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Q&A
Does the DOT physical include a drug test?
What drugs are tested for, if a DOT drug test is requested?
What if the DOT drug screen tests positive?
Why do I have to have a urine test for my DOT physical?
Is protein in the urine a disqualifier?
Is sugar in the urine a disqualifier?
Is blood in the urine a disqualifier?
Can I get a medical certificate if I’m being treated for a medical condition by my doctor?
What if I take insulin by injection and my diabetes is under control?
My doctor put me on Metformin. Can I still drive truck?
What medications disqualify me from getting a medical card?
Can I be qualified if I have a prescription for medical marijuana?
What if I take nitroglycerine for angina?
Can I still drive if I take prescription Paxil, Imitrex, and Zonisamide?
Can I take Xanax and still drive truck? My doctor put me on it and I don’t want to lose my job.
Can I still drive if I take a blood thinner?
Can I still drive while taking Provigil (Modafinil)?
Does the DOT physical include a drug test?
The DOT physical exam to get your medical card, does not include a drug test. This does not mean that any Company you want to work for, will not request a pre-employment drug test — they most likely will. But the DOT physical exam requirements do not include a drug test.
What drugs are tested for, if a DOT drug test is requested?
The 5 Panel drug test analyzes urine for the following drugs:
- Marijuana (THC metabolite)
- Cocaine
- Amphetamines
- Opiates (including heroin)
- Phencyclidine (PCP)
What if the DOT drug screen tests positive?
The DOT drug screen is looking for illegal or non-prescription drugs. Yet, sometimes normal prescription medications can trip a positive test.
If the urinalysis is positive for one or more of the drugs on the 5 panel drug test, then the driver will be contacted in person by the Medical Review Officer. The MRO will interview the driver to determine if there is an alternative medical explanation for the drugs found in the urine specimen. If the driver provides appropriate documentation from a prescribing physician, a confirmation test with a split sample is performed for each identified drug. Confirmation ensures that over-the-counter medications or preparations are not reported as positive results. If the MRO determines that it is a legitimate medical use of the prohibited drug, the drug test result is reported as negative to the employer. Otherwise the drug test will be reported as positive.
Why do I have to have a urine test for my DOT physical?
The urine test is just a kidney screen to test for sugar and protein. It’s done to determine that there is no early onset of conditions like high blood pressure breaking down the kidneys, or early signs of diabetes, or kidney infection.
Is protein in the urine a disqualifier?
No, not necessarily. Protein in the urine may indicate kidney disease. The medical examiner will make a decision based on the amount of protein in the urine. The medical examiner may certify, time limit your certification or temporarily disqualify your medical certificate while you have the condition checked by a specialist.
Is sugar in the urine a disqualifier?
Yes, it is an indicator of the onset of diabetes or already a diabetic that does not have the condition under control. The driver would be disqualified until the condition is under control, either with medications or diet.
Is blood in the urine a disqualifier?
No, not necessarily. If the medical examiner believes that the blood in the urine may indicate a condition that affects the ability of the commercial driver to safely, the driver may be referred to a primary care physician or specialist for further evaluation. The medical examiner may certify, time limit your certification or temporarily disqualify your medical certificate while you have the condition checked by a specialist.
Can I get a medical certificate if I’m being treated for a medical condition by my doctor?
Depending on the risk posed by the condition and treatment, the medical examiner may require documentation from your doctor. To assist in the preparation of the documentation, you can get more information here, courtesy of Trucker Docs. Even though your prescribing physician may be of the opinion that your condition and treatment is safe to drive, the decision to certify still rests with the medical examiner.
If you have non-insulin treated diabetes the medical examiner will check that your diabetes is adequately controlled. If it is controlled, you will get a time-limited certification and most likely need to re-certify annually.
If your diabetes is treated with insulin, you will be disqualified for inter-state driving. You may be able to drive intra-state.
The DOT does have a few, very stable insulin dependent drivers testing on insulin waivers, but you would have to check with the FMCSA on this issue.
What if I take insulin by injection and my diabetes is under control?
Without a DOT Diabetes exemption waiver the answer is No, not for interstate driving, even if your condition is stable.
