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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 work in a chemical manufacturing facility where our operators load our chemicals into DOT regulated trucks and we ship our chemicals via pipeline. Based on the information above we are required to take annual DOT physicals because of the way we ship our products offsite and not because we are re-certifying for our commercial drivers license. Does or will taking blood thinners dis-qualify me in this situation?
@ Danny M
It will raise some questions and the medical examiner may ask for some additional information from your prescribing doctor, but you should be OK.
My doctor wants to put me on an anxiety med the off brand of Zoloft I’m classified as a short haul driver meaning I start and stop within 12 hour day not allowed to go over those hours will this be a problem with my medical card
@ Bob
The medications are going to raise questions and you’ll need to be on the new medications for at least 30 days before you can retest for the DOT medical card. Class A commercial drivers are limited to 11 hours of driving inside a 14 hour window and must take at least a 30 minute break within an 8 hour span. If you are not a class A driver, then check with your local DLD.
I’m a class b driver and the medication is Viibryd there are no side affects of drowsiness or sleepiness is that something that will put my med card at risk
@ Bob
You are a class B driver and you will fall under your states variances. Your medication and the conditions it is used for will raise questions during any medical examination. Be prepared to provide medical documentation and a signed medical release form from your prescribing doctor.
I work for a pain management office and one of our patients takes tramadol and tramadol extended release. Dr Oppong is wondering if the tramadol extended release is one of the approved drugs. Thank you for your time
@ Megan
Both of the medications are going to raise questions with the CME. Your patient is going to need to provide medical documentation for the CME to help with his or her decision making process. Also depends on the type of driver license your patient holds. FMCSA guidelines were established for the long haul, over the road drivers.
Is Effexor or a blood pressure medication a disqualifyer for a CDL in Oklahoma?
@ James M
Both medications are going to need further medical documentation. The bp meds will limit the length of the medical card to one year, but the Effexor will need additional supporting documentation and a medical release from the prescribing doctor.
I was diagnosed with bipolar, depression, and I think anxiety as a teen. I no longer am on medications and its been a few years. Would I be disqualified from getting my medical card? Could I get a letter from my doctor stating that I’m no longer on medications and that I’m no longer receiving treatment, and get a waiver.
And I get a waiver whats the chances of the doctor passing me.
@ Nick
No waiver is necessary, get the letter from your doctor and you should be OK.
What about low dose Tramadol? Are there specific sleep medicines that are not allowed?
@ Digger
Any medication is going to raise questions. Be prepared to provide medical documentation and answer additional questions regarding your prescription and its usage.
I have just been prescribed Abilify for bipolar also take Zoloft for depression. Can I still keep my Cdl class A?
@ Michael r
Keeping your cdl is one thing , but your medications have invalidated your medical certificate. Check with your local DOT examiner to determine your wait period and what is needed in the way of medical documentation before returning to the CME for a DOT medical card.
My husband wants to get xanax prn for an international flight for our vacation, but he says he will lose his job due to DOT guidelines…its just for vacation. Is this true?
@ Sonia
Only if he tested positive on a random drug screen.
A driver who had been off on medical leave has submitted medical releases to our company to return to work. He’s worried that his taking LIPITOR and CLAVIX will medically disqualify him when he goes for his medical recert exam. Will it?
@ Douglas M
It does not disqualify him, but he will need to provide additional medical documentation for the CME to consider doing the examination.
Can you take CBD oil if you have your cdl class a license, or will you test positive on a drug test.
@ Mary
You may test positive for a drug screen. Then you have to explain yourself to the MRO and the company.
My diabetic medication (metformin/glipizide) was adjusted while I was attending CDL Training. I am now being told that I must be on my diabetic medications for 6 months prior to returning to CDL training
@ David
Sounds like a company policy, FMCSA would like to have you on a new medication regime for at least 90 days and provide the examiner with supporting documentation.
I was denied renewal of DOT medical card for the prescribed meds Tramadol and Trazadone. Are these drugs that are prohibited for DOT. I have been on them since 2008 when came back from Iraq. Answer would be great. Thanks
@ Phillip K
You need to provide medical documentation to the examiner so he understands your condition and present prescription. If you can, get signed medical release forms from your prescribing doctors.
I’m taking a 25mg pill of metoprolol does keep me from getting a two year card
@ Harry
It is a high blood pressure medication and will limit your card to yearly
I have been in opioid recovery for 5 years I currently take methadone, would this be considered a medicine not approved.
@ Jj
Yes. FMCSA guidelines are pretty strict on this one.
Do I have to disclose to my “employer” the fact that I take lorazepam as needed for occasional anxiety and ambien CR for insomnia? I know I have to report it to the CME, he has cleared me for use for the past 4 years. I would like to know if the “employer” has the right to know.
@ Brad
If you perform your duties without restrictions and you have a valid medical card, then why would they ask?
I guess I should’ve been more clear. Does the employer have the right to ask you about medications on an application for employment?
