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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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My husband is being hired by UPS. He has been on a medication regimen for about 20 years. He takes Adderall and Xanax. He has has this regimen again for about 20 years and there has been no adverse reaction in that entire time. His prescribing doctor is completing the medical exemption form at the request of the CME but my question is whether or not they can still deny him the position.
Is Lyrica for back pain a disqualifying drug For a class A license?
@ Stacey O.
The medication and the condition are going to raise questions during the DOT examination. Your examiner is going to need documentation from your prescribing doctor before he makes any decision.
Will I fail non cdl dot for taking klonopin prescribed by a dr for anxiety?
@ Michael James D
As long as the states guidelines accept this medication, then you should be good.
Is atomoxetine(Strattera) an approved drug under DOT guidelines
@ Eric P
Yes, it will require a medical release from your prescribing doctor and medical documentation too.
I have a class A CDL but I need my medical card to have this lic. I have chronic pain so my doctor has prescribed the lowest possible of hydrocodone with Tylenol it helps with my sever headaches and that’s about it. What do I need to do to get my medical card. I also had a question the medical exam person also called around to check on my medication I receive are they required to do that.
@ John
You will need a medical release form from your prescribing doctor. You need to have been on this medication for thirty days or longer before any CME will consider testing for a DOT medical card. The CME may request additional documentation to aid him in his decision making process.
I take Gabapentin and Lyrica, but not for seizure prevention. Rather, it is for Neuropathy. Will those medications still prevent me from driving a school bus?
@ Jim
As a school bus driver and not a class A driver, you fall under the states variances. Check with your local DLD for guidance. Also, you will need to explain to the examiner that you are a school bus driver and bring supporting medical documentation you have.
Thank you for your response. What does DLD stand for?
@ Jim
My apologizes, Drivers License Department.
Can I still drive while taking cabozantinib or vandetanib for cancer
@ Eric
Depending on your drivers license class. Class A, you will need to provide medical documentation when you take your DOT medical examination.
the supporting documentation would have to include reports from my treating Dr.
@ Eric
That is correct.
in 2018 I was DOT certified while on the methadone program, had the proper documents from the prescribing provider and I was issued my card. being so I have to get re-cert every year vs. every two this year I have been having issues with getting recertified even though I have lowered my dose and am being tapered off,. how was I able to be issued my card and now a year later having a problem being reissued?
@ kc
Some examiners use the guidelines, and with proper medical supporting documentation, will grant a short term or one year card. Some examiners read the same information and interpret it differently. Go back to the CME that did your exam last time.
I keep getting denied for being on methadone for pain management even with a doctors note saying im safe to drive a cmv I do have a cdl a license and a 1 year medical card
@ Wes C
FMCSA has very strict guidelines and regulations regarding the meds you are on. You are lucky to have a one year medical card. That will probably stay with you for some time until you are off the medication or supporting medical documentation leads into another direction. Methadone for pain management is always going to raise questions with a CME.
I went to a doctor recently to see about getting on aderol but he said its highly addicting and wouldnt prescribe it to me . I was told it helps people concentrate better while reading and in everyday life. Anyways then i recently got my class a license and realized that medication would have kept me from advancing in my career. Just saying..
I was recently diagnosed as ADHD, and my doctor proscribed Topiramate and Adzenys (amphetamine). She said there is a lot of success with this combination. But will I lose my CDL?
Hello I was prescribed risperidone about three years ago and it makes me feel fine and I have no symptoms is it automatic disqualification.
@ Aaron
Just make sure you bring a medical release form from your prescribing physician. And any other medical documentation that supports your situation.
Is amitriptyline 10mg a disqualifying drug for CDL A. Prescribed for nerve pain. I have to renew my dot physical and wonder if it will be a problem.
@ Mike
The medical diagnosis and the medication are going to raise questions, but with good documentation you should do fine.
@ Kalyn
Your CDL is state issued. Most likely you won’t lose your cdl, but they may enforce some restrictions. Check with your local DLD.
I drive a City Transit Bus, CDL class B. For my back strain and pain, my doctor prescribed Cyclobenzaprine (muscle relaxer) and Tramadol (pain medication).
Can I take Tramadol and / or Cyclobenzaprine at my job – random drug testing is done, as well as, all post accidents.
Are these two drugs “allowed” to have in a commercial driver’s system if drug-tested?
@ Margaret R
You are a class B, not FMCSA class A. Drug testing medical review officer may request prescriptions from the doctor before filing final findings.
I’m a bus driver. Is wellbutrin banned by USDOT?
@ Marty
Lots depends on your drivers license class. Class A, will raise questions. If your are some other class, then check with your local DLD for the best answer as a bus driver.
can I drive trucks if I’m getting prescribed metadone or subuxone or Subutex..
@ pierre
Probably not. You won’t pass a DOT/FMCSA medical certification examination.
I was taking Suboxone after becoming physically dependent on prescription pain medication that my Doctor prescribed me for pain after 4 years I tapered down and have now been off of all medications for 4 months and feel great I got my life back. Is my past going to prevent me from getting my CDL? I’ve never used illegal drugs and never abused any.
@ Ando
Getting your cdl is a state issued license. Getting a class A DOT medical card is a Federal issue. If you presently no longer take any medications, then you should be fine.
a year ago I had a accident outside & hit my head, with a lil brain damage. they were told I had a seizure. and put on zepra, the test showed I never had a seizure, and they took me off zepra a few months ago. I drive a cdl b, can I get my license back right away, or do I have to wait? If I had a letter from the dr. saying that I never had on, and would be okay to drive?
@ CO
Your question is best answered by your states drivers licensing division.
