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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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Your comments are also welcome.
I want to know can you take Ambien and have a CDL.
@ Johnathan
For a class A cdl, you will have issues. For a lesser class cdl, you should be fine. Check with your local DLD for conformation.
If I take the once a week trulicity shot will it disqualify me for my medical card
@ Kevin McA
It should not be an issue. The CME may request additional documentation to aid in his/her decision making process.
Over the summer, after falling and feeling weak. I was diagnosed with adrenal Insufficiency. A very rare condition where the adrenal glands are no longer producing cortisone which caused my blood pressure to drop to unsafe levels. My primary physician put me on Prednisone which replaces or stimulates the diminished cortisone production. Since doing so, my blood pressure has returned to normal levels and I have not fallen or felt faint ever since. The doctors say, I’ll have to take Prednisone every day for the rest of my life but that this medication is a cure for this condition for anyone who has this. Will this condition keep me from obtaining my CDL-A
@ Raymond C
Your situation and condition are going to raise questions with the CME. He / She will request additional supporting medical documentation to aid in the final decision making process.
I’m a class A CDL Driver and I have depression (grief) and is discussing with my doctor to help me “cope” with the loss of my child what medication is safe for OTR Driver?
@ Chazz o
We are so sorry for your loss.
Until your doctor has given a prescription, it would be difficult to answer your question. There will be many possibilities.
I’m on Zoloft, Xanax, Seroquel and Wellbutrin for major postpartum depression and anxiety. I have a class B license and drive buses for a correctional facility. HR won’t answer wether I’ll be allowed to drive or not and I can’t find anything regarding this for DOT physical
@ J
Since you are a class B driver, you fall under the states guidelines and regulations, not federal DOT/FMCSA. In most states if you are driving a car/pickup truck, then you would be able to drive. Confirm with your local drivers license department.
My husband has applied for a driving job for FedEx in Iowa. He has been on the methadone program for 9 years. Will this disqualify him from being able to drive for them?
@ Lynn
Not sure if a cdl is required for this position. If he is going for a class A cdl, then he will have some difficulty with a DOT/FMCSA medical examiner. If he needs a lesser class cdl, then he needs to inform the examiner that he will fall under the states guidelines and variances, not federal DOT/FMCSA.
I worked at FedEx for 28yrs, if FXF found out he almost certainly lose his job,, and the way they would do it [to keep from being sued] is he will be chosen for a random, if the test comes back positive they have a MRO that will make sure it stays positive, even if you have a prescription to cause positive, An there is nothing you can do about it,.
If my pain management doctor won’t release a statement it’s ok for me to drive because I take oxymoron 10mg will I be disqualified?
@ Ron A
Disqualified from what? Driving what? What class cdl?
Can I take 40 mg Oxycodone 2X daily for chronic pains in my knee and shoulder and pass a CME examination to get a medical card to drive a non CDL under 26,000 pounds gvw 26 foot box truck in New England states? The truck is bases in New Hampshire!
@ Big D
Since you are not a cdl holder, then you fall under the states guidelines and variances. You must inform the examiner of this before he begins. Most CME’s are doing class A cdl examinations and following the federal guidelines, which do not apply to you.
Can you take suboxone and till just get a DOT health card
@ Zack J
Not without questions and supporting medical documentation. For a class A, it will be very difficult. For lesser class cdl’s you will fall under the states guidelines and variances. They usually are not as strict at the state level.
Can i take etoldalac and drive truck
@ William T
The medication is not the issue but the reasoning for taking these meds is.
I want to get my cdls. But I take Subutex. I have no side affects and have been on the same dose for over 2 years. Will I be able to get my cdls or hazmats with this perscription? I take no other drugs. And haven’t failed a drug test in the entirety of being on this drug.
@ Cj
Both the medication and the reasoning behind taking it are going to come into question by the CME. You will need supporting documentation from your prescribing doctor.
Will admitting to having a prescription of Percocet on your dot physical application disqualify you from getting a dot card.
@ Daryle W
The CME will have questions as to why you are taking it.
Can I be taking chemo treatments & still pass a dot physical & obtain/keep my cdl?
@ Tammy S
For a class A cdl, no. You would need to be released without restrictions or limitations. For a lesser cdl class holder, you fall under the states guidelines and regulations.
I take clozapine for a mood disorder. Will this disqualify me from renewing my CDL?
@ Daniel
Should not be an issue. CME may request a medical release form from your prescribing physician.
Will suboxone show up on a dot physical? For a class A cdl?
@ Gabe
If your company request a drug screen, then yes.
I have heard from some drivers that DOT doctors have access to a prescription database and can see every prescription I have ever had filled.
Is this true?
I was prescribed Tylenol-3 codine 4 months ago for oral surgery, took it once, then ibprufen only for the next week.
I would rather not list that I took Tylenol-3 codine or even bring it up so as to prevent red flags for no reason. My prescribing dentist is in another state and won’t mail any documentation without a visit. I know that’s BS but I don’t want to spend the money on a flight for a doctor’s note. It’s completely gone from my system (please correct me if I am wrong) and I won’t be taking a follicle test.
Thanks for the information.
@ Kevin
You took Tylenol for a dental procedure. End of subject. No dental notes are needed.
Can I drive with a prescription a prescription that I have had going on 10 years For back pain hydrocodone
@ Kevin
It will raise questions with the medical examiner. If you can provide supporting medical documentation from your prescribing physician, including the length of time you have used this med., it will be helpful. Be aware for a class A cdl, it will be difficult to pass the physical due to the back pain and the prescription.
I have TMJ and get chronic headaches. I’ve been on a small dosage of Methodone for 10 years. It does nothing but control my headaches. I’ve never done any other drugs in my life. Will i be able to get my CDL with a Dr’s note?
@ Lisa R W
The doctors explanation will be a great help, but depending on the class cdl you are going for will come into play. For a class A, you are working with the Federal DOT/FMCSA. For a lesser class cdl you are in the states regulations and guidelines.
I’m prescribed alprazolam . For depression and anxiety . Is this drug on the list of DOT disqualifications ??
@ Jack
The medication has side effects that will questioned, as well as the reason for the prescription. The CMER will ask for additional supporting medical documentation.
I am currently prescribed maintenance methadone for the last 5-6 years. Being that certain Maintenance drugs Suboxone & Methadone are not approved by DOT, can you tell me what Maintenance Medications ARE approved instead of?
@ Gina
There is no list of acceptable medications, only symptoms, and diagnosis’s. Lots depend on the class cdl you hold. Other than class A, which has to meet federal regulations, you will fall under the states guidelines and regulations. So check with your local DLD. If you are a class A, be prepared with a medical release form from your prescribing physician and as much supporting medical documentation as possible. The CME will need this data to aid in his decision making process.
Thank you for replying. It’s class B, I got my permit & did 4 mons training on school bus, road test is next week & i just found this out . I’ve taken it for yrs with no issue & have great reports on my driving in training. Hoping there were other options available or something “in place of” that will pass a 19-A