@ Brad
They can ask, doesn’t mean you have to answer. Sounds more like a legal question.
Is Adderall a disqualifying medication? I have never been diagnosed with ADD/ADHD but my doctor had put me on it for “motivation” during a depressive episode. I am currently off of the Adderall, is there a length of time I need to be off of it? Also, I take Zoloft and Abilify are either of these disqualifying?
@ Gus
Your medications will raise questions with the CME, but can be overcome with proper medical documentation.
I was diagnosed with general anxiety after I had an anxiety attack after my toilet leaked and severely damaged my home resulting in 15k worth of damage. I went to the doctor and cycled through some meds briefly and eventually started to feel normal again and stopped the medication along with working with my doctor approval of my choice to stop, she left it up to me to decide if I wanted to try another medication but I felt like I am ok enough now.
Since my anxiety and mood has been manageable and comfortable and I have no future appointments and am not on medication can I expect to have any issues at my next DOT physical examination?
@ Mike
Make sure you have a medical release from your doctor stating that you have been off these meds for however long its been and you should be fine.
I take mirapex medication for Restless legs..NOt parkinsons..I have always been able to drive Class A…but new MD says I can’t drive because of the Restless leg syndrom..and taking the mirapex..is this true
@ James S
Have a medical release form from your prescribing doctor explaining that you take the meds for restless legs and not Parkinsons. And get a second opinion from somewhere else.
I’ am going to start my training to get my CDL here in Florida. But I’m on Suboxone. Will I still be able to get my license in Fl.?
@ Carla P
The medication is going to require medical documentation. Be prepared to obtain the documentation that the CME will request.
Opana 5 mg 1 every 4 hrs. as needed for pain .. can I still drive a class B dump truck
@ Harold S
You are class B driver and are under the states variances. Check with your local DLD for the best answer.
Hi I was just failed by dot examiner for a prescription of suboxone in MA. What do I do? Or is there another route
@ Christopher P V
It will depend on the reasoning for the suboxone prescription. Medical documentation and a medical release form from your prescribing physician will help, but may require further explanation for the medical examiner.
I was just denied a med card I also being prescribed suboxone. Prior to this blog just in May 2019 I was at DMV in Vermont I asked about driving a commercial vehicle prescribed suboxzone . I was told yes depending on the examiner and if they felt I was stable and safe I could obtain a med card . I had also brought a letter from my prescribing doctor with my stability over the past three years. I’ve never had any relapse episodes what so ever and no negative ua’s I went to concentra yesterday and was flat out refused because I’m prescribed suboxzone I feel this is unfair I do not see any difference from my prescription s than ANYONE anyone on nitro for heart condition or someone on adderil. For hypertension or someone with diabetis on insulin or someone with seizures on meds. I feel discriminated to the max. This is not methadone where I’m falling asleep I feel safe on suboxzone I feel confident to drive any vehicle. This needs to be addressed so people can live earn an income to provide for their families in their recovery and be proud of their sobriety and not want to give up and feel useless. It’s all reflected on opioid abuse. THE STATE WANTS IT TO END WELL THEN where do people go if this continues.
@ Peggy
Your state DMV is correct, it depends on the FMCSA examiner. Some examiners fully understand the FMCSA guidelines and others took a class somewhere that said no to suboxone. Go get a second opinion from another examiner, especially one who under stands the guidelines.
Can I be punished for taking a prescribed medication even if the prescription is expired? Will the MRO deem that as a positive or negative test? Also where would I find that regulation regarding expired prescriptions in the DOT rules?
@ Adam D
MRO will list it as positive. No punishment other than employability due to a positive drug screen, but that is a company policy issue, not DOT
Will the prescription drugs Suboxone and Clonazepam disqualify me on my drug test
@ Larry S
You would need to provide prescriptions to the MRO doing the testing.
Yes, even with proper documentation the benzodiazepine will likely lead to your disqualification. The other med, which is also a sedative, is up to the dot doctor. This is from the 2009 expert panel of medical opinions in psychiatric disorders. It even gives a table on how long you need to be off your bento to drive. https://www.fmcsa.dot.gov/sites/fmcsa.dot.gov/files/docs/Medical-Expert-Panel-Psychiatric-Psychiatric-MEP-Panel-Opin.pdf
My doc is considering putting me on 30mg of cymbalta for pain. Is this ia disqualifying drug as far as my DOT physical goes ?? We agreed to not take anything until we are sure.
@ S
Both the medication and the reasoning for the use if these medications are going to called into question. You will need medical documentation from your prescribing doctor. If you start a new medication you will invalidate your present medical card and will need a new DOT medical certification after you have gone through the waiting period.
I take Latuda, Zolpidem, and Doxepin can I pass if I have medical clearance from my doctor? What are the steps I need to take?
@ Andrew
You will not pass a FMCSA/DOT medical certification examination while taking these medications.