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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 have heard about a new procedure that the medical examiner must check the data base of the Pharmacy Monitoring Board. Even for a DOT physical. Is this true? Will non-addictive drugs such as Pradaxa be reported on this Pharmacy Monitoring Board data base?
I have a prescription for Pradaxa but since there are no INR’s like warfarin, it’s not monitored by my PC physician.
@ Vic B
CME’s do not use the Pharmacy Monitoring Board unless there is reasoning to do so. If a driver presents with signs of abuse, over utilization, or medications that present with serious side effects, then the CME will use the board.
I have been taking armodafinil for 10 years. I did not report it but the company doctor looked and saw where I had it filled a month prior. My doctor prescribed it for swing shift disorder. I was forced to stop taking it. What signs could the medical examiner have looked for to warrant looking at the pharmacy board?
@ Scott
You did not report the medication on your DOT/FMCSA intake form and the examiner must have questioned something in your answers to his questions which triggered a pharmacy board review.
Best advice: if you are not taking a medication that is tested for, DON’T MENTION IT!! If you’re on Methadone, good job!! It doesn’t show up so keep you’re mouth shut! Same with anxiety and psych meds! Be quiet!!
But, be aware of the side effects, be a responsible professional driver, and dont kill anyone!!
Safety first!!
@ Brian
We do not agree with this approach, even though we know it happens. Just be aware that false information on the DOT/FMCSA federal forms could cost you your job and career.
If ur going to lose it anyway for mentioning it then who cares if u falsify documents. People need to feed there families and alot of doctors dont understand the effects since they have never taken them theirselves.
@ Jon
It is unfortunate that a lot of CME’s do not work with drivers on a full time basis. It requires that the CME understands federal guidelines and regulations, state variances and the effects of medications, as it works with the drivers and their hours of operation. But in the end you get to take personal responsibility for your actions, no matter the outcome.
I am on buprenorphine, and have been for 4 years now. I just went to get my dot physical and was denied due to this, is it even possi le to move forward. My dr has written a letter and is willing to advocate for me but I am so frustrated and just lost? Any advice?
@ Aliya
For a class A over the road driver, there are going to be many questions and yes with proper documentation you will be able to drive with a valid medical card. Your medication raises questions and requires further investigation via the CME. Also if you are not a class A driver, then you fall under the states variances and not DOT/FMCSA. Make sure your examiner know the difference in the guidelines and regulations.
I take Stribild for my h.iv also under control will that denied me from getting my medical card
@ Kerby
The medication will cause questions, but with a medical release and supporting documentation from your prescribing physician you should do fine.
I take geodon and. Wellbutrin and Effexor and buspar. Can I still get a medical card if I have my psychiatrist write a letter saying I have been on them for years? I would also get a letter saying I am safe to drive a truck.
@ John D
Your condition is going to raise questions. You will need medical documentation and medical release forms from your prescribing physicians. The more information you bring with you at the time of your medical examination the easier you make it for the CME.
I take Zolpidem 10mg for Insomnia.I recently started taking it and use it when I really need it. I already new that I can’t be on Benzos, but this med is not considered a Benzo. I started taking Zolpidem after my last physical so at the time there was no meds to declare. Is this med accepted by the D.O.T.?
@ Troy
Under FMCSA guidelines you should be on any new medication for at least thirty days before having a new DOT medical examination. If you are not having any ill effects/side effects, then the DOT medical examiner will want to have some supporting medical documentation and a medical release from your prescribing physician.
Good afternoon,
I was put on a medication for Parkinson Disease. It is the short name is CARB/LEVO. Would this disqualify me from driving a CMV? Thanks Tom
@ Thomas A A
You will need to be on these medications for 30 to 90 days before retaking your DOT/FMCSA medical certification examination. Once cleared from all possible side effects, you’ll need a medical release form from your prescribing doctor and supporting documentation so the CME can make a well informed decision regarding your case. There will be questions and if all else, signs and symptoms, are within the normal limits, you could do fine.
My husband was recently placed on Zoloft, low dose 25mgs, for anxiety. Its helping. But when he went for DOT physical, with a letteokr from Doctor indicating the very low dosage won’t affect him operating LARGE CRANES, etc, he was told by examiner he’s required to get a PSYCHIATRIST and cognitive therapy because it’s an antidepressant or he’d be in jeopardy of losing LICENSE. IS THIS TRUE?
@ April H
If your husband was recently placed on this meds, then the CME is looking to cover any possible risk factors. Your husband may need to be on the meds for 90 + days before being cleared. It is up to the CME and his interpretation of the FMCSA guidelines.
Is Naltrexone a Disqualify medication? It is not a narcotic.
@ Tim D
The medication is not one that will disqualify and the condition for which it is prescribed will raise questions with a CME. Make sure you can support your situation with documentation and a medical release from your prescribing physician.
What if I was on Zoloft (generic) and I was token off of it, do I have to let the examiner know. Honestly I just kind of stopped taking it and realize I didn’t really need it, I just manage my anxiety now
@ Matthew V M
There are questions on your intake form for DOT/FMCSA that will ask. You were not taken off these meds, you just quit them.