My husband was was prescribed a medication to help him to quit drinking. This drug is not a controlled substance and only aids in stopping to drink. Can the DOT physician make a personal opinion and weather or not he has a drinking problem. Note my husband has never had any infraction or write ups at his job in 31 years of employment nor has he ever had a driving infraction outside of work. He started to drink again in the past year dealing with his mothers diagnosis of dementia and myself (his wife) having breast cancer. He went for a his yearly exam with his primary care in May and his doctor recommended that he take this medication. Subsequently, the company my husband works for has to start a substance abuse program immediately due to the DOT certificate denial. He has now gone through 5 weeks of quite the run around with many specialist telling him they have never heard of a situation like this. It appears that this particular PA based her decision not to pass my husband due to her own personal opinion. I just learned through some research that he could have a second opinion, is it too late for him to do this? Can the DOT PA fail him base on a personal oppinion?
@ Amy
Go get a second opinion.
I take Gabapentin for neuropathy. Is that a disqualifying medication?
I had a test show positive mro contacted me I sent them a copy of the script. I returned to work then they wanted a safety sensitive letter the Dr did not return this all though the results of the test is now negative what happens without the letter
I went to get my medical card renewed for school bus and had a new DR this time….He was asking me about my medication that I take and I said that I take one for Restless Leg syndrome and he said dont say that cause it is a automatic fail. I have been on this med for years and never had a issue with other Drs durning my physical.Is this true that it is a automatic fail?
@ Barbara C
No, it is not true. And you do not fall under FMCSA guidelines, your in the states variances. Make sure your examine doctor understands the difference. Your a school bus driver not a big rig long haul driver.
I’ve taken requip for years and have a class B. I’ve only had one question and that was if I knew how to take it correctly even thought I had written the answer when I listed my meds. I had to get a letter from my Dr stating that I knew how to take it, go figure but have never been asked by any other Examiner
@ Debbie
Your examiner is holding you to a class A drivers standards and you are class B. You fall under the states variances, not federal DOT guidelines. Your examiner should know the differences.
I read for 30 minutes And didn’t see this one I am on ambien for sleep I have drove and had dot physical and no problem this time around I got denied I was wondering why
@ Dustin
The medication has some pretty serious side effects and the FMCSA does not want big rig, long haul drivers using it and driving. If you have been on this medication for years, then get your prescribing doctor to help you with medical releases and supporting documentation.
This is an amazing website filled with valuable, reliable information not found elsewhere, or at least not that I have found yet.
I’m a veteran/retiree. I just recently applied to a reputable trucking company for acceptance into their paid CDL-A training program. I have a current DoT medical card from my primary care provider who is also a certified FMSCA Examiner.
My concern is that the company I applied at, like most others, will be doing their own DoT physical and may be more stringent.
Here are my primary concerns:
I have been on Duloxetine 20MG, better known as Cymbalta, for over a year. It is for depression, anxiety, neck pain; it works great! I have absolutely no side effects.
I have read on other websites that prescription medications for these conditions is a red flag, obviously, but many drivers go on to say not to waste your time, you won’t be hired and some even say you shouldn’t be hired.
Is this medication and the dosage “likely to result in a failed DoT physical” by the trucking company’s examiner?
Note: This is the lowest possible dosage, actually, it’s an initial dosage; I never needed to go higher.
If it’s likely to result in failed DoT exam, I intend to ask my Doc to remove me from this medicine to ensure no “red flags” are raised. I am still functional and fully capable without the prescription, but frankly, it does help me feel better in all three areas. Does this alternative plan give me a better chance with the company DoT examiner?
Lastly, when you sign the medical release form mentioned in this thread and others, does that literally give the DoT examiner “full access” to read all your medical records, including mental health?
Would it not be sufficient enough to show the company’s DoT examiner both my current DoT card (within 30 days) by approved FMSCA Examiner and a note/letter from my primary provider (both are the same doctor) stating that my conditions (noted above) and the prescribed medication, Duloxetine, DO NOT IN ANY WAY HINDER MY ABILITY TO PERFORM THE DUTIES AND RESPONSIBILITIES OF A COMMERCIAL TRUCK DRIVER IN A SAFE MANNER?
Seems like that’s what the point of the DoT medical card is for, but some have recommended this letter. What are your thoughts on such a letter?
Thank you very much in advance.
J
@ Army Vet/retired
Your medication is going to raise questions and will need supporting medical documentation and a medical release form from your prescribing physician. Be aware that companies that offer a paid-cdl training have thousands of people to choose from, so they are looking for any reason to release you before they spend a penny on you. A medical release form from your doctor does not allow a CME to read your medical records. You may want to reconsider.
is taking pravastatin for high cholesterol disqualify me from passing medical for class A with tx in california.
@ Brad R
No.
I do the dot doctors count your your pills?
I have a diagnosis of bipolar and have been on geodon and effexor xr for 2 years and been stable. Are these medications disqualifying.
@ Robert
The medications are going to raise questions, so be prepared. You’ll need a medical release form from your prescribing physicians and your most recent test results/medical documentation available for the CME.
I’ve had 9 back surgeries, I’ve got a pain pump. Will this stop me from getting DOT Certificate. Driving is about all I’ve got left
I was taking zoloft up until about 4 months ago for mild depression but I am no longer taking it. I am currently taking Wellbutrin time release 150mg once per day. Will I have any problems at paid CDL training with Roehl transport?
@ Philip F
It will depend on the companies hiring policy. Check with their HR department before going much further. These companies have thousands of applicants and will look for any reason to dismiss before spending a penny on a incoming potential driver.
@ Don
Lots will depend on the class license you are going for. As a class A, over the road, long haul driver, you will not pass the FMCSA guidelines or the medical certification examination. As a local intra-state cdl driver with a lesser class license, you may be OK. Check with your local DLD for more information.