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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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Hello,
I take lithium daily, will I pass the DOT for CDL license? Do I need to tell the medical examiner in advance?
@ Joe
The medical examiner is going to have questions regarding this prescription and may request additional medical documentation. It is not an automatic failure.
I’m prescribed hydrocod/ acetim for a bulging disc in my neck , can I still pass dot physical ? I don’t have any side affects , I don’t get drowsy.
@ Gary
The bulging disc is the problem. The medications are going to raise questions with the CME and he will want supporting documentation before making his/her final decision.
An employee was given 1 Year with periodic monitoring due to HBP? Does that mean the employee needs to see the doctor within that year?
There is no information on the medical form stating that the employee needs to return within 45 60 or 90 days. Please advise?
@ mike R
The DOT/FMCSA examiner is not the one doing the monitoring, but the drivers PCP will be the one responsible for monitoring. The one year card is for the driver to maintain a stable blood pressure and the DOT/FMCSA examiner is to check the driver every year rather than every 2 years.
so does that mean the driver needs to see his PCP within the one year. If an audit is done on the company and no record is found that the employee seen his PCP during that one year, can violations be given by DMV?
@ mike R
If your driver is on high blood pressure medication, then he should be monitored by his primary care doctor. If he is not on meds, then he needs to monitor his bp and keep its under 140/90. DOT/FMCSA limits the drivers to a one year card when they are on bp medications and it reads like the CME needs to monitor the driver, but it is not his responsibility to do so. The CME limited the drivers card to one year and will monitor on a yearly basis. So the company is never in violation.
I am about to do my physical exam for my DOT license. I have been having trouble sleeping at night due to restless legs and my doctor wants to prescribe me Ropinirole to take at bedtime to help with restlessness to help me sleep but I am unsure if this will affect me being able to get my DOT License??
@ Michael H
This medication will raise many questions with the DOT medical examiner. Once you start these meds, you will be in a waiting period to determine the possible side effects. Check with your doctor to see if he has any other suggestions.
I take alprazolam for my anxiety and my doctor issued a letter stating that I should take it no less than 12 hours before my report time, is that still a hazard?
@ Cynthia W
The medication is going to raise questions with the CME. Have a note from your prescribing doctor explaining the length of time that you have been on these meds. Also, a medical release form from your doctors will help in the decision making process of the CME.
I take 20 mg of lexapro daily for 20-25 years
20 mg of adderall 3 x daily for 15-20 years
8 mg of suboxone 2X daily for 15 years
I’m getting my Class B for a new job.
Ive been driving for 35 years at a non CDL job
Will these prescriptions disqualify me ?
@ Jimmy
Since you are going for a class B, you fall under the states guidelines and not federal DOT/FMCSA. Check with your local drivers license department for your best answer.
Dose taking 1mg of haldol per day disqualify one from getting a driver’s license in the state of Washington.
@ Cn
Most likely not going to effect your ability to get your drivers license. If you are going for a cdl, which is state issued, you will need to check with your local drivers license department. If you are going for a class A license you will need a DOT/FMCSA medical certification examination. That would be the only situation that may require some supporting documentation and a medical release form from your prescribing doctors.
Can I pass a dot/drug test for a new job if I’m prescribed klonopin & buspar for anxiety?
@ Sam
As long as you have the prescription available for the MRO, medical review officer, you should be fine.
disabled vet. Prescribed sertaline hcl- and bupropion for depression. And prazosin for sleeping- nightmares. I know that the sertaline and prazosin are accepted but is the bupropion? I do not expierience any of the side effects only feeling full for eating no drowsiness or anything like that. Can I still drive over the road
@ Tom c.
Both your medications and your medical/psychological conditions are going to raise questions. The CME is going to request supporting medical documentation for your conditions. You will need documentation and medical releases from all of your prescribing doctors. Only then will the CME have what he/she needs in their decision making process.
I am getting ready to start training to become a CDL A truck driver. Will I be ok and pass the DOT physical and drug test if I have type 2 diabetes and a prescription for suboxone?
@ John G
You are going to raise lots of questions with any CME. The diabetes is one question and will need medical documentation explaining that you have your condition under control. The suboxone will be the real issue. The CME will question you regarding this prescription and its need. Based on your response, he not qualify you to drive class A interstate or may fail the examination all together due to the reasoning behind the prescription.
