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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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We have a driver that has been on Tramadal for 2 years and in August of 2015 and August of 2016 he was given a one year DOT Medical Examiners Certificate. This year when he went he was told that this medication automatically disqualifies him. What changed and are there any alternatives?
@Ed
Tramadal is not an automatic disqualifier. He needs to take a medical release form from his prescribing doctor and make sure the octor explains the driver’s condition and the need for the medication, and the length of time the driver has been on this medication without ill effect. He should be able to get a one year medical card.
Hi. I’ve been taking Xanax for about two years now. I’m 34 years old and two years ago my mother suffered a ruptured aneurism and two strokes during the surgery and I left my 8 years as an engineer on park avenue to be my mothers caretaker. She’s 57 and can’t see, walk, go to the bathroom, etc. I was diagnosed with anxiety disorder and I go to the doctor every month to make sure I’m ok because just seeing my mother on a 24 hour basis hurts. I even have a baby monitor for her to call my name that gets me up four times a night. My father is in the midst of hiring a 24 hour nurse now that we see the therapy and all of her doctors and 20 pills a day aren’t going to change her. I’m engaged myself to a woman with a 9 year old son that’s partly autistic. I want to be a ups driver and retire as a ups driver. I want a career and not just a job. Just last month my father had emergency open heart surgery and I had to take care of both of them. He’s starting to get better but it’s imperative I get this job at UPS. It’s close to home and checks off all the boxes I need to start my life again. Im 6’6″ 240 lbs and my doctor prescribes me 4 one mg Xanax a day. Just please tell me whatever I have to do to be successful when I go on that job interview. Thank you so much for your help and I look forward to hearing from you. Thank you again. Take care.
@Rob
If you are going for a class A license, it will raise a lot of questions.
If you’re going for a local delivery UPS job, then you fall under state variances. So check with your local drivers license department for their answer to your question.
Hi I take gabapentin for hot flashes will I need to get a note from my doctor
@Giana
It would be helpful.
I take oxycodone for chronic pain and i drive perfectly while on the medication, doesn’t affect my driving at all In fact I currently do a driving job and i have a doctor’s note from my physician saying i’m allowed to drive while taking this medication. Would I be able to get a CDL if I brought a note from my doctor saying it’s OK for me to drive?
As it stands right now the DOT 5 panel doesn’t test for synthetic opioids.
That is all going to change in October of 2017
Do DOT Drug Tests look for painkillers?
No.
Why not?
Because the wheels of government move slowly.
But I thought DOT tested for opiates?
Yes. DOT tests for drugs that are natural opiates such as morphine, codeine, and heroin. However, painkillers like LorTab, Vicodin, and OxyContin are synthetic or partly synthetic opiates, also known as opioids. They are not tested for in the standard DOT Panel.
thx for the info, i only ask because i was gonna go to truck driver school and they told me taking oxycodone was a disqualifier, maybe i should try a different school?
wow, pretty cool. Do you have to declare what you are taking under penalty of law? Nothing I take will show up at this time but the DOT will disqualify me for two of my 4 meds on the spot. I am thinking of going to heavy equipment school and (I think) will need at least a CDL-B.
I take addersll for ADHD. Is this a disqualified?
@James
Depending how long you’ve been on the medication and stable, get a medical release from your prescribing doctor, and it should not be a problem.
Jesse
It will raise a ton of questions and it is highly unlikely that you will get a class A interstate medical card on that medication.
I am taking Adipex for weight loss and looking for a CDL school. Will taking the Adipex prevent me from getting a pass on the DOT physical? Thanks!
@Liz
More than likely, yes, due to it’s other effects. It will definitely raise questions.
I am a CME, had a driver come in with dx of fibromyalgia and Insomnia and is taking meds that concern me; Flexeril and Gabapentin 300mg tid, daily and has been for approx. 3yrs. Her former PCP was her last DOT examiner and is now retired.
@Mark
Is there a question here?
What’s the laws on Chantix? 1 doctor told me it was fine to take with CDL and another said no..
As far as I know, Chantix is an automatic DQ due to side effects like seizures, dizziness, heart irregularity…I warn all of my drivers who currently smoke that if they have any intentions of quitting they should avoid Chantix, if possible.
@Lee
Class A driver – No!
Hi there, I am wondering if the prescribed medication Ropinirole @ 3mg at bedtime for Restless Leg Syndrome is a disqualifier to obtain my DOT medical card?
@Lance
The medication is going to raise many questions so make sure your have a medical release form from your prescribing doctor in hand when you go for your DOT physical.
I take Citalopram 5mg daily. Will this show up on a DOT urine or hair test?
@Chip
No likely. Drug test is not looking for this type of drug. And… with a proper prescription you would be okay anyway, on a drug test.
Can you drive a school bus while taking prescribed suboxone for opiod dependency.
I would like to know this too
And do they test for it? I’m on 1mg going in for physical now we will see
I Take seroquel at nite and clonezpam does this disqualify me for a chauffers liscence
@Stacy
First check with you local drivers license department on the requirements for this type of license and ask what medical restrictions apply. This is a state level question, and our focus is to know federal requirements.
@Eric
Most probably not, but conform with your local drivers license department.
I take buprenorphine – subutex and I have for the past year. Will that show up in the drug test? Will that dq me for class A CDL? Can the medical examiner or DOT in Washington state see what medications we get prescribed and filled?
