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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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Is having neuropathy a disqualifier for driving a commercial vehicle?
@Cyn
This will depend on the location and severity of the condition and its underlying causes.
So in short the answer could be a yes and it could be a no. More information would be needed to make this determination.
Firstly, thank you so much for taking the time to answer all these questions, it’s very helpful.
I am a newly diagnosed diabetic, my blood sugar is nowhere near being under control. Does the urine test reflect a long time glucose problem, such as the A1c, or does it reflect only what glucose levels are the day of testing? Also, for a renewal of medical card is the urine tested for drug use? I know the initial pre employment is a drug test but does a renewal only test for protien and glucose levels?
I’m on so many meds because of the trucking lifestyle that I actually would like to be medically disqualified only because I am having a VERY difficult time getting healthy being a truck driver, but I don’t want to loose my CDL, I need 6 months off just to get a stronger medical platform to integrate a drastic diet and excersice Routine to get my glucose and blood pressureunder control.
Thanks for your time.
@Michelle
The urine test is only to establish where your sugar is at the moment, and there shouldn’t be any in your urine. If there is, then your condition is not under control and you will not receive a medical certificate until it is controlled.
Secondly, the DOT urine test, used at the time of renewal, is only to determine the proper function of the kidneys and to look for blood, sugar and protein, not drugs.
If you need to take time off, and your medical card is expiring, check with your state – They may allow you to self-certify in a category that does not require a medical card, in order to maintain your CDL. This may be okay as long as you don’t start driving until you qualify for a new medical card. At that time you will need to do a DOT physical exam and then send a new self-certification form with a copy of your new medical card, to your state driver licensing agency.
‘Way to go’ on taking control of your situation, and best wishes for your improved health.
Just wondering: I want to get back into weight lifting but at my age I feel I need some help and taking a steroid supplement I think would help, but need to know if it will cause me to fail my urine test.
@Reginald
You shouldn’t have any problems with a urine test for the DOT physical.
And for the DOT drug test – All the DOT drug test is looking for are schedule one drugs, like heroine, cocaine, etc. Drug testing is looking at very specific perimeters; I don’t believe steroids will show up unless they are specifically looking for them.
I went to renew my medical card in april. I only received a renewal for 3 months. The doctor found protein in my urine and told me that i had to go to my regular doctor to check for diabetes. I went and checked and received a blood sugar level of 167 at a 7.7 and the dot dr stated to me that he would not renew unless it was a below 7. Despite the research i have done and looking on the tx dps site i found that it has to be below a 200. how can the dot dr refuse to renew it for longer time? However i have just recently received my medication for the issue and now only have 2 weeks to get another blood check done. My question is can the dot dr refuse to renew under these circumstances?
@Cynthia
Yes he can, because he is the one who signs the card and if something happens to you while you’re driving, it falls back on him. He has to determine your medical fitness to operate a CMV safely.
So take all your information with you, along with your medical release form completed by your primary healthcare provider, and you should be able to extend your card until your condition is stable.
Can you be disqualified from having a CDL for being prescribed suboxone ? Can a Physician (not the prescribing physician of the suboxones) turn you into DMV for taking suboxone?
@Glenna
The DOT examiner is only determining your medical fitness to operate a commercial motor vehicle.
If you are taking a properly prescribed medication that has side effects which alter your ability to safely operate a CMV, then he will disqualify you until such time as you can be medically fit again.
He does not report anything to anyone. He simply indicates on the NRCME data that you are presently unqualified. No reasons are requested, either by the NRCME or the state.
I’m on a prescription for tramadol and percocet FOR VERY extreme headaches from an injury when I was a teen. I’m not an OTR driver and I only take the percocet at night when I’m not wworking and if the headache is too severe for the tramadol to help (but never take it while working period). I recently had a UA and am currently waiting for the results and I’m very stressed out about this. My doctor is going to write a note for me stating that it stint affect my driving if I take then according to the prescription schedule (at night and at home off the clock). Will I be ok?
@macattak
Your test results are, most likely, going to be positive.
But, the medical review officer will try to touch base with you to determine the meds you are on. Just answer any questions he may have and you should be OK.
Ok. Thank you for putting my mind at ease some. Its really an awesome thing you are doing with this “forum”. Some people have medications and have serious questions concerning the way the UA for drivers is handled. Other forums will bash you for asking any questions period regarding the drug testing procedures, claiming that you obviously must be abusing if your worried about it. Some people have real medical issues which creates concerns and worries. Since the UA I have stopped taking my medications because I’m so worried about it and have had a very bad migraine for 4 days now. At this point I figured I would just wait until the MRO calls and make sure I am ok to continue following my doctors orders. Once again, thank you for your time and keep up the good work!
