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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 had my DOT Physical Card for 2-3 years, through Concentra the last 2 years. Now all of a sudden they said they will not OK a DOT card because I am on Lyrica for Neuropathy, not Seizures, due to T2 Diabetes, it helps decrease the Burning in my feet. This is due to explanation that it is Concentra “POLICY” that Lyrica is on there NOT OK List of Meds even with a letter from my PCP. Is this True with your company or do I just need a form from my PCP as before stating that it does not interfer with my driving a Bus safely?? Reading through the Internet stated Lyrica is NOT a Disqualifying Drug but is up to the Examiner and the situation. My present Card Expires mid July so trying to get my ducks in a row with all my paperwork before I make an Appt. I appreciate your assistance…. If I do need to come off it, how long do I need to be off it before an Exam so I can discuss with my PCP.
@ Robert S
Unless you are a class A cdl holder, you are being mis-led. Lesser class cdl’s are under the states guidelines and variances, not federal DOT/FMCSA. Make sure the examiner know the difference and knows what class cdl you hold.
I hurt my back and my doctor gave me Monica and tizinidine. Will this affect my DOT mesical card?
@ Cary B
For a class A driver, you will need a medical release form to return to work, without restrictions or limitations. And you will need a new DOT/FMCSA medical certification examination. So you would be off the meds and there would be no issues.
i take anxiety meds and seroquel will they disqualified me from getting my medical card and pass the dot exam
@ Danial S
Your situation and medications will raise questions with the medical examiner. He/she will request additional medical documentation to support their decision making process, but over all, you should be OK.
I have mild OSA (AHI = 5.5) and have had some difficulty acclimating to a CPAP. I have alternated between Provigil and Nuvigil over the last year or so. 1) Would not using a CPAP disqualify me from getting a CDL-A? 2) Would taking either of those medications disqualify me from getting a CDL-A?
I have also taken Ritalin, which I prefer for less side effects. Would taking Ritalin disqualify for a CDL-A? DX: daytime sleepiness and shift work sleep disorder.
Thank you for your help!
@ Sarah
Your OSA and your medications are going to raise questions with any CME. But with proper medical documentation and supporting evidence for your conditions and symptoms, you may have a good chance. Class A cdl has the strictest physical examination requirements and will need the documentation for the CME in his/her decision making process.
Is Wellbutrin acceptable to hold a cdl medical card?
@ Tony
It may raise questions as to why you are taking this medication, but should not be an issue.
Hi, I been on Norco for years and take as needed. I’m also on Lyrica. Will this disqualify me on my DOT physical?
@ Christy
Both medications are going to raise questions with the medical examiner. If you are going for a class A, it will be difficult. For a lesser class cdl, you would fall under the states guidelines and variances. Make sure the medical examiner understands the differences and know what class cdl you are carrying.
I have low T and use Testosterone, is that a disqualifier?
@ Lawrence
It is not something that would disqualify you.
The VA has had me on Methadone for 20+ years, it has allowed me to be a contributing member of society for those years, I gave up my Class A CDL years ago due to a change of employment. Now I am retired and own a single axle tractor w/sleeper which pulls my 42’ toy hauler. I am told I am required to obtain a class A CDL, if I am going to do this I would like to get my full Class A CDL back, is this possible. I guess I should follow up with the rest of the medications the VA has me on, as I mentioned 10mg of methadone twice a day, 5mg of oxycodone as needed for break thru pain and vyavanse for my ADD and because it is also known to potentially help with a likely diagnosis of CTE. I am a 100% permanent and totally disappointed veteran who simply wants to travel this country that I made a career out f serving while in the U.S. Navy riding submarines.
@ Richard S
According to DOT/FMCSA guidelines, you will not pass a class A medical certification examination. Check with your local drivers license department on the class A requirements and see if they have another option for your situation and circumstances.
Can you be on suboxone in CA. And still pass the dot test
@ Sam
Class A cld, is going to be very difficult. Lesser class cdl’s fall under the states guidelines and variances. Check with your local DLD for confirmation.
My doctor wants to prescribe Ozempic to help with weight loss. I am not diabetic. Will this affect my dot physical, or disqualify me?
