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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 class a Cdl
My doctor prescribed phentermine but it will show a false positive for amphetamine, can I take this medication
@ Cade
As a class A driver interstate, this medication will be a disqualifier.
I have been on medication for bipolar disorder and insomnia for years and have my dot card but I’m looking into ketamine treatment. Would this disqualify me?
@ Dee
It is going to raise questions with any CME. It will require supporting medical documentation and a waiting period for possible side effects of the treatment.
Im a class a driver. My doctor prescribed temazepam. It tha ok for occasional use?
@ Rick
Not without supporting medical documentation and even with that you may not pass a class A cdl medical certification examination.
I’m being disqualified from getting my medical card renewed with a written statement from my prescribing doctor. The clinic doctor stated because I’m on buprenorphin it falls in the same category as methadone. How can that be? the two medications are in different classes. Methadone is a category 1 and buprenorphin is a category 3. Two completely different medications. Now I’m without a job due to a medication I’ve been on for years and never had issues in the past.
@ Sean
Get a second opinion from another CME. With proper documentation you should be cleared for at least a year at the time.
Does the drug Memantine keep me from holding DOT license for
@ Tom D
It will raise questions. Make sure you bring as much supporting documentation as possible. This aids in the CME’s decision making process.
My doc prescribed me 5/325mg oxycodone/acetaminophen as needed for back and leg pain. I start cdl school in 26 days. Will this be a problem?
@ CT
This is going to be an issue. Both the medication and the ability to perform the duties of a CMV operator are going to be in question.
Good morning,
My doctor recently prescribed Meloxicam to me for shoulder inflammation. This is to be taken once a day or as needed for discomfort. Is this a disqualifying medication? I have a Class B CDL for driving school bus
Thank you.
@ Bob S
You should be fine with this. If there is any questions, just make sure you have a copy of the prescription.
My doctor recently prescribed me Lyrica for nerve pain. Can I still get a dot medical card?
@ John
It will require some supporting documentation from your prescribing physician. Also a medical release form from your physician.
Can I pass a Dot Physical if my dr has me using Ozempic or Monnjaro injectables.
@ John
Either of these medications are going to raise questions and will require supporting medical documentation from your prescribing physician.
I went for a dot physical to renew med card and dr said I didn’t disclose on suboxone and had to have my dr fill out a form and redo it. How did he know I filled a script 10 days prior? If I just go to a different office will they know that the last dr did not give me my med card cause of it. Apparently checking yes to medications and when asking what flags you. I’ve always said yes and just put otc meds, diet supplements and it hasn’t been a problem. I’m stumped how he knew I filled a script previously.
@ Todd
Looks like this CME is trying to work with you, so just do what he is asking and don’t falsely any of your information.
Going elsewhere is going to be ‘doc shopping’ and will be a red flag.
If you are on prescription naltrexone can you still pass your DOT physical?
@ Nathan
The medication is going to raise questions with any CME, but it is possible with good documentation from your prescribing physician.
My doctor is wanting to prescribe phentermine for appetite suppression and tobhelp me lose weight gained due to an autoimmune thyroid condition. Can I take phentermine with a class b cdl school bus driver license in texas? Do i just need to have a letter from my doctor? Or is it not allowed at all?
@ Randee C
As a class b cdl holder, you fall under your states guidelines and variances, not federal DOT/FMCSA. Check with your local DLD for guidance.
I currently have a class a cdl and getting ready to renew my medical card but