You may be able to drive intra-state. Each state has its own rules.
What are the requirements for blood sugar limits? I just found a job driving school bus. I am a diabetic, non-insulin dependent. When I took the test my blood sugar was 350, but in the past few days I’ve gotten it down to about 170. I have never had a low or high blood sugar blackout. Will I have to get an exemption?
The medical examiner needs to see your blood sugar levels below 120. That is the level for blood sugar spillover into the urine. The concern is not whether you have ever had a blood sugar blackout, it’s – Could you have a blood sugar blackout while driving a bus full of little people? Safety first for you, the driver, and for the public at large.
My doctor put me on Metformin. Can I still drive truck?
The Metformin is to control your blood sugar as a borderline diabetic. It will limit your DOT medical certificate to one year at a time.
I’m a CDL driver. I had to start insulin for my diabetes. My medical card expires in a month. Will the doctor know I’m taking insulin when he does my tests?
It does not matter whether he knows or not. On the DOT medical examination form that you fill out, it will ask if you are a diabetic and also how you control the condition. So you are the one who is going to tell him about the insulin.
Your examining doctor should ask quite a few questions regarding your insulin usage to help determine your options.
What medications disqualify me from getting a medical card?
Any habit forming drug; methadone; anti-seizure medication, is disqualifying.
The medical examiner will review every medication – prescription, non-prescription, and supplement to determine if its use will adversely affect the safe operation of a commercial vehicle. The medical examiner may require documentation from your prescribing physician. In this case the medical examiner may, but is not required to grant you a medical card.
Can I be qualified if I have a prescription for medical marijuana?
No. Marijuana is a disqualifier, even if you have a prescription.
A CMV driver cannot be qualified if on Methadone. There are exceptions to the rule regarding other drugs prescribed by a physician, but this does NOT apply to Methadone.
What if I take nitroglycerine for angina?
Nitroglycerine use is not disqualifying. The medical examiner may require an evaluation by your Cardiologist to make sure that your angina condition is stable.
Can I still drive if I take prescription Paxil, Imitrex, and Zonisamide?
These three drugs are going to be a red flag for any examiner. You should bring with you a letter from your prescribing physician, explaining the need for the medications and their possible side effects. All three are listed with side effects of drowsiness, weakness, dizziness, and should not be used while driving or using machinery. You are going to have to explain to the medical examiner why and how much if any of these medications you are taking and the basic circumstances for their needs.
Can I take Xanax and still drive truck? My doctor put me on it and I don’t want to lose my job.
One of the best ways for a driver to answer a question about whether a medication may be a disqualifier or not, is to read about the side effects of that medication.
Lets take a look at some of the side effects of Xanax which include: “Drowsiness, light-headedness, headache, tiredness, dizziness, irritability, talkativeness, difficulty concentrating, dry mouth, increased salivation, changes in sex drive or ability, nausea, constipation, changes in appetite, weight changes, difficulty urinating, and joint pain. Some other side effects can be serious. The following symptoms are uncommon, but if you experience any of them, call your doctor immediately: shortness of breath, seizures, seeing things or hearing voices that do not exist (hallucinating), severe skin rash, yellowing of the skin or eyes, depression, memory problems, confusion, problems with speech, unusual changes in behavior or mood, thinking about harming or killing yourself or trying to do so, and problems with coordination or balance.”
As you can see, some of these issues can be unsafe for you and the public. It will cause any medical examiner to question your reaction to this medication. Talk with your prescribing doctor and ask questions with regards to driving while using any medication.
I take Prozac for anxiety and I no longer have anxiety attacks. Will this be a problem for my DOT physical?
If the anxiety disorder is controlled with the medication, then there is no real problem. Just make sure you inform the medical examiner about your condition and the medications you are taking for it.
I have been diagnosed with panic attacks. I don’t have them often but I do take Lorazepam for them on a PRN basis. Can this disqualify me from driving a school bus?
The side effects of the medication could be a disqualifier from driving a bus. I would bring a note from your physician stating how long and how often you use this medication.
