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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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what is the dose limit on Gabapentin
@ Anna
Due to its side effects, it would not allow a class A, OTR driver to pass the DOT medical certification process. A medical release form from the prescribing doctor will be needed to present to the CME at the time of examination. The doctor needs to explain the dosages and the length of time that the driver has been on the medication. At least that way the CME has a more complete picture to make his final decision making process.
My husband has a bad back and has been on pain meds for many years, I would guess about 6 years. The dosage has remained the same in that time. He has never failed a drug test and his driving record is perfect. He has driven for over 10 years. His doctor has been the prescribing physician the entire time. He used to work at a company overseeing CDL drivers so he understands the effects on a driver. Because of that my husband has been allowed no more than two a day and he is NEVER take it 6 hours before his shift and never during his shift. With the new laws, the CDL examiner he saw this time told him he could NOT take that amount even though my husband’s doctor filled out the necessary paperwork stating he had been on it for a while and the dosage was ok. The examiner told him the only way he would issue my husband his medical card was if he reduced his dosage to one a day. This examiner doesn’t know my husband, he doesn’t know anything about him. But without dropping the dosage, the examiner was willing to prevent my husband from being able to work. His regular doctor was shocked by the situation. However my husband is forced to comply or lose his job. What options do we have? I cannot believe that a doctor who has never seen my husband before is able to completely decide what he can and cannot put in his body if permitted by a physician.
@ Shell
If you can, goes else where for a second opinion. The CME has no right to determine a drivers medications or their dosages, his only job is to determine medical fitness for duty according to the FMCSA guidelines. Go get a second opinion and make sure you have all the supporting paperwork in hand when you go.
I was wondering if my husband takes Ativan and has for over a year, Does he have to discontinue it for his truck physical. He is seeing a Doctor while taking this and takes it as needed . Thank You
@Jill
He should not discontinue any properly prescribed medication. Just make sure he takes a medical release form from his prescribing doctor when he goes for the DOT medical examination. Have the doctor explain that your husband has been on this medication for some time and has had no side effects.
I don’t think Ativan comes up on a regular drug test and I am also pretty sure it has a short 1/2 life.
Hello, I am trying to get my CDL. I am now trying to get my permit. November 28, 2017 I went to get my DOT PHYSICAL done. After completing my PHYSICAL I was told by MEDICAL examiner that I was disqualified because I had just started the medication chantix. I stopped taking the chantix that day. MEDICAL examiner was not able to answer my questions. Is there a time limit to when I can go back to get my PHYSICAL done again? Do I have to go back to that same examiner? What do I need to do to be able to get this physical out of the way so I can get my permit so I can start driving?? Please help.
@ Kortney
Chantix is a disqualified due to its known side effects. Once you have discontinued the medication you can then go to any examiner and have a new medical examination done.
Can you take Wellbutrin aka Buproprion for smoking cessation if you have a letter from your doctor??
@ Ace
With proper documentation and a medical release form from your prescribing doctor, more than likely you will be fine.
I’ve had a CDL Class A for 6 years now, and I have chronic pain. My pain management dr wants to insert a Intrathecal drug delivery, or “pain pump,” which is a method of giving medication directly to your spinal cord instead of taking oral narcotics. He believes I’ll be able to return to OTR driving since the cognitive abilities won’t be affected like taking oral medications. Will DOT allow the “pain pump”???
I’ve got the same question! Need an answer… fast!
I have same question, but it would be a non narcotic pain pump ( plaita) . Seems no one can answer so far.
@ Larry
Give us the correct name of the medications and we will do our best to answer your question.
Will I pass a DOT physical with a pain pump with dilaudid, with no side effects
@ Jeremey
There will be plenty of questions and much needed supporting documentation, as well as, a medical release form from your prescribing physician.
so my school wouldn’t take me while on Aderral, understandable. I switched to Vyvanse with proper documentation and a Dr note. Multiple potential employers have politely invited me to reapply after stopping medication on the “approved with Dr note” list. I’ve done so but now my ADHD is untreated. They argue that while I’m okay with the DOT on the medication their company doesn’t recognize this exception. I have my CDL A but am unemployable when on treatment. Recommendations appreciated.
I am prescribed Hydrocodone 7.5/325 and Tizanidine HCL 4mg for bad lower back. I only usually take it in the evening after a long day to help with pain about 3 times a week. With a prescription, would I be disqualified from driving?
I went in on Tuesday to have my DOT medical renewed. I carried in my “medications list” which included Tramadol 50mg 1 – 2 pills every 4 to 6 hours as needed for pain. (This was a physicians prescription).
I was told by the physician that “Tramadol” was an “absolute” MAY NOT ISSUE on the DOT physical if I was prescribed this medication. I was asked to get my physician to “suspend” the prescription and to permanently stop taking this drug.
I have complied. Please clarify/verify this information.
I went a few days ago and did my dot physical and the Dr told to get my Dr to sign a medical release form so I asked my Dr and she said no she will not sign it but she has me on no kind of restrictions what do I do at this point
I did my dot physical and I did both urine test and hair follicle test but they want me to get my doctor to fill out a medical release but my doctor said that she wasn’t gonna do it but she doesn’t have me on no kind of restrictions what do I do ? or what can I do?. I’m suppose to be starting school on the 30th of this month.
Is sleep apnea a disqualifier
It needs to be under control. If you use a CPAP you need to bring your printout with you for your physical.