@macattak
Thank you for your appreciation. It goes a long way in a world that seems too overwhelmed to stop for just a second and appreciate that there is still goodness around. Best wishes for continued health improvement.
Your very welcome. I actually have just one more question. I’ve been taking tramadol at night but do you know if tramadol use is aloud while operating a truck?
@Macattak
Tramadol may impair your thinking or reactions. Avoid driving or operating machinery until you know how this medicine will affect you. Dizziness or severe drowsiness can cause falls or other accidents.
So starting from here, if you have been taking this medication for any period of time, then you know how to work with it.
I would get your prescribing doctor to fill out a medical release form regarding this med. It will answer any DOT examiners questions as to your ability to operate a CMV safely. Without your doctor’s release, you will, more than likely, have issues with the DOT.
The DOT examiner still has the final say in qualifying you for a medical card, or not.
hi I take warfarin for dvt and am on oxygen at night for sleep apnea and have just been diagnosed with heart problems I will soon have an operation for will any of these thing disqualify me from getting a medical card.
@Joel
I would wait until you have completed your heart surgery and recovery period before trying to answer this question.
Medical cards are given to drivers who are medically fit to operate a commercial motor vehicle.
You will need to have a new DOT medical examination done once you have been released from your primary healthcare provider.
Good Luck on everything.
thank you!
what prescription medications will cause me to be disqualified , i need the hole list so i may see which medication i can take. and which meds i have to change. thank you!
@Wali
There is no such thing as the list you are looking for.
Medicine restrictions are based on the medical condition of the patient and other effects of the drugs.
There is no disqualifying list of medications, only schedule one drugs. (cocaine, pot, speed, etc.)
I had an accident back in 2009 and had to have back surgery and have been on and off hydrocodone ever since. will the hydrocodone keep me from passing a DOT physical
@wanttodrive
The medication will cause questions due to its effects and potential side effects.
What I would do is have your primary prescribing doctor fill out your medical release form and take that with you when you go for the DOT examination.
The meds are going to test positive on your pre-employment drug screen, so you will also need the prescription from your doctor handy for the medical review officer when he calls.
Yes there is one medication,methadone(regardless of the reason for the prescription)
I’ve been diagnosed with ADHD and take 30 mg of adderall ER a day will that disqualify me
@Bob
I would get your medical release form filled out by your primary healthcare provider and take it with you when you go for your DOT examination. It will explain your condition and need for meds. Lets the DOT examiner make a better and more informed decision.
I’ve been prescribed 150mg of Welbutron twice a day and Xanax .25mg. for use every eight hours [as needed] and bed time [as needed]. I average one dose [or less] of the Xanax daily and would like to know if it would be a disqualifier on a DOT physical or drug screen. From reading some of the other questions and answers, it sounds like I should get a letter from my Doctor.
@Mike
The meds you are taking would raise eyebrows for sure, but a letter/or medical release form filled out by your primary healthcare provider will go a long way to clear the air about your med needs and usage.
I am using insulin to treat diabetes five years ago, and I have commercial driver license from 2000, I am under control so far so good, so I stop driving because I lost my job so In did another duties. I tried to get my medical card but the doctor did not certified because I need a waiver, he gave me a number to call so I did and let a message I have not get any notice from Federal Motor carrier. What can I do.
@Heber
The medical examiner should have provided you with a medical certificate, (if he felt you were medically fit for duty). That medical certificate should have stated on it that the medical card is only good with a valid diabetes waiver.
Then you can start the process of acquiring the Diabetes Waiver. I would check with your local DMV first, and then with FMCSA.
I hold a current CDL I have a new job starting Wed and they want me to get a dot waiver because I am insulin dependent diabetic. I was told to go to DMV what will I need to get this?
@Jeff
When you go to the DMV to get this process started, you should just need your driver’s license and your medical card stating you need to have an insulin waiver.
The DMV should give you the forms you need to start the process to get a diabetes waiver.
Before you go, you may want to call your DMV and confirm that that is all you need.
I am trying to get my cdl I am on Effexor and suboxone but am coming off of my suboxones will I be able to get my cdl
@Erica
Because of the conditions you are working with, there will be more questions other than the meds you take.
Your best bet is bring a note/medical release form completed by your primary healthcare provider explaining your present condition. This provides additional information for the DOT examiner to work with.
With the stricter rules and regs from the FMCSA, the medical release is going to be required before you have the examination.
I take Lyrica for peripheral neuropathy. I have taken it for many years with no side effects. Will this disqualify me?