A bus-load of kids could be stressful and may trigger your need to medicate. So the medical examiner would be concerned about the side effects of the medication. The big concern here is for your safety and the safety of the children.
I want to keep my CDL but I have anxiety and need to get on some medication. I don’t want to lose my license. What anti-anxiety medication in okay to take and still be safe to drive?
Talk with your MD and explain that you are a commercial OTR driver. That way the doctor can work out which, out of dozens of medications, will work best and not interfere with your ability to operate a commercial motor vehicle. Most of the anxiety meds do not run positive for drug testing. They usually have side-effects that cause drowsiness and that is the main problem. So give the provider as much information as possible and go from there.
You will need to get documentation from your MD stating that no side effects are present that will impact your ability to safely operate a commercial vehicle.
Can I still drive if I take a blood thinner?
Yes, you may still drive. You will need to get documentation from your treating physician as to when the condition started, what was the diagnosis, what has the treatment consisted of, what medication are you on, and is the condition stable. All of these things are to help the medical examiner determine whether you are medically fit to operate a CMV safely.
Can I still drive while taking Provigil (Modafinil)?
The use of Provigil needs careful supervision. Drivers being prescribed Provigil should not be qualified until they have been monitored closely for at least 6 weeks while taking Provigil. The medical examiner will require documentation from your treating physician stating that the treatment is effective, and that no side effects are present that will impact your ability to safely operate a commercial vehicle.
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I know for a fact my supervisor is abusing anabolic steroids long term and his behavior is getting dramatically noticeable he has got a class a cdl I feel he is a danger to others as well as himself is there a way dot can test for this and is there an anonymous hotline I can call
@ Shawn
Report the situation to the HR department and let them handle it.
You’re gonna report someone for using steroids? Pshhh, what a beta b*tch. If anything they make your reaction times sharper
Hello my name is Casey I am planning on goin to school for my class a calls for otr or local but I’m on adderal 30 mg 2 times daily for narcolepsy without cataplexy so it basically just gets me woke up good bc of how deep I sleep I have been on it for several years and have no problems with it and he also prescribed me ativan 2 mg 1 tablet 2 times a day and a half at bed time for my anxiety I have been on that for 2 years now, I don’t have any problems day to day I can wake up and function no problem will this be an issue for me to be able to get approved to to keep my medication as I try to move toward in getting my cdl ? Thanks
@ Casey
Your condition and medications are going to be issues for OTR class A. Check with your local DLD in respects to driving intra-state only with a class A license.
I suffered a mild TBI 6 months ago, and have been diagnosed with PCS, severe depressive disorder, PTSD, and severe anxiety from the incident that happened. I have been a commercial driver for 10 years but now suffer from insomnia and have been in ambien(until it no longer worked for me, belsomira, melatonin etc),currently take 2 mg lorazepam, 200mg sertraline, 100mg topimax all daily and then 250 mg tramadol as need for pain throughout the day for a prior shoulder injury that was reaggitated from above incident(I had the injections in my shoulder and they don’t work any more). I have not returned to work, but will I be able to renew my dot card when it expires in 5 months?
@ Dave
No, you are no longer qualified to operate a cmv safely
Hello,
I take blood pressure medication and anti rejection medications for a kidney transplant I had 5 years ago.
My blood pressure is controlled and I don’t have diabetes.
Would I be disqualified from getting a DOT card?
@ Kris
No. But, you will need medical documentation and your primary doctors medical releases to get started.
My friend is a cdl A driver his dot card is expired he is trying to renew it and is prescribe nortriptyline hcl 25mg because of his headache and migraines but he only takes it while going to sleep will he still be certified for his DOT physical or well he be denied.
@ Leserey
He will need to provide supporting documentation from his prescribing doctor, along with a medical release form from his prescribing physician.
My friend was prescribe nortriptyline hcl 25mg cap. because of his headaches and migraines but he’s only supposed to take it when he going sleeps. Will that affect him from getting certified for his DOT physical
Will taking phentermine for weight loss disqualify me?
@ Lisa R
Yes
Why?
