg and the doc told me not to take any no less than 8 hours before driving. Today I go to get my physical renewed, went to a different doc. I’m an honest person and was honest with this doc of my medication as well. She told me it was a Federal Law that if I take Xanax I cannot drive a school bus! So, one doc says I can and one doc says I can’t. Who is right?
I had a TBI 1 year ago and also had back surgery for 4 herniated disc in my lower back. I posses a class B with Haz. Been on long term disability since the head injury. As of now I am on 350 mg 3x a day Carisrodol and 3 mg of Ropinrole 1 x a day. Doctor has me at a 35 lbs weight lifting and driving as tolerated and to avoid night time driving. My long term just told me their doctors don’t find me disabled from driving and took away my benefits. Stating I can return to my driving job. Am I able to go drive a truck again right now??
@Wendy
You are going to need to explain your job to the doctors and the CME that does your examintion.
As a class A Interstate driver you could not qualify to pass the DOT medical exam.
As a class B driver, working Intra-state only, you may have a chance with proper documentation from all of your doctors, once fully released to return to work.
Does a back injury caused by an accident, in which three disks are herniated permanently disqualify me from driving a commercial vehicle? Out right now on a medical leave and not sure path for rehabilitation yet but rumor had it I “can’t” drive again. Your thoughts please.
Thanks MIKE
@Mike
Until you can qualify as ‘medically fit for duty’ you will not qualify as a driver for interstate driving.
I’m a class A driver will using of gabapentin disqualify in a new employment drug test
@Keith
As long as you have a valid medical doctors prescription available for the MRO, if he asks for it, then you should be fine.
I have had anxiety for several years. My doctor has given rx for lexapro at bedtime..and alprazolam TID PRN. The lexapro is helping so I barely need the alprazolam. I have documentation from my doctor that I am able to perform all of my duties at work, including my class B CDL. Will I be disqualified? Will my employer be notified that I am taking these medications?
@Stewart
Medical records are not shared with the employer by the CME. If the company requires a copy of your medical records, then it would be you who shared that information.
Get a medical release form from your prescribing doctor explaining your medication needs and usage. As a class B driver, you are not held to the same level of examination as a class A, so you should be fine.
what would be a reason to have take the DOT medical examination every 3 months
@Donald
You cannot take the DOT medical exam every 3 months. If you have a new medical condition that needs to be gotten under control, you may get a one-time 3 month card to get the condition under control. If not under control within the 3-month period you will be disqualified. You do not get another 3-month card with that medical problem.
I have been driving for 20 years and my back is paying for it. I refuse pain meds but my Dr suggested Neurontin because of the nerve issues. I researched and see that neurontin is an anti seizure med which is automatically disqualifying. But since not prescribed for seizures (no history of any type of seizures) would it be ok with a Dr note saying will not affect driving? She said it would really help with the nerve problems stemming from my back
@Paul
You want as much information from your doctor explaining the needs for this medication. Because the meds are usually for seizures it will be an instant question. With proper documentation you should be alright, if everything else is normal.
Also a medical release form along with the other documentation will be helpful too.
As long as you do not have history of seizures in the past, you should be okay with taking neurontin. Be cautious when you start taking for the first week or so, because it may make you drowsy. I am a certified DOT medical examiner, and can surely say that is not an issue if you are tolerating it without getting drowsy. I also practice in urgent care setting, where we see many patients with migraine like headaches for which I have prescribed anti-seizure medications which has helped patients. Majority of practitioners know about common off label usages of the medications that is routinely prescribed.
Hope it helps.
DOTNP.
I had my DOT physical and was denied because i take insulin. My sugar level is below 120. One person said if you are driving a air brake truck you would be denied but not for regular brakes. Is there insulin regulations?
@Alan
A lot depends on the class drivers license you are operating under.
As a class A you would be disqualified without a FMCSA insulin waiver.
But if you are driving a class B and running within the state you should be fine. Best bet is to check with your local drivers license department and see what they have to say.
It will also help if you have a medical release from your doctor. Good luck.
Can my dr prescribe phentermine 37.5 as a weight loss aide? Or would disqualify mr cdl or med card?
@Ryan
You would need to be on this medication for at least 30 days before driving again. You and your doctor need to see how you react to the medication. It could cause a safety issue and that is what everyone is looking out for.
hi is it ok to get testosterone injections once per month for having a deficiency and still operate a class A vehicle or will i test dirty
@Lonnie
This should not be a problem and if some weird reason it did test positive, you would have a medical release from your prescribing doctor to support a negative finding.
I was just put on Lyrica for Neuropathy. Would this condition and or medication be a disqualifer?
@Jeff
Depending on the class drivers license you are operating under: Class A and it’s going to raise questions. Class D it it will not be major question. Class A, make sure you have a medical release from your neurologist explaining your condition and the need for the meds.
I recently took a DOT physical and received a 2 year medical card. I stated I took Tramadol, Ambien, Zoloft and Tizanidine and have been for at least 10 yrs. Everything but Tramadol is taken at night. The doctor stated I should be fine and stated I could drive a commercial vehicle.
I started CDL school this week and talked to several recruiters. I talked to 2 of them privately and stated I had just heard companies may not hire a qualified driver just because of their medications. One stated he would check, but wasn’t optimistic. The other told me (off the record) that it is very common for companies pass on hiring someone taking these medications just for their own liability reasons. Did I just give a CDL school $4000 to not be able to find a job? I would appreciate any feedback.
@Mike
Without a lot of documentation from all doctors involved, you should not have been cleared as fit for duty and given a medical card. Some of your medications should have been instant disqualifiers until you provided medical documentation to support the CME’s final decision making process.
With proper documentation from your doctors with medical releases from each of them, then you may be good to go. But your meds are going to cause questions for any CME or company. It can all be fixed with good documentation from your primary care physicians.
I did not see Venlafaxine HCL ER Caps. 75 mg 1 daily, do I need a note from primary physician regarding any medication ex, allergy Monoklust, 1 at night Tamsulosin .4mg daily
Your page has been most helpful. Thank you
@Lynda
Your medication will raise questions due to the purpose of the medication rather than the med itself. Get a note from your prescribing doctor explaining the needs for the medication and how long you have been using it. With that information in hand you help the CME make a more informed decision.
Is taking clonidine for hypertension disqualifying for DOT?
@John
It is going to cause questions because this medication has side effects that could impair your ability to operate a CMV safely. Get a medical release form from your doctor explaining your need for the medication and how long you have been using it. It typically is not used for hypertension, so have your prescribing doctor explain his reasoning for this medications usage.