Hi, I’m a 39 y/o partially disabled Air Force Veteran who has been taking some form of pain medication for a fractured spine for over 10 years. Over the last 5 years, the VA has been laser focused on getting people off of opiate pain medication and since I was taking very large doses of oxycodone and others they decided to put me on a combination of medication of which is now Methadone and Gabapentin along with my other meds for other health issues. My question is, because I have no income and the country needs drivers I decided I’d look into becoming a CDL driver however I’m not sure that I am eligible since I’m on pain medication. Would it be worth my time to even start since I’m on these medications? In other words would I be allowed to drive even though I’m taking these medications?
Thank you very much.
@ A J M
DOT/FMCSA class A cdl drivers medical certification process, you will have a very difficult time, both due to injuries and medications. You might look into intra-state only or a cdl other than class A. This would put you into the states guidelines and regulations, not DOT/FMCSA.
Can you pass a DOT physical and be on prebagalin 25mg
@ Conquia
For a class A cdl, you will not pass the DOT/FMCSA medical certification examination.
I have been taking oxycodone for almost 20 years. My primary has completed my DOT Certification with the proper documentation pertaining to my medical diagnosis. Will the Illinois Medical examiner pull my certification even though my Dr. provided the necessary recommendation?
@ Kristina P
If you’re a class A driver then there will be questions which would require medical documentation. A lesser class license falls under the states guidelines and variances. Make sure your examiner knows the difference.
I have my cdl class A and am a team driver with my husband. I recently was diagnosed with it a mood disorder and anxiety. I am being prescribed with Latuda or Abilify. I scanned through the comments and questions but didn’t see anything about this condition or medication. Can someone give me any advice. Will I loose my cdls or medical card with this condition.
@ Kate
Both your medical condition and your medications are going to raise questions with the medical examiner. You will need to be on your medication for 30 days before taking a new medical certification examination. The CME will need a medical release form from your prescribing doctors and any supporting documentation that releases you to return to work without being a risk to yourself and the public at large.
I’m taking doxepin and I was told I fail on my dot physical. She said I couldn’t even get a reason for it as I am on a few prescriptions that needed a reason and the doxepin was not even to be considered. Why and for what reason? It’s not a narcotic.
@ Bernard U
The medications that you are taking are going to raise questions with any CME. The side effects place you in a possible high risk bracket. Proper documentation and medical releases would be very helpful for the CME’s decision making process.
Why was I denied to apply for my medical clearance because I take doxepin for sleep?
Is it legal to drive with a CDL with a morphine pain pump in Kansas?
@ Josh
CDL’s are state issued and you need to abide by the states rules and requirements. If you are not a class A driver or you are and have a intra-state only restriction, then the best answer is going to be from your states drivers license department.
One of my drivers reached out to me to find out if there was a change in the FMCSA approval to use Ambien. He read somewhere (as did I, and it was just released June 2021 from Overdrive Online.com) that the FMCSA has made some changes in regards to certain medications, one of those is Short-acting anxiolytics (such as Ambien) are not disqualifying as long as the short-acting preparation is used and the driver leaves enough time for the drug to clear the system. I have tried to validate this info through the FMCSA and other research but not finding this. Has their been any updates to the Short-acting/Fast-acting Ambien being allowed for CDL drivers?
@ DOT Compliance
Like so many things with DOT/FMCSA there are guidelines, recommendations, and regulations. Your question falls into guidelines. If a driver has been on this medication for an extended period of time without side effects and can be supported with medical documentation from the prescribing doctor, then short-acting / fast-acting Ambien may be accepted. Time on the medication and supporting documentation with a medical release from his prescribing physician will be the key.
ARE DRIVERS BEING REQUIRED TO HAVE THE COVID VACCINE
@ Diane P
There are no federal mandates only company requirements at this time.
Can you take 100 mg of trazodone a night and still get a CDL school bus driver license?
@ Debbie D
As a school bus driver, your cdl is not a class A license. This means that you will fall under the states guidelines, variances and regulations, not DOT/FMCSA. If you are able to driver with a class D license, then you will probably be fine. Confirm with your local drivers license department.
I am prescribed hydrocodone for a back injury from years ago, I only take it on occasion when needed. Will this be ok for a non-cdl med card?
@ Need2Know
Since you are non-cdl, make sure the examiner know this fact. You will fall under your states guidelines and variances, not DOT/FMCSA.
Which of the following blood pressure medications will be allowed on a DOT test? chlorthalidone or hydrochlorothiazide or amlodipine. If none, what other type would be acceptable?
@ Lu
You should not have an issue with any of these. Make sure you have a medical release form from your prescribing doctors.