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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 am prescribed saboxone, which is similar but not the same as, methadone. Can I still get a d.o.t. physical card?
@ John C
The medication is going to raise questions and depending on the class cdl you have, will require medical documentation. Then, based on the CME’s findings and class license you have, he/she will make a final decision.
I have had a pain pump for 4 year now. It gives me a small dilaudid dose every 6 hrs. I also have been taking adderrall for adhd for over 6 years now. Would me taking these under doctors care would it keep me from driving a cmv.
@ Leslie E
Your medications are going to raise questions with any CME. You will need a medical release form from your prescribing doctors. Then it will be up to the examining doctor, once he has all the needed information for his decision making process.
I take Kepra . I have never had a seizure but I was bit by a mosquito and got West Nile virus. I have been on kepra ever since. Will being on that disqualify me
@ Paul
The medication is going to raise questions with the CME. Make sure you have supporting documentation from your prescribing physician indicating the use and need of the meds.
Can I get a medical card taking Ozempic injection for type 2 diabetes?
@ Cliff
It will depend on the class cdl you are striving for. Class A interstate driver, no. Lesser class cdl or intra-state only maybe, because you will fall under the state guidelines and regulations, not federal DOT/FMCSA.
Ozempic is a semaglutide injection, not insulin. Why would it be disqualifying?
@ Stevi
It is being used to control type 2 diabetes, and will require a medical waiver from the CME doing the examination. It is not impossible to get a medical card, for class A, just a bit more paperwork.
Can I get a med card with a pacemaker/ defib.
@ Chris
DOT/FMCSA, class A interstate driver, no. Intra-state drivers or lesser class cdl holders fall under the states guidelines and variances. The state may be more lenient than the federal guidelines.
So I am prescribed prazosin 1mg at bedtime, escitalopram 20mg in morning hydroxyzine 50mg 2x/day or as needed, Vyvanse 30mg in morning, and Clonidine 0.1mg at bedtime. I just got my Class A and Medical card. Will any of these be a problem in future physicals?
@ Lance D
If you managed to acquire a valid medical card this time, you should not have any issues. It will usually require supporting medical documentation at each DOT/FMCSA medical certification examination.
Is Trazadone ok to take driving a tractor trailer
@ Ed
The medication and the reason for taking this medication will come into question with any CME. With proper supporting medical documentation, you could be OK.
I’ve been diagnosed with depression and pd prescribed sertiline and I have a cold. Have to take dot physical next week.
Will this cause me to fail?
@ Scott
Your medication and situation are going to raise questions with the CME. He/she will need supporting documentation and an indication as to how long you have been on your meds with a working prognosis. All this information is to aid the CME in their decision making process.
If I take viagra without a prescription can I fail my drug screen ?
@ Lirio01
No, unless you arrive with an erection.
Just tried my first dot physical. He first said because I have bipolar even tho I’m stable it disqualified me, I asked how no answer. He then said my prescription valium that I’ve taken for over 15 yrs disqualified me. He never asked for a doctor’s note or anything. He spent most out time looking up what disqualifies me. So have others been disqualified for this same thing. What can I do?
@ Carren m
Go elsewhere for a second opinion. The examiner must be willing to perform the work needed to clear you for the medical certification examination.
Will I be disqualified if I take and have a prescription for oxycodone?
@ G
The prescription will raise questions as to why you are using this medication. That will be the biggest issue first, then the medication will come into question.
Can I take naltrexone and pass a CDL drug test
@ William K
There may be questions, but with a prescription on hand you should be OK.
I am on Suboxone for that disqualify me from getting a DOT physical
@ Lee
For a class A, it will be very difficult. Lesser class cdl’s are state, not federal, regulated and are more lenient on their requirements.
Can I take Phentermine with a doctor prescription and drive a schoolbus?
@ Gina P
Your cdl falls under your states guidelines and regulations. Check with your local drivers license department. Be aware of this medications side effects.
I have been taking “Adderall” for over 3 years, prescribed by my doctor because of my A.D.D. I have had no side effects while taking this nor has it impaired my capability to drive. The company I work for has a position to drive a van and DOT physical is required which I did not pass because of the prescription I take. Taking something such as Adderall, does this disqualify all opportunities to drive for company vehicles?
@ Doug
You should not have had any issues with this. Even a class A driver can pass the medical with this medication. I would go somewhere else for a second opinion.
I got my DOT certificate and am also taking adderall. My drug test is requiring my Dr. to call the drug testing facility. I am thinking they have to confirm diagnosis, length of time on med and ability to do the job.
@ Deb
Good possibility.
IfnI Have a marinol RX….will a MRO retest my sample to see if it’s marijuana or the Marinol?? Or just report a positive??
@ Steven
MRO will request a copy of the prescription and then re-test.
Retest for what?? What test will come up differently than a positive for thc?
@ Steven
He will retest for your prescription.
The Physician Assistant that did my medical exam here in Montana give me 1 year for my medical card today. Was told because I am on medication. Wellbutrin or Bupropion, Sertraline, allopurinol. I have never had this 1 year stipulation put on me for other medical cards. Always got 2 years. Have been on these meds for over 20years except for the Allopurinol. And that has been for 2 to 3 years. Have had a CDL for over 20 years. Is this correct. Thank you
@ Cliff J
It is the Physician Assistants interpretation of the DOT/FMCSA guidelines, not a change in the guidelines or regulations themselves.
Hello, trying to find out if ROPINERALE would disqualify someone from attaining a CDL license? Help appreciated. Thank you!
@ B G
The medication will raise questions with any CME and will require some documentation regarding the conditions it is being prescribed for. Class cdl will also determine how strict the examiner must be, state or federal.
Is Chantax permitted as a quit smoking aid?
I have tried all other “aids” repeatedly and haven’t had much success.
@ Paul
Our advice, use whatever it takes to get the job done, you know smoking is not good for you. But be aware that this medication has side effects and may effect your medical card.
Can you get your medical card renewed if you have a cancer diagnosis and are now on chemotherapy.
@ John
For a class A cdl, no. Lower class cdl’s possibly, since they are state guidelines not federal DOT/FMCSA.