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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’ve been currently diagnosed with small bowel syndrome from having an aneurysm in 2014. I’m currently on an IV 4 days a week for 12 hours via a picc line in my upper right arm. I normally go on IV while I’m sleeping. I can choose any 4 days weekly. My IV is for a nutrition disorder & basically feeds me all the nutrition that normally would be needed in the body. I’m actually in the best shape of my life. Would this disqualify me from passing my physical?
@ Andre H
At present you would not pass a DOT medical certification examination.
Will warfarin prevent you from receiving your DOT medical clearance?
@ Harry C B jr
Depends on your diagnosis and the length of time that you will be on this medication. You will need a medical release form from your prescribing doctor and any other treating physicians.
i had a blood clot sept 2018.am on coumadin do i need a stess test to renew my physical.i had a stress test may 2017
@ ron
New stress test are needed every two years, but considering you recent medical episode, a new one may be requested by the CME.
Can I drive a commercial vehicle when on lyrica according to dot/fmcsa…
@ David
It will depend on why you are taking these medications. Medical release from the prescribing doctor will be a real help.
I’m a wondering after the QAnd A I have read how someone with, OSA, diabetes, very high BP, supposed to be taking blood thinners and nitro on Lyrica, and a tituiam rod in his leg which prevents him from bending his leg, has no feeling in his legs or hands, stage 3 kindey failure and has had his CPAP repoed by Medicare bc he didn’t use it for a yr and can’t take bp meds bc of his kidneys would be allowed to drive a semi 6 nights a week? Just mind boggling. Also, has been referred to by his doctor as a ticking time bomb?!.
@ Angie
Not sure where you read that a driver of this type would be allowed to drive a class A commercial vehicle. He would not pass a DOT/FMCSA medical certification examination.
Can you take Barbiturates for headache and drive school bus
@ Deedee
You would want to check with the bus company and see what they have to say.
I am taking Norco for a back injury I received in 2013 and also on ambien for sleeping problems at night. I went in to renew my medical card for my class A and they told me that both of those prescriptsions disqualify me from getting new card. I asked them when did that changed cause they were the same people that approved my last card. I showed them my old card and they took a copy of it and said will do some checking. Found out today that little shit heads cancelled my old card and now I’m without a job cause they approved it then and not now. Why’s that what can I do to get this resolved and a new physical done and get back to work any help PLEASE???????
@ Rick
Your medications and restrictions will cause you to fail a interstate class A DOT/FMCSA medical certification examination. You might check into what the requirements are to drive class A intra-state. Your local DLD should be able to answer the question. You would fall under the states variances and your medical examiner should know the differences between the two.
I am taking quetiapine (seroquel) for bipolar disorder. Would this disqualify me from driving trucks?
@ Aaron
It will raise questions that will need supporting documentation from your doctors. Your DOT medical examiner should be able to inform you of the needed documentation.
I take haloperidol 1mg 3 times per day for Tourettes. i have an extremely mild case of Tourettes.. Ive been taking it for 30 yrs. Will either disqualify me from operating a CMV?
@ Jackie
The condition and the medication will raise questions that will need supporting documentation from your doctors. Your DOT medical examiner should be able to inform you of the needed documentation.
We have a driver that has been prescribed Ambien to help him sleep. Will this prevent him from receiving a Medical Examiner’s Certificate? Thanks
@ Mike
Yes, it is one of the meds which will require a lot of documentation.
My Doctor prescribed Chantix to help me stop smoking. She told me it was safe to take, but when I picked up the Chantix it has a label that says it may impair my ability to operate a motor vehicle. I have a DOT yearly recertification coming up next month(limited due to sleep apnea that I control with a cpap machine). Is this going to show up on a tox screen? Do I need to wait until after I take the physical before starting this?
@ Benjamin G
Chantix is going to be a DOT disqualifier. Too many known side effects, especially just getting started on the medication.
A co-worker has a class A license and is taking diabetes pills, his sugar has dropped twice while driving a truck, and he has blacked out while driving, a co-driver riding along took the wheel, not allowing a crash. this same driver is still operating commercial equipment, is a doctor’s medical release sufficient when this keeps happening?
@ Daniel V
Your driver should be disqualified to drive until this issue is corrected and stable. A doctor’s medical release is insufficient in this situation.
I am a school bus driver in Arizona and have severe shoulder issues can I take Diclofenac Sodium 75 mg 1 at dinner and be able to drive then morning
@ Valerie B
It will raise questions with the federal DOT, but you are a school bus driver and fall under the states variances. Check with your local DLD for the most appropriate answer.
I have had migraine headaches with auuras that last no more than 40 min. I don’ t take medications for them because there isn’t anything that has ever worked. I have loved my entire life with them and have adapted. Will this bar me from obtaining a CDL?
@ Anon
It may interfere with your passing the DOT medical certification examination, not your cdl. If you have supporting documentation from your doctors and they are willing to sign a release form for you, stating you have no restrictions or limitations, then maybe. It seems that the auras will be the big issue, besides the headaches that follow. You will need to supply good documentation for your DOT medical examiner.