My husband has been prescribed Suboxone by a physician for several years and really wants to get his Class A CDL license. Will this medication cause him to not be able to acquire one or will documentation from his physician give him the opportunity to pass the medical exam?
Im in same boat with same question! I hope for an answer as well..reading for hours online & still no definite answer 🙁 i do know that suboxone wont show up in testing,but DOT dox have access to an Rx website that will show Rx patient has filled. So it depends on DOT doctor i suppose;but thats not a good enough answer for me.
I passd my DOT physical and im on suboxone
How did you handle the medical questions? I am taking something for a similar thing …. glad to about your results.
Nervous
Hi Trucker Doc’s, I too have been researching info on CDL Licensing & DOT-exams, surrounding the use of Buprenorphine. I’m a 54 yr old male from Vermont, and I’ve been prescribed Suboxone now for approx’y 10-years. (W/absolutely NO incidents) I’m going to get my Class-A CDL, (My mind is made-up, and I’m very excited to get my CDL) so I can begin a new Career driving all over the country & making a decent income. I desperately need my CDL license ! I have yet to talk to my Suboxone prescribing Dr, to ask for his full support, along w/his supporting documentation to bring w/me to my DOT Medical exam, to give to the DOT-Medical examiner, in hopes he/she will agree & honor passing my exam. I know some states don’t allow DOT Medical examiners to access the States patients prescription history, and some individuals lie about their Suboxone prescription, therefore dishonestly squeezing through the medical exam & CDL licensing procedures. That’s lying. And will soon catch up to the individual & his newly acquired CDL license. I’m not going to lie. I’m going to hesitantly TRUST my prescribing Dr. who is supposed to be a Professional in the “Medical Profession”, to advocate for me ! And I’m ALSO going to fully TRUST the DOT-Medical examiner, who is also supposed to be a Professional in the “Medical profession”, to agree w/the tests & studies that have have been done, proving Buprenorphine to NOT Impair driving abilities, specifically reaction time ! So, my trust is on these two Medical Doctors ability to follow their Medical-oaths and NOT use their personal/bias feelings surrounding Suboxone! ESPECIALLY if they feel Suboxone is a drug that impairs ones driving abilities ! Because I’ve been taking Suboxone twice a day for over 10-years now, coupled w/a 12-Step program, and it has changed my entire life, for the better 10-fold ! TO the point, where I would protect the life I have today w/everything I have ! I have been riding my Harleys, my cars, my trucks, for all this time w/absolutely NO impairment issues whatsoever ! So, as lomg as the Dr’s don’t use their Bias’, I’ll have my CDL permit on March 13th of this year, 2019, when I have my written portion of my CDL license scheduled at the DMV ! So, if Truckers Doc’s have ANY supporting info, advise for me, PLEASE LET ME KNOW ! Thank you !
@ Richard McG
Answered above.
Same boat here. I’ve been taking Subutex for about 7 years along with Seroquel and I’m seriously considering just trying to quit them both. My biggest concern is relapse. I haven’t touched a pain pill since the day I started taking the Subutex. I’m 53 and I’m finally in a situation where I can go to school for the 7-10 weeks required to complete the class and now I’m finding out about the prescription drug requirements. I’m in Georgia so if anyone can help I’m all ears.
@ Richard P
If you have been on these medication for 7 years, then you would need a medical release from your prescribing doctor and a release from your substance abuse doctors. It is possible, but there are plenty of hoops to jump through.
What state are you in?
@ Angel W
Plenty of documentation from the prescribing physician will be needed. There may be opportunity for his cdl medical exam.
I’m on cloNIDine and Ritalin for adhd but it says on my paper I was certified for DOT physical for a year do I still need a note from my primary care physician before I can obtain my clp I start trucking school the 27th of this month. If anyone could answer this it would be much appreciated thanks.
@ Jon
Your current medical card is all you need until it’s time to takE a new physical. Time of a new physical, get medical release form before you go for the DOT medical examination
I take 3mg of lorazepam at night. Does this disqualify me from a DOT medical card?
@ Jay
It will raise questions as to why you take this med. Make sure you have a medical release form from your prescribing doctor with a functioning/working prognosis.