How far back of a print out do i need. Ive used it for years.
@ James
For C-pap 30 days.
Not 30 days but 6 months is the standard.
At my annual CDL physical , the doctor gave me a medical release form. I am on wellbutrin and effexor for 3 years. Other antidepressants 14 years prior. I drive school bus. My use of antidepressants has only become an issue this and last year.
The examining doctor wrote on my physical form that I had medical form to get clearance for use of mental health meds. My employer got the original copy with that message. I never wanted my employer to know of my personal issues.
Is this acceptable on the doctors part???
this is what is killing me about applying for new jobs. Having to tell these things to people I don’t know. It isn’t their business. Plus I will fail the drug test due to LEGALLY prescribed meds. I guess everyone is 100% healthy but me.
Can you get a cdl while taking suboxone?
It is on a case by case basis. But you’ll be one lucky person to find a dot examiner to pass you. And if you do hold on to that release. Because if you’re ever stopped by dot. And it is found on you. You’ll be shut down then towed. And tell your employer also. Good luck because one or the other will refuse you for taking the medication. Even though they’re thousands and thousands of drivers taking either suboxone or subutex. Dot does not do a drug screen for these meds. But they can and probably will pull a Kasper report. And when and if they do then you’re disqualified for lying. It is a no win situation. Most driving with a prescription for suboxone/subutex has just not mentioned it.
I have not found any regulations on Suboxone in the fmcsa guidelines could you show where it is so I can review
@ Allen
It’s not a regulation, it’s a guideline for the examiners to use to evaluate a drivers risk factor. FMCSA guidelines are gray in this area.
I am hoping you can help clarify something with Ritalin. My husband was prescribed Ritalin following an accident that resulted in a traumatic brain injury and has been on it for the last 2+ months. He works in a safety sensitive position because he supervises employees with a Class B license. He does not possess the Class B himself. All employees have been informed by the employer that drugs are being added to the DOT Drug Testing Panel and that employees that are subject to testing should seek alternative medications or stop taking them all together.
We have been trying to determine if Ritalin is a banned substance but have been getting conflicting information. He needs to take this medication as the accident has left him with severe explosive disorder that leads him to lose his temper with the least provocation. Without this medication, he would probably lose his job. He already had several run in’s with upper management before he started on this medication. Is this medication something that he can get a letter from his doctor for? In the meantime, his doctor has prescribed modafinil. Is that a banned drug? It doesn’t work nearly as well, but if that is all he can take, it is better than nothing.
Thanks for any definitive information that you can provide
I am a CME and have a question on past marijuana use. If a patient documents on the physical examination form that he used marijuana two months ago is this a disqualifer? Or does this warrant a drug screen to verify they are not currently using? Thanks in advance.
is flexoril 10mg disqualifying for cmv driver
I have sickle cell anemia and have been driving for almost 3 years now. I take Percocet and Delaudid as needed. On the days I take these meds I don’t drive. My questions is how many hours am I required to sit after taking these meds? My dispatcher makes me sit for 24 hours but since I am a long time user of narcotics for chronic pain I believe if I only take Percocet that I am able to drive again after 6 hours. Honestly thats being overly precaution because most time taking a Percocet is like taking a Motrin or Alieve. It’s doesn’t do anything to me. Taking Delaudid however does have greater side effects so sitting out for 24 hours is usually needed.
Is suboxone a disqualifier in PA for a NON CDL medical card? There is nothing written that I have found that explicitly says one way or another.
will Trazodone make me fail a DOT physical?
I am an OTR truck driver. I have had adhd for 50 years. I dont take meds for it for fear of DOT physical CDL failure. As a result I suffer from major insomnia. I have been taking otr Walmart Equate DyphenHydramine HCI sleeping pills which I have in my truck. But after reading several websites i am scared they might be illegal with DOT. Ive been taking the DyphenHydramine HCI sleeping pills for 6 years now and they have recently lost their effectiveness. Is there anything I can legally take as a sleeping aid and have in the truck that will solve insomnia ?
@Michael
You’ll need to check with you primary doctor to find out what’s going to be most effective for you. And there’s a time period that you need to be on this medication, and not driving, to test the medications side effects, and most of the medications for ADHD are acceptable, with proper documentation from your prescribing doctor.
I take astorvaston Lisinopril metroplol will these drugs stop me frpm getting dot card.
Xanax works great as a sleeping aid for this ADHD person. None of the other stuff works at all on me, so maybe won’t work for you, but worth a try as no hangover and only long term issues.
you could try kratom, but I don’t that Kratom is water soluable (stays in body longer) it IS legal in 46 states. but it is getting demonized while alcohol gets the free pass. a lot of people and places consider it a fail IN the 46 states where it is 101% LEGAL.
I have a driver who is taking Norco and Fentanyl for current dental problems. He took a waiver to his DOT from his PCP who said in his opinion he was safe to drive, however, the ME said he will not certify him. I know he is on some pretty potent stuff here. My question is, is it worth seeking a second opinion here or will he get pretty much the same answer and is it actually legal for him to be taking these substances while driving? He takes his meds at night only. Thank you!
@Employer
As a class A driver, he would be disqualified until off these medications.
As a local driver on these medications, it still raises serious safety issues.
Honestly, prescribed or not, it sounds pretty fishy for a person to be prescribed fentanyl for “dental problems”—and then to add norcos on top! SMH I would keep an eye on that person. Seriously,