I am undergoing chemo treatments. I went through the complete dot physical. I doctor said I am in good health and completely able to do my job,but he refused to certify me. Also I had a note from my doctor giving ok for full work status. Was this a bad call
@ Kurt G
You are still undergoing treatment. Until fully released from his care, without restrictions, you can not qualify for a medical card. FMCSA guidelines are being followed. The good news is once fully released, you’ll be able to pass the DOT examination. Not a bad call just FMCSA guidelines.
I have been taking gabapentin 300mg for 10 years for neuropathy.. I am a local truck driver and have passed my physical every year and my drug tests. Went for my physical this year and passed everything, but was told she would not renew my license since I take gabapentin.. Cannot my primary doctor supply a letter documenting my history. I need my job.
@ John A
Yes, all the CME needs is supporting documentation from your primary doctor.
I have been taking Norco with a prescription for a few years now due to a problem with my neck that I will someday have to have surgery to correct. I want to get my CDL A and start driving trucks but I’m not sure how this would affect me.
@ Peggy F
You will have a tough go of it. You must be able to perform the duties of a CMV operator, without restrictions or limitation, to pass the medical certification examination.
My friend is prescribed vyvansse and has his class A. He had a note from his doctor and it’s always been openly disclosed on his DOT medical exam/card. His doctor recently changed him to a vyvannse/Adderall mix. Does this new medication require him to get a new DOT physical immediately? He has a note from his doctor that neither medication will hinder is ability to operate a vehicle. Is that sufficient until his next DOT exam?
@ Hunter
FMCSA wants any driver that starts a new medication to be on it of 30 days before taking a new DOT medical examination.
Doc,
What does FMSCA say about coming “off” medications, if anything at all?
@ J
Depending on the medications one is coming off, FMCSA has specific time frame guidelines for different meds.
I am a CDL holder in the state of maryland, I supervise school buses and my part time job I drive motor coaches. I am prescribed to take Metformin 500mg once a day, Modafinil once a day,(for Sleep apnea) Gabapentine 300mg for diabetic neuropathy, to take at night, Amolidpine, and a Ketoprofen 20% Gapentin 5% Ketamine 5% in lipoderm for pinched nerves in my lower back. with the everchanging laws in Maryland am I OK taking any of these? if not I’ll speak to my doctor and have my meds adjusted
@ David C H
Much depends on what class cdl you hold. Class A, it will raise many questions during the medical certification exam. Also check with your states DLD for their variances and requirements.
My license is Class B, with P, S endorsements
i spoke to my doctor, he says at the levels that I’m taking there isn’t any concern, except for the Gabapentin at 300mg tab. he said to be mindful when using that along with the Ketoprofen topical as to not use too much.
I am a Class A CDL Driver, and I have been prescribed 800mg Ibuprofen for pain from a small fall at home. Does this disqualify me from going back to work? Do I need a letter from my dr stating that I am ok to drive on this medication?
@ Don
Yes, a doctors release for you to return to work, without limitations or restriction, would be very helpful.
I’ve been taken Lyrica for 5 yrs and have had no problems getting recertified till now. All meds in order for diabetes and up to date. Dr thinks it causes drowsiness and dizziness, but that’s not the case. I drive local for a big carrier. Need help!
@ Grady W
Get your doctor to provide a medical release form explaining your medications and the time frame in which you have been on these medications.
Is Ritalin a DOT disqualifier
@ Kelly O
You would need medical documentation for your DOT medical certificate examination. In and of itself, it is not a disqualifier.
I don’t mean to Impose on your question but I am being prescribed Ritalin for Ideopathic Hypersomnia, I currently hold a Class A CDL in Missouri but only need a Class E for my Job. I’m trying to find out if this medication will disqualify me from holding a Class E license.
@ Travis
You will need to question your states drivers license department for the best answer.
Can I renew my CDL if I have a medical marijuana card?
@ Larry W
You need to check with your local drivers license division for the answer. You may be able to with a intra-state restriction.
I’m seeing a weight loss Dr that has prescribed appetite suppressant for me does that disqualifying me from driving?
PS awesome information on this site thank you for your help!
@ Gary
All depends on the type of suppressant you were prescribed. Some will be a disqualifier and some are not.
Which ones are a disqualification?
I take quetiapine/seroquel er for anxiety…does this drug disqualify me for a dot??? It’s not a controlled substance.
@ RAE
The meds cause side effects that will raise questions. Make sure you have a medical release form from your prescribing doctor and the length of time that you have been on these meds.
Doc l think lm in this category as well for PTSD
Sertraline
Trazodone
Prazosin
Tiggers are nightmares only.
I am currently taking sertraline (100mg twice a day), Mirtazapine (30 mg at night) and clonazpam ( 1mg twice a day) for issues associated with PTSD (i.e. panic, depression, and nightmares). I have been on the medications for over three years with no side affects. I`m taking the medication as perscribed and can get a note from my doctor stating all this. I’m getting ready to start a state certified (Washington) CDL course and want to know if it’s even worth the effort? Whats my first step?
@ Richard McC
Start with a medical release form from each of your prescribing doctor and the latest results of an test that has been completed. You are going to need documentation, so be as prepared as possible.