@Ellen
Not if you bring a letter from your primary healthcare provider stating your condition, use of medications and whether you condition is stable and well maintained. You will probably receive a one year medical certificate, due to the condition. But, the note from your doctor helps the DOT examiner make a more informed decision in this case.
A minor point to the question regarding Suboxone above. As a physician licensed to prescribe Suboxone for narcotic withdrawal, it is my impression that Suboxone (buprenorphine/naloxone) is not allowed to be prescribed primarily for the control of pain. Of course, if a patient became addicted to narcotics due to severe pain, and Suboxone was used to treat the addiction, it might not be possible to wean the patient off of Suboxone. As far as I know w/r to the current DOT regulations, it is recommended to not certify a driver who takes Suboxone, but the recommendation is discretionary. And, as of May 21, 2014, all physicians who provide DOT exams need a new certification.
What is the blood pressure range for be a school bus driver in SC
@Olin
See BP and Hypertension for these details.
I was taking lamectal when I recently went in to redo my dot physical. Because of being diagnosed as Bi-Polar I have to go to a psychiatrist. Well since then she says she does not believe I am Bi-Polar and that I may just need anti depressants. Will I need a waiver for anti depressants
@Michele
Just get a note from your doctor stating the facts and you should not have any real problems, no waiver needed.
Is there a time frame “rule” regarding when a driver can take a narcotic and then drive. This driver is taking a class 2 which his primary suggests not driving.
@Susan
If a driver is taking a narcotic for some reason, then he is not going to qualify for the DOT medical certificate. That’s a rule not a suggestion.
When he gets off the medication and has the chance to clean his system out, then he can go and have his examination done and should not have any real problems.
I am taking Gabapentin and was disqualified from getting a CDL. I do not have diabetes and my dr says this would not cause me any problems in operating a motor vehicle. Can you please explain why this drug is disqualifying please. Thank you
@Steve
First big question, Why are you taking this medication?
Gabapentin’s most common side effects in adult patients include dizziness, fatigue, weight gain, drowsiness, and peripheral edema (swelling of extremities); these mainly occur at higher doses in the elderly. Used to treat seizures and pain.
So what I would do is get a medical release form completed by your primary healthcare provider. Then with that form in hand, I would start over again. If your doctor explains his reasoning for the use of this medication, then the DOT examiner has more information to work with.
Thank you so much for this amazing and informative website.
My fiancee is at the top of his field as a automobile computer diagnostician. He recently had a dream job opportunity open up with UPS. After a horrible accident 12 years ago a pain specialist put him on Suboxone ( a very low dose of 8mg to 10mg) per day.
He has absolutely no side effects from this medication.
Not understanding what was required of him, he went in for his physical. The (very young & inexperienced) doctor let him know how dangerous Suboxone is & that is it had 3 to 4 times the side effects of Methadone.
Are you kidding me? I happen to know from my extensive training that Suboxone has little to know side effects and knowing my fiancee the way I do, I can testify that this medication does Not inhibit his ability to drive a motor vehicle or use sensitive machinery.
He has been driving, test driving, working on & around sensitive machinery for over 20 years; 12 of them while on Suboxone without one incident.
It appears as though my Fiancee was disqualified by a biased & uneducated youngster of a doctor without the examiner even attempting to delve deeper into his condition & why he is on the medication nor did he offer to communicate with his treating physician who happens to also be a MRO & one of the top pain specialist in the NW part of the US.
My heart breaks for him.
What can he do? He was confused as to what events happen next. The documentation given him were vague at best and mention “under counsel”. What does this mean?
Is it possible for him to visit an MRO?
How should he proceed?
Thank you so much for your time and consideration.
Sincerely,
MarieElena
@MarieElena
Basically, you could download the medical release form from this website and have your doctor/mro complete the medical release form. Then take that form with you to another examiner and have the test redone.
Thank you for the info.
So the “Physical” was then an “examiner”?
This is so odd to me because the doc was very young and had 0 knowledge of Suboxone.
If he does have his doc fill out the form and then visits another “Examiner”, will that look bad to his perspective employer and does or will the Employer know about his decision to be seen by another examiner?
Should he call UPS and alert them to what he is doing?
I know these questions are speculative at best. I was thinking perhaps you could put yourself into his shoes; what would you do to try and guarantee the best outcome – that he is indeed qualified to obtain any license or clearance needed medically to obtain this job with UPS.
What if you take anti-seizure medication because you have a problem with sense of smell only.
Don’t have seizures where you black out or pass out..
@Leon
Make sure you bring a note from your prescribing doctor stating the need for the medication and what it is being used for. That will help the DOT examiner decide what actions need to be taken.