I have a CDL and a school bus endorsement in the state of Illinois. I have had surgery for cancer and now I am receiving chemo treatments. I am not working right now due to the risk of being exposed to flu, germs and side effects of chemo. My question is will I be able to get my yearly physical to keep my license current when it comes due? I would not drive while I am receiving chemo but I would like to keep my license current.
Thank you,
Julie
@ Julie L
Once you are released to return to work, then go for your new medical card. You need to be released before going for the examination.
can i take lyrica and pass dot drug test
@ Jim
Just be prepared to provide a copy of the prescription.
I take testosterone shots and the Dr that gave me my DOT physical said that I can only get a 1 year certificate. I’ve been on it for the last 3 physicals and always got a 2 year. Is she wrong or did they change the rules?
@ Michael M
Nothing changed but your examiner and his interpretation of the FMCSA guidelines.
Is having Scleromyxedema a disqualifier for a CDL?
I would like to know if I will be able to get a CDL while taking methotrexate.
@ Mike W
Your situation and the medications that you take to treat the condition may raise questions with a medical examiner from the FMCSA. Your cdl is state issued, so you need to check with your state first about the cdl. Then, based on the class license you carry, you will need a medical card. FMCSA guidelines were established for class A long and heavy haul drivers, that may not be you.
Are Tramadol and Wellbutrin disqualifier for CDL?
@ Jenna
Both of these medications are going to raise questions from a CME for a class A cdl driver. CDL’s are state issued, check with your state drivers license department for cdl questions.
I’m 6’1 265 lbs, when I started driving 8 years ago I was 210. I’m struggling to lose weight, I went to a clinic and they offered me phentermine. If I get a release from the prescribing doctor will this medication disqualify me from operating a cmv?
@ Justin
Most likely. FMCSA guidelines recommend that CME’s not approve a driver using phentermine.
How long must a patient be off Chantix in order to pass the dot Medical Exm?
@ Tricia J
The CME will want you off this medication for at least 30 days, but it is his/her decision and use of the FMCSA guidelines that will determine the final decision.
I was hurt on the job and taken to the hospital need to know if I can take my pain meds not driving due to my injury but plan on going back after but I am using workers comp to pay for my Bills
@ Chin h
Your medical card was invalidated at the time of the injury. You will need to retake the DOT/FMCSA medical examination once you have been released to return to work. Make sure there are no restrictions or limitations placed on you at the time of the new DOT examination.
Dear Sir/Madam:
Is Sertraline a banned substance under DOT regulations?
@ Barry
The medication is not the question, but the existing diagnosis is going to require a medical release form from your prescribing doctor and additional documentation.
I’ve been taking oxycodone for 6 years now, due to breaking my back and several failed fusion attempts. I’m still able to drive and lead a pretty normal life. I’ve had a CDL for roughly 10 years now, but my medical card renewal is coming up. I have proper documentation from doctor that my oxycodone does not affect me mentally and doesn’t effect my driving abilities. With my documentation from my doctor, will be okay to continue to drive and carry my class A CDL?
Please call me when you find putt the answer to this question. I just went for a DOT physical in Waterville, Maine at WORKPLACE HEALTH & they would not pass me because I am on oxycodone (w a Dr note and approval to drive w my CAL A ) & by thier assessment I AM HIGH RISK FOR SLEEP APNEA… My personal physician says I do NOT have sleep apnea!!! Good luck at your physical!
@ Denise M
Get a second opinion from a CME that has a better understanding of the FMCSA guidelines.
@ Nater
You will need medical documentation and a medical release form from your prescribing doctors. And you will need to find a CME who understands the guidelines as fully as possible. Oxycodone is going to raise questions and the examiner is going to need as much supporting documentation as possible to help in his decision making process.
How do you go about passing your physical if you’re doctor prescribed you Adderall? I took a break from driving and in that time was given a prescription for Adderall for my ADHD and am now looking to get back into driving. The Adderall doesn’t make me drowsy or keep me awake all night, I take it at the start of my day and am able to function and sleep just fine. Is it possible to legally drive with a prescription for Adderall or is it just a straight no?
@ Thomas C
Just bring a medical release form from your prescribing doctor and you should be fine, if all else is within normal limits.
Are weekly injectable diabetic medications non-insulin a disqualification drug or require a medical waiver of any type more than oral medications when taken by a type 2 diabetic for a CDL? Examples are trulicity or ozempic.
@ Donna P H
They are not disqualifiers, but will require supporting medical documentation and a medical release form from your prescribing physician.
My doctor perscibe me sumatriptan and propranolol for a migrain headaches, will this disqualify me from obtain my cdl card. Both medications are not considered as a control substance and I have no side effects. I have three more months before I take the dot physical. Any recommendations or words of advice is truly appreciate.
@ Kelvin R G
The medications and the condition will raise questions with the medical examiner. You will need to provide medical documentation and a medical release form from your prescribing doctor. CDL is state issued, but the class of the license will determine the guidelines used for the medical card. ex. class A over the road, long haul fall under the federal DOT / FMCSA guidelines. Class B or intra-state cld’s fall under the state variances.