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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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Will Kratom make me fail a dot drug test?
@ Drew
You may fail since Kratom does have opioid characteristics.
If a driver is prescribed a pain medication by their doctor, are they required to report that information to their supervisor or medical examiner?
@ Tim
If you have pain or illness which has taken you out of driving or places a risk factor, both to yourself or the public at large, then it would be best to inform your supervisor. And you would need to have a new DOT/FMCSA medical examination, so yes you would need to inform the medical examiner.
I have already taken a DOT drug screen but after I got home I realized I didn’t take in my medication bottles with me. Now I’m afraid I will fail my drug test. I am taking Metoprol just 25mg twice a day for a mitral valve problem. Is that medicine going to make me get a false positive?
@ Brian
If you did a DOT drug screen and it comes back positive, then the medical review officer for the drug testing company will contact you and ask for a copy of your medication prescription. Just be prepared to supply the information to him.
I have my Class B and I drive a school bus. I also have severe RLS and my neurologist wants to prescribe Gabapentin. Will this medication preclude me from driving?
@ Lisa
Class B license holder fall under the states variances and guidelines. Check with your local drivers license department for the best answer.
I am not truck driving right now but do have a CDL and my health card needs to be renewed. My doctor has me on Trazadone and Fluoxetine for sleep and anxiety. I am okay when I take them and once my body got used to them I had no side effects Will this keep me from getting my health card?.
@ Manuel M
Your medications and health conditions will raise questions, but with proper documentation you may be cleared.
I have been prescribed a steroid (budesonide/prednisone} for a long term time. can I operate a commercial vehicle while on oral steroids according to FMCSA guidelines ?
@ Lisa
It will not be the medications that will raise questions, but the conditions that they are prescribed for.
I have a coworker that is wanting to get his Class B license, he has been prescribed by his doctor to be on Oxycodone 30mg, Klonopin 0.5mg and Lisinpril 12.5mg. Will he just need a form proving he has to be on these medications? or will they keep him from being able to get his license? We are in Mississippi. TIA!
@ Kaitlyn D
Class B drivers license falls under the states variances and guidelines. Coworker needs to check with the local drivers license department for best answer.
What about bunephrine? Suboxone. If prescribed and have been on it for over a year?
@ Brooke
Both will raise questions and the suboxone will be the main question. It will require medical documentation, medical release forms and still not pass the examination due to your meds.
Why would you even tell anyone? 20 years of trucking 14 of which I’ve been on suboxone or subutex… I’ve just never told anyone.
Joe m, i have some questions for you, are you able to see this? Would like to speak to you if possible. I’m about to go through what your talkin about.
I have been diagnosed with infrequent migraines and I’m taking Butalbital/Acetaminophen/Caffeine. Am I still able to drive Class A CDL multi-state.
@ Scott A
It depends on when you started have the symptoms and how long you have been on your present medication regime. The CME is going to ask questions and will need some medical documentation from your doctors, and medical releases from them too.
I have diabetes. I take insulin and other medication. I have looked and can not find a clear answer weather i can still drive OTR, have class A. Have been on medication for the last 3 months and trying to get back to work.
@ Nathan
Your diabetes and your treatment protocol are going to be questioned by the medical examiner. He / she will need supporting documentation from your doctors, but it may be possible to get back to driving.
Hello I REALLY REALLY NEED AN ANSWER.
I was given a random drug test ( I have class a ) and it came up positive for oxydodone. The issue is I literally took one the day before for extreme toothache. I realized I got a prescription a few months back for 8 of them . I forgot about that when I was asked if I had a prescription. I lost my job the following day. Is there any way I can appeal this or inform whoever it is to possibly remove this “ failed dot drug test “ from my record and possibly get my job back ? I’m not a drug user at all and my system is always clean, unfortunately random test came at worst possible time. PLEASE PLEASE REPLY AND THANK YOU FROM THE BOTTOM OF MY HEART.
@ Juan N
The best you may do is to contact the MRO (medical review officer) that performed the drug screen originally. Let him know that you do have a proper prescription for the meds and see if he can help you out in this situation. The MRO’s contact information should be on the final report on file.
I am a penndot certified flagger (traffic control). In addition, i work for natural gas installation. Can I perform my job while taking gabapetin?