I am currently taking Seroquel(antidepressant) and Doxepin(sleeping pill) daily before I go to sleep at night….does that automatically disqualifies me from getting a CDL?
I am interested of getting CDL training but want to make sure if these 2 medications I am taking would automatically disqualifies me or not. I am based in Los Angeles, California.
Thank you very much for your help and greatly appreciated.
@ Joe
The medications are going to set off red flags and will need plenty of documentation from the treating and prescribing doctors. And as an interstate driver, driving class A, your medications will be working against you.
I have been on a small dose of Clonazepam (1.5mg/day) for 18 months to treat mild anxiety. It doesn’t impair my daily activities, including driving, and never makes me drowsy. Is it a disqualier for a medical certificate for intrastate school bus CDL?
@ Christopher
It is highly unlikely, but confirm with your local drivers license department.
I recently got diagnosed with bipolar disorder and started taking depakote for it. I read that if you’re taking an antiepileptic for seizures it can disqualify you to be DOT certified again. I was wondering if it was the same for bipolar disorder? I really hope not because all other medications have not worked or have had negative effects on me.
@ James
The medications that you are taking right now, will disqualify you from driving class A otr, interstate.
With proper documentation from your prescribing doctors, you may be able to qualify for intra-state cdl. It will take a bit of back and forth, but you may be able to maintain your cdl.
How will topamax affect me returning to driving? I read the comments about gabapentin and know they are similar. But can’t seem to find a definitive answer anywhere else.
Suffered a head injury that lead to this.
@ Squatchytrucker
This medication is for controlling seizures and is going to raise many questions that will require supporting documentation. Be as prepared as possible. Both the head injury and the medications are disqualifiers without good documentation.
My husband was just prescribed 20mg of furosemide/day and the side effects are potential dizziness. Can he drive (class A) on this?
@ Heather
NO. He needs to be on the medication for thirty days before returning to driving. At that time he will need a new medical certification examination, so make sure he has the proper documentation before returning for the DOT exam.
hello, I was diagnosed with bipolar a few years ago and now take latuda. I am perfectly stable and have had zero issues with anything. I’m extremely concerned I will not pass my DOT medical exam, is this an automatic disqualification? If my perscribing doctor signed a medical release and the DOT doctor passes me, what are the chances of being hired with bipolar? Also, will Companies tell you ahead of time which meds they allow, so I can adjust if I need to?
@ Mary
If the meds are working and your primary prescribing doctor will fill in a medical release form for you and you supply any additional information that the examiner needs, then it’s possible to pass the examination. Proper documentation is going to be the key. As far as what companies will accept, that’s an unknown to us.
I have a Class A Cdl license in Indiana. I just had elective heart surgery to correct Afib and then developed a complication w a 2nd surgery that has a longer recovery time than what FMLA can allow for recovery. I am still taking Percocet sporadically for pain with doc approval. I have no side effects for this RX. With a doc note can I continue to take Percocet and pass CDL physical and drive on my job? (Employer is refusing to hold my job when FMLA time expires).
@ Shari S
If you are still recovering and taking the Rx. you can’t pass the DOT medical certification examination. You will need to be fully recovered and have documentation from your cardiologist before you are eligible to do the examination.
I was just prescribed Xanax temporarily for anxiety. I have to get my DOT physical within the next month. Will I need a letter from my PCP and still be able to drive?
@ Michael
It would be highly recommended.
Hi, I was just hired as a customer accounts manager with a company that for some reason require you to have a DOT physical. I have passed everything for my medical card but they will not give it to me because I am on Klonopin and Zoloft. I have to get a Letter of Safety from my doctor. This is the thing: my doctor is out due to a triple bypass and no one knows when he will return. The doctor filling in for him will not give me this letter cause I am actually not his patient. What do I need to do? Someone please help me.
If my liver enzymes are high will I pass a DOT physical?
@ Chris
Lots depend on the reasoning for the enzyme count to be elevated.
My doctor just put me on Prednisone, for a very short time. Will I fail a drug screening with that in my system ?
@ Tom P
No, but there may be questions regarding the need for the medication.