My PD has no problem with filling out the paperwork and has several patients who have their CDL already but he didn’t do that paperwork for them and told me it’s no ones business but my owns. I’d rather be honest up front but I’d still like to know can they access what prescriptions we are currently filling…..,
will Eloquiss disqualify me. Had a knee surgery and prescribed the meds for 6 to 9 months. what kind of testing needs to be done if any or do I just need medical release form thanks for the help
@Zac
Start with a medical release form from your doctor explaining your situation and needs for your medications. It’s going to raise questions, but with proper documentation you may be OK, based on the class drivers license that you hold.
I have had 12 back surgery 2001 till 2017 my Dr. Said I can drive I had drove some.in about 8 deffent states I been on morphine 60 mg time release for 15 year have CDL and dot physical iam disabled why won’t a Dr. Do dot physical and some will by the company will not allow it
@John
Companies are allowed to have a stricter policy than FMCSA regulations. Sounds like you are restricted by a company policy if you have been able to pass the DOT physical in the past.
I recently have been put on Victoza to control my diabetes. It’s described as a noninsulin. Is this medicine okay for the D.O.T certification. Also, what is the allowed Ac1 levels? Thank you.
@Sam
The medication is not considered insulin and should pass for a one year card, as long as all else is in the normal ranges and your latest a1c results are normal. Make sure that you have a medical release form from your doctor explaining your condition, medications being taken and copy of your most recent a1c test. Your doctor will know what a normal a1c should be.
I’m trying to get certified to drive our company box truck, I don’t need the drug test just the physical, thing is I’m currently taking Suboxone and most likely will be for a long time. I have a medical condition that causes chronic pain and after getting a spinal cord stimulator that helps but doesn’t completely solve the problem my doctor determined a suboxone maintance dose would help be a safer long term solution then say oxy or hydrocodone. My doctor has provided me a note and fully believes this doesn’t effect my ability to drive . Can I get a medical approval or is it going to be a no go everywhere. First place I went wouldn’t even consider approving with Suboxone as listed med even with a strong doctor’s opinion that I’m fine to drive. At this point I’m tempted to just try without listing it but hate to be dishonest and I assume they will check database to see what I’m prescribed.
@Brett
You are going to be driving a box truck, less than 26,000 pounds. That means you fall under the states variances and not FMCSA. Check with your local drivers license department to determine the best solution.
The CME needs to understand the differences and should evaluate accordingly. You are not going for a class A license and should not be evaluated as such. You can’t grade an apple by an oranges standards.
Your PCP can complete you DOT physical for you.
i am on medications want to go with my son in his semi can i take prescribed meds i have with me cymbalta atenol naproxin ? thank you
Will HUMIRA medication for arthritis disqualify you for exam
@Andy
It will pose questions due to its other effects, but with proper documentation and a medical release form from your doctor you should be fine, as long as all else is within normal limits.
Can a firefighter who drives a fire truck, who wants to get a CDL license, still take suboxone? A letter from his prescribing physician could be provided.
@Rob
It may be possible, with proper documentation.
I drive School Bus in the state of IL. I see a Neurologist for migraines and degenerative disc disease in my neck and low back… compliments of being a driver.
I have been placed on 300mg of Gabapentine, 3 times a day…
Am I still able to drive the School Bus while on this medication?????
I received a document from the Physicians who provide our physicals, but the medication and it’s formulary – Neurontin, don’t show up as a “do not use while…,” so there is a lot of confusion as to whether or not I can take it and drive.
Please let me know what you can – Thanks!!!
@Erica
You drive a school bus, so you fall under the states variances and not FMCSA guidelines for a class A interstate driver.
You want to check with your local drivers license department and find out more about this medication and driving children around. It’s the states variances and guidelines that you need to comply with.
i have a class A driving license but have been off work for 2 years, because of vertigo. I was having them at least 2 times a month so put off work . I’m now on dilantin 300 mg a day for the past 2 months , no vertigo , Can I now go get my dot physical or will the medicine keep me from getting it back.
@Dee
Get a medical release form from your doctor explaining your condition and medications, with his working prognosis. This information will be vital for the CME to make the final decision in your case.
I am have CDL for hauling cars and the doctor has prescribed muscle relaxers, are these on the No list for driving?
@Paul
It all depends on the reasoning for the prescription. It will drug test positive and you will need to supply a copy of the prescription if needed. Also if the prescription was given for an injury that you are recovering from, then your medical certificate was invalidated at that time and a new medical card is required by the FMCSA.
if I lie about my prescription in mass will they know during my dot exam with no drug test?
@Johndoe
Not unless they check your medical prescription data base. Is it worth it?
I have recently been prescribed sertraline for anxiety. Will this show up on a drug test for my CDL and will it prohibit me from keeping my 2 yr Fed Med card. Possibly be going to change jobs will it b a problem on a pre employment drug screen. Not experiencing any adverse side effects
@Gel
This medication is going to raise questions. Mostly due to the potential side effects. You will need to be on this medication for at least 30 days prior to retaking your federal medical certification examination. Make sure you have a medical release form from your doctor explaining your situation and a working prognosis. This medication may show up in your drug screen. If it does, all you need is a written prescription from your doctor and be able to fax a copy to the medical review doctor.
can they check the V. A.’s database?