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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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Can diazapam for anxiety a disqualify you?
@Oxford
In and of itself, no. You will need a medical release form from your doctor explaining your condition and need for your medication. With good documentation and medical release forms you should have no problems, if all else is fine.
Can anyone point me in the right direction for finding an approved medication list for CDL drivers. I currently need to go to the doctor to get put on something for anxiety attacks that happen on occasion.
I am on Effexor XR and take medication for ADHD. I just don’t want my doctor to give me a benzo or something that could affect my physical.
Thanks
@Kelly
The FMCSA does not have a list of medications, except for a very few. If you are going to start a new medication, you will need to be on that med for at least 30 days before going for a new medical certification examintion. Also you will need a medical release form from your doctor explaining your situation and a working prognosis. That information is very useful for the examiner to determine your state of ‘fit for duty’ status.
can you or have been on pain meds and have or get a cdl
Is there a list of medications or class of meds that are disqualifies for a CDL B for school bus driver in Washington state? I had my dot physical today and one of my prescription meds are illegal to drive on. I’ve been on it for years. When did the list change? Xanax and Clonazepan we’re prescribed to me for years. Now I can’t get my medical card until I have a clean UA.
Thank you
@Judith
Your examiner is over reading his rules and regs. As a class B school bus driver, you fall under the states variances and not class A Interstate driver standards. Check with your local drivers license department and confirm that your meds are accepted by the state. And let the examiner know what type of driving you do. You may want to have your doctor fill out a medical release form for you too.
I’m a CDL holder who takes oral medication for diabetes. I’m looking for information on how NON insulin injectable meds like Trulicity are handled by FMCSA. I can find info on insulin rules everywhere online, and I even asked the examiner at my last medical exam. But I can’t find info on non insulin injectable meds and cdl rules anywhere. Is it handled the same as insulin? Any info would be greatly appreciated. Thanks.
@Joseph
Non-insulin injectable will require a medical release form from your doctor stating the medications that you take and the length of time that you have been taking this medication. Also you will need a copy of your latest A1c as supporting documentation. Medical certificate will be for a max of one year.
Thanx for the info. One more question. Since my medical card is good until the end of December, would I be legal if my Dr. prescribed it for me now? I wouldn’t think so. I’m trying to figure out the steps I would need to take to start the drug legally if and when the time comes. Do I just go on it and take the necessary medical release form and A1C info to the DOT Dr. at the time of renewal? Somehow, I have to think that this wouldn’t be legal for the time in between. So what would be the step at the very beginning? Again, thanx for the help. It’s been fantastic.
I’ve just been issued a 2 year DOT medical card (I drive small DOT box trucks not semis, I just have a chauffeur license) and was not on any medication. I do want to start taking Phentermine 37.5. Assuming I get it prescribed by my general physician, how would I go about it with regards to my DOT medical card?
@Mike
You are going to fall under your states variances and not the FMCSA rules and regs.
Unless you are a class A interstate driver, all you should need to do is check with your local drivers license department to confirm what, if anything, needs to be done.
I have been taking phentermine for years as it works for my adhd
This year for my class A the medical examiner says I can’t take is because its an amphetamine. True? Can’t I get a Dr note to be approved to take this?.
I am looking for a pain medicine for my neuophthy in my feet and still drive a school bus in the state of Ohio. Thanks for your help
I was recently hired to get a class B cdl in witch I will be driving a school bus, I have a prescription for norco do to work related injury, can I be cleared to drive the bus on that pain medication if not what pain medication can I get cleared to take to drive.
What prescribed pain medication can you be taking to operate a school bus that you can get cleared on the physical.
i take sertraline hcl for anxiety , it has helped me and i have no side effects, will thi be a problem?
@Nick
It should not cause any issues. You will want to have a medical release form from your doctor explaining your medication needs and a working prognosis. That information is very useful to the CME in his decision making process.
@Eugene
Since you are a school bus driver and do not fall under the FMCSA guidelines, we would recommend that you check with with your local drivers licenses department for the best answer.