@ Brenda H
You are not a class A driver, which is what the DOT/FMCSA guidelines were established for. Best answer to your question will come from your local drivers license department.
I have prior drug use in past hospital records. Years ago would that disqualify me from getting my d.o.t physical
@ Prudencio O
With proper documentatio, you could take the examination.
I am receiving negative pressure wound therapy for an abdominal wound surgery. I currently have a tube and bag hanging from my waistline. I also have a PICC line in my right arm for antibiotic administration. I am wondering if this will inhibit my ability to pass a FMCSA DOT exam. Please advise.
@ Bobbie
You will need to be completely released, without restrictions or limitations, before going to the next DOT/FMCSA medical examination. And be prepared to provide supporting medical documentation.
My doctor prescribed me phentermine can I still drive a CMV while taking this medication.
@ Dave
DOT/FMCSA guidelines suggest not passing a drivers who is on this medication.
Can you drive a truck if you’re taking antipsychotics like Risperdal
@ Brandan
The meds and your medical situation are going to raise questions and will need supporting medical documentation. But it is possible under the right circumstances.
If you was taking medicine for depression/bipolar. But no longer take meds for 3years. Would this disqualify me?
@ Crystal
If you have been off medication for 3 years and have had no other symptoms, then the CME may request some additional information from your previous doctor. You should be fine otherwise, if all else is within normal limits.
You cannot be on antipsychotics
@ Peppi
DOT/FMCSA guidelines and regulations say otherwise.
Are beta blockers a disqualifying medication for cmv operation?
@ Greg S
The meds are not a disqualification, the conditions may be. Be prepared to answer questions and provide needed medical documentation for the CME.
My cardiologist took me off of warfarin and will prescribe me Xarelto to take it’s place. I failed my DOT physical because I wasn’t therapeutic. My cardiologist said by me being on the new medication I would be therapeutic. So does that mean that I can go take my physical this week and get my new card?
@ Victor K
Any blood thinner medication is going to raise questions with the CME. Be prepared to answer his questions and provide supporting medical documentation, if he ask for more information.
i did the self certification in order to keep my cdl because im not driving trucks anymore,so i can not drive trucks till i get a new dot card but now i have the medical cannabis card for anxiety treatment,do i need to do something else?
@ luis
Depending on your class drivers license would determine what your next step is. Class A medical cannabis is still a disqualifier. Any other class drivers license is under the states guidelines and variances. Check with your state DLD for further information on what to do next.
I take Cymbalta, Gralise and Flexeril for nerve pain, as I have a form of Fibromaylgia. I also take Wellbutrin XL to help me stop smoking. Then I take Norco 10/325 for chronic pain, from a broken spine, but not when I am driving. I drive a school bus in Texas and was told at my physical the Norco disqualifies me. I have doctor documentation/release for all my meds stating I am safe to drive a school bus. The FMCSA website states it is up to the medical examiner to approve me or not. Should I seek a different examiner or am I in an auto fail situation? It has never been a problem until I got this new doctor this year.
@ Susan J
FMCSA established its guidelines and requirements for class A long haul and heavy haul drivers. You do not fall under the FMCSA’s guidelines, but your states guidelines. Your CME must know the difference and work within those (state related) guidelines, not the FMCSA guidelines.
Can i be a long haul driver if im taking lithium and seriquel?
@ Paul G
The examiner is going to request additional documentation regarding the diagnosis and medications prescribed. Long haul drivers have a very different lifestyle and must abide by a more intense physical, mental and social evaluation.
Will 100mg of losartan once daily affect my DOT medical card?
@ Les
It will raise questions as to why you are taking this medication. With proper documentation from your primary doctor, you do OK, if all else is within normal limits.
Is OTC Valerian Root restricted in any way?
@ CHRISTOPHER B
No. Why you take it may come into question by the CME though.
I have been prescribed klonopin to stop migraines from anxiety and have been on it for several years and don’t experience them migraines or anxiety and I do not feel the klonopin at all, I never have,it just takes care of my anxiety apparently,will this disqualify me from getting my CDL?
@ Jason S
Your medications are going to raise questions and will need supporting medical documentation. Getting your cdl is a state related issue and getting a medical card for a class A drivers license will be a federal issue.