Thank you
@ Melissa
It will raise questions, but with proper documentation from your prescribing physician, it should not be an issue.
I have a medical condition, it under control and doesn’t cause me any side effects or issues while taking my meds. Now the doctor wants of course a letter for my meds but he also wants my doctor to say that I’m not a threat to myself or others. My therapist said that’s not legal. Is it legal for them to ask that question?
@ Christi M
For class A cdl, the DOT/FMCSA is pretty strict and requires the medical examiner have as much information as possible available before making his/her final decision to grant a medical card. Lesser class cdl’s are state guidelines and not federal.
I have tingling in my feet due to an injury many years ago, will I fail the dot exam due to this problem. I’ve been to same dot doctor and he ask me to stand on one foot for a period of about 20 seconds.
@ Mark
If you are capable of performing the test, then there is no issue.Again, the CME may raise questions, but it is not an instant disqualifier.
I was just put on gabapentin 300mgs 2x times a day will my dot card get taken away. Only taking the meds for nerve pain
@ Rebecca
For class A, this medication and the reasoning behind its use are medical card disqualifiers. The side effect have not been ruled out and are high risk to otr drivers. You would need to be on this medication for 30 days and require a new medical certification examination.
My husband died and my anxiety is so bad it’s ulcerated my stomach. My doctor wants me to take 0.25 mg of Xanax at bedtime for a few days along with protonix to see if it helps calm my system down. He specifically told me to take it at the start of my ten hour break and never to take it before or during driving. He’s only prescribed it for a few days short term. Does this meet DOT requirements? I’ve always avoided anything that might interfere with my job, but he said he felt I needed it for a few days before I end up getting really sick.
@ Cass
DOT/FMCSA’s primary concern is whether these medications pose any type of risk factor to you and the public at large. That includes possible side effects of the medication. Your possible side effects are dizziness, drowsiness, headaches and diarrhea. These are possible concerns for the DOT/FMCSA. Maybe take a few days off driving to take these meds for the short term.
Hello,
I am trying to become a CDL holder and I take Zoloft. Will be disqualified? I also take trazadone as needed for sleep.
I was put on these due to the stress of my current job, and am actually changing careers for the betterment of my health and well being. I am thinking that once I retire, and move on to my second career hopefully CDL Driver) I will no longer have a need for any medications.
Thank you for your time,
Jules
@ Jules
This medications are going to raise questions with the medical examiner and will require supporting documentation. Also, depending on the class cdl you are working toward will be taken into consideration. Class A is federal standard qualifications. Lesser class cdl’s are state regulations and guidelines.
if i was put on a disqualifying medication in the past but no longer take that medication would that disqualify me from reviving a class a cdl
@ Demarcus
It will require some documentation to support your situation, but you can get your class A back.
I have been taking Trulicity for diabetes and have recently been prescribed Tresiba instead, will this affect my CDL physical and my ability to drive a school bus. I am retired, but will probably drive occasionally.
@ Jerry W
Since you are not a class A driver, you fall under your states guidelines and regulations. Best to check with your local drivers license department for clarification.
I’ve been on cymbalta, buspirone for a year for anxiety, before that I was on a diff med for same issue for past 7 years. Will they keep me from getting a cdl license. I have anxiety and ptsd from finding my brother hanging. These meds have been wonderful. I have zero side affects.
@ Terri
The medications will raise questions, but with proper supporting medical documentation, you should be fine. For a class A cdl, the questions will be stricter, but lesser class cdl’s will be a bit easier.
I was prescribed buspar and pristiq. Are these ok with CDL?
@ Rick
You will need to be on these medications for a month to rule out any possible side effects. Then you will need a medical release form from your prescribing doctor before you take your new DOT/FMCSA medical certification examination. All of this if you are a class A cdl holder. But, you should be OK.
Can I take Seroquel and get a CDL?
@ Brian O
Your medication is going to raise questions. For DOT/FMCSA class A cdl, you will need supporting documentation. If you are a lesser class cdl holder, then you fall under the states guidelines and variances, not federal regs.