I recently was put on a low dose of suboxone will this keep me from getting my medical card in Pennsylvania
@Greg
A lot will depend on the reasoning and the type of driver class you are. In most cases, the examiner will want a medical release form from the doctor and he will also want you to be on the medications for a period of time, to determine if there are any side effects that would pose a safety issue. So have your doctor complete a medical release form explaining the reasoning for the medication and a working prognosis, that would be a big help for the examiner. If you operate intra-state only, then you would need to check with your local drivers license department for the most state-specific answer.
Suboxone does not show up in drug test.
are you sure? I posted on this topic above and then thought about it. My pain med shows up on a 5 panel and it is a synthetic. but I am allowed to “fail” because it is a legal Dr. Prescription, and not a driving job.
I meant to note I might be looking into getting a CDL-B, unless I am farting in the wind due to my meds. aka don’t waste the time with the training.
I take gabapentin for nerve pain associated with my neurofibromatosis. I also take hydroxyzine Associated itching from the Neuro fibromatosis. how would this affect me getting a medical card?
@Larry
You’ll need a medical release form from your doctor explaining why and how these medications are working for you and what the possible side effects are. That helps the CME make the best and most informed decision.
Is cymbalta for depression and some arthritis pain a problem for class A CDL interstate drivers?
@Mary
Start with a medical release form from your doctor explaining your condition and situation. That will be a huge help to the medical examiner.
Thank you for the information!
I do have a question about my specific situation. I hold a class A CDL in GA, it expires in 2 months. I had a work injury a couple of years ago and take a medication called “Nucynta ER” for the pain. I understand that this is an opioid in the same class as percocet. If I complete a DOT physical to retain my CDL will I have any issues with this med? I am not currently driving but my state requires a valid physical to renew a license.
Thank you.
@Phillip
You are going to need a medical release form from your doctor explaining why you should be taking these medications. Also have him explain what his working prognosis is and his future expectations are.
Ok, thank you very much. I will speak with the doctor the next time I am there. I don’t have any intention of taking a driving job at the moment but may pursue it once I am over the injury. The hang up for me is that I have to renew my license and if I don’t have a medical card I will loose the CDL, whether I am actively driving for anyone or not.
@Phillip
Speak with your local drivers license department and see if they will allow you to self-certify in a “excepted” status. That way you will not need a medical card *As long as you are not driving a CMV*.
If you want to go back to driving you will need to self-certify again in a “non-excepted” status, and you will need a current medical card.
Ok, great. Thank you again. I’ll give them a call.
Just wanted to update. I completed the self certification form through the GA DDS. I selected the option for intrastate exempt. Since I am not currently driving this allowed me to keep the CDL without having to submit a med card. If/when I drive again I’ll have to re certify and provide a card. For now though, it took care of everything.
@Phillip
That’s good news. Happy we could help. Well done and thank you for the feedback!
Hello and please help me figure this out!
I’m taking 1-2mg suboxone daily!
Will this disqualify me from obtaining my CDL A
@Robert
It will all depend on the reason and the length of time that you have been on these meds.
Start with a medical release form from your doctor explaining your situation and conditions. If you can, also have your doctor state his working prognosis and future expectations. That will help the CME understand your situation and make the best decision based on his findings.
I have a driver who has CAD, HTN and diabetes, he desperately wants/needs to quit smoking. He has been approved by his Dr and insurance for 6 months of Chantix. Is this drug prohibited for CMV drivers?Should I advise him to take a waiver to his DOT ME from his PCP? The FMCSA website is vague on this unless I am just not looking in the right place!
@Employer
This medication is a disqualifier via FMCSA guidelines and regulations for a class A Interstate driver.
If you are taking BRILINTA® (ticagrelor) and Atorvastatin can you still drive a truck based on FMCSA guidelines?
Thanks
@Marian
It will depend on the reasoning for the prescription. And we would recommend that you get a medical release form from your own doctor before going for your examination.
I have ADHD and am on ritilan to help me focus a throughout the day. Will I fail my medical cert and drug tests. Which would affect my Career.
