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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 question is how much more extensive is the cdl test when you are diabetic? Is a bad a1c a disqualifier? What range does it need to test in and what range does blood sugar need to test in and does federal or state law require access to blood sugar. Meter results or records of blood sugar numbers and if so how often? What does the test for the federal diabetes waiver entail that the state tests for diabetics don’t?
@dj
As a diabetic, yopur condition needs to be under control. Have your primary doctor complete your medical release form before you go for your DOT examination.
That will answer any of the questions your DOT examiner will have. The medical examiner needs the medical release form filled out explaining that you have your condition under control, that’s it.
Your medical card will be good for a maximum of one year, based on your present condition.
Aside from the obviously illegal drugs and prescription drugs used w/o a prescription, is there a list or history of over-the-counter or mail-order dietary/nutritional/herbal supplements causing problems on a DOT drug screen? Has there been an attempt to warn producers, retailers, and consumers about them?
Is tramadol a disqualifying drug from FMCSA, Doc gave client a 60 day Card, why?
@Richard
Without some level of explanation as to the need and potential side effects of this narcotic, you may be disqualified as a CDL driver.
Have your prescribing doctor fill out a medical release form indicating the need, if ongoing, and proper usage.
This helps the CME determine what is going on and how best to proceed. I suspect the reason your driver received a 60 day card was for the driver to get all his information together and get it back to the CME.
I take xanax only when needed I go for DOT urine screening in couple days. Do I need note from my doctor explaining why I take it.
@John
No. If the test comes back positive, the MRO will call you and ask for your prescription. That is all you will need to do.
i am currently on a suboxone tapper and have heard many different answer to weather i can obtain a cdl or heavy equipment certificate. any info on this would be greatly appreciated
@Larry
The medication you are taking has some negative sie effects that would inhibit your driving and heavy equipment certs.
If you have been on these meds for an extended period of time, then I would have your primary doctor fill out a medical release form and take that with you when you get your next physical done.
If meds are properly prescribed and your doctor feels that you would be safe to operate heavy equipment, then the release would be a big help to the examiner. Good Luck
I am being tested to be a kidney donor. Can a CDL holder donate a kidney without worrying about medical waivers? How will this affect my medical certificate?
@TJolly
You can be a donor and overall it does not effect your cdl.
Be aware that once you go in for the surgery, you must be fully healed from the operation and you will need to get a new medical certificate after the surgery. Good Luck
will taking a blood pressure medication like lisinopril disqualify me from driving a truck
@ K Hoff
No, it only limits how long your medical card will be good for. One year is a maximum length card, as long as your blood pressure is being held below 140/90. Otherwise the card will be for less until you get the pressure under control.
Will I be disqualified if I take victoza for my type2 diabeteis
@Fernando
No, but I would recommend that you have your primary doctor fill out a medical release form for you before you go for your next DOT medical. Your certification will be good 1 year at a max.
I currently hold a class A license but am unable to drive due to inulin use. I am looking at a job needing a class C license. do the same DOT rules for insulin use apply with a class C license driving a refer bobtail truck?
@Mike
Each state is different.
From a federal standpoint, you would have to obtain a insulin waiver.
But if you are going to drive intra-state only then check with your local DLD and find out for sure within your state’s rules.
I was recently prescribed Imitrex after being diagnosed with debilitating but infrequent migraines. Before I always controlled my migraines through otc medicine and avoidance of triggers. My migraines start out with a “soft” headache and eye socket pain that lasts around a half hour before things get bad (more than enough time to safely stop a truck if need be).
Will I be disqualified from obtaining a CDL because of this?
@Plain Jane
The medication is not a disqualifier, but you will need to explain the potential side effects. Use the medication for a while and see how you react to it.
If all goes well, then have your primary healthcare provider fill out a medical release form explaining your medication usage and its effectiveness.
This will answer the DOT examiners questions.
Can I take dilantin and pass the medical exam for the health card if seizure free over 1 year? If not are there other meds for this that are acceptable?
Do Dot test for suboxone?
@Garnett
Not on the DOT physical examination for your medical certification, which is not a drug test. But it should pop positive on your pre-employment or random DOT drug screen.
Is a cdl driver that gets cortisone injections once a month for upper back/neck pain pass the DOT physical and drive legally?
@Keith
If the condition is under control and there are no other limitations, then you shouldn’t have any problems.
Can you drive while taking opana 20 and percocet both x1 every 12 hours….
@Sylvia
Possibly, but only if you have a medical release form completed by your primary healthcare provider.
It needs to state the reasons and amounts of your prescription. And it needs to state that you are safe and stable to drive without possible side effects of the meds. Good Luck.
Can I have a CDL if I am taking vicadin
@Rick
The side effects of this medication is that it may impair your thinking or reactions. Avoid driving or operating machinery until you know how Vicodin will affect you. Dizziness or severe drowsiness can cause falls or other accidents.
If you get a medical release form completed by your primary doctor, then you may have a shot at getting a CDL, but be aware that the side effects are not conducive to commercial truck driving.
I am currently on Ketorolac, and Rizatriptan for migraines. Would these medicines disqualify me from getting my cdl?
@Corrina
Both of these medications have components that could be disqualifiers.
Have your primary doctor complete a medical release form for you and take it to the dot examination. This will answer a lot of questions right up front. With a release and proper documentation you may be good to go.
my husband has just finished the truck driving course he has been taking Hydrocodone for 3 years for a bad knee . At the school they told him he could drive as long as his DR would sign off now hes being told that DOT does not allow it. Is this just the person hes working for or is it DOT policies
@Chrissy
He will need a medical release form completed by his primary doctor, explaining the needs and usage of the medications that he is taking.
Federal DOT has a set of rules/law that must be adhered to. The Medical release form from his primary allows the rules to be evaluated a little differently due to outside circumstances and situations.
I am on Ambien to sleep and small dose of Carbidopa for restless leg that only bothers me when i am laying down. As long as i take these two i sleep great and function great. Will I be able to pass the DOT Physical?
I was told i did not qualify and to bring a written doctors statement. Will that get me reinstated?
if someone has positive drug test is there anyway he can save his cdl
@Debbie
Most likely his company will send him through a substance abuse program. Take the program and afterwards he should be in OK shape. And don’t do that again!
Would suboxone be considered one of the habit forming drugs to prevent me from obtaining my medical card?
@Christine
Yes. Check with your doctor and see if he can put you on another medication.