Ritalin in your system can be detected and it will show a positive drug screen for amphetamines . I’m pretty sure your going to need a note from your psychiatrist / primary care Doctor Who prescribed the Ridlen for you . As for keeping you employment, that’s up to the doctors and what they sign offf on. Best of luck to you,
I am prescribed tramadol HCL 50 mg one to two tablets daily that I have been taking for two years. Will this show up on a prehire DOT drug screen test and disqualify me from getting hired?
@Ray
It will show up in the pre-hire drug screen, but if you have a medical doctors prescription for these, then you will be ask to provide that information to the MRO following the positive test results. So the test will be positive, then the MRO will get in touch with you and ask you to fax a copy of the script, then he will retest the split sample and make his final determination. If everything is in the normal ranges, you should be fine.
I have been taking Nuvgil for 3years by Script for Severe Shift work disorder, Sleep Apnea ( the type that your so tired your brain quits telling you to breath). My insurance covers this med. but it is ridiculous expensive. I am not comfortable with this. I recently spoke with my Doctor about switching to Aderhal instead, only because of the cost. The Doctor said yes, that we would and could. I left the apt. thinking we switched. Here is my dilemma. I have access to Aderhal from a bunch of meds. my mother had when she passed recently. Thinking I would be covered by script, I took one. Turns out that the new script would not go thru until the Nuvigil script expired. After I took this I had a random and tested positive for amphetamines. Thinking I had a script.no problem. Well their is a time lapse in the script. The MRO wants a copy of it and it must be dated before the Random. So here I am, with a script that is 20 days after. I contacted the Doctor and they wrote a letter to the MRO who is rejecting this and is firm on the Date. The MRO cares less about the Nuvigil. Do I tell the MRO the truth. Here I sit with a prescription, Doctor supervision and a bottle of aderhal with 90 pills and I am going to fail a drug test. Not sure what to do .
@Dave
You could try and have your doctor write a note to the MRO, but in reality, you are probably not going to pass this drug screen. MRO has to function under FMCSA regulations and you are outside of those regs.
So…are any pain pills acceptable while carrying CDL
@Lena
All depends on the reasoning for the medication. You will need a medical release form from your doctor explaining why you are taking these medications and what his prognosis for your condition is.
I was prescribed Celexa and klonopin for anxiety for few months between 2009-2010. I have not had had any anxiety ever since. It’s been almost 7 years. I have not been on any medication ever since. Can I still pass the Medical exam and get my cdl?
@JT
With a solid explanation, and since the condition was so long ago, you should not have any major hold ups. If there is a way to have your primary doctor fill in a medical release form stating that all of the information is correct, then you should in good shape.
Hi,
Is gabapentin a dis-qualifier for my CDL? I currently drive inter-state.. My doc prescribed it for sciatica pain due to pinched nerves.
Is Robaxin also a disqualifier. I am getting older (57) and want to keep my license for another 8-9 years.
Thanks.
dave
@David
These medications and the condition for which you are being prescribed would have you disqualified. One will be very questionable due to being an anti-convulsant and the other is a muscle spasm controller. These all imply that you are not medically fit to perform the duties of a CMV operator and would have you listed as an unsafe driver. Try to get the condition under control as quickly as possible and get off the medication and you should be OK. Good Luck.
The gabapentin is being prescribed because of nerve pain. I have pinched nerves etc. I’m not taking either right now because I like getting paid. I was not sure if gabapentin would make me fail a random.
Robaxin was suggested by someone as an alternative to tramadol.
Will gabapentin show up on a DOT drug test?
@Bob
More than likely, and given the reasoning for taking this medication will cause many questions. Once found in the DOT drug screen you would have to give the MRO a copy of the prescription or fail the drug screen as positive. Given the known side effects of the medication also would disqualify you as a driver. FMCSA is looking for safety issues and this is a big one.
Can I pass the DOT test if I take methotrexate 2.5 for RA. I no longer have RA symptoms but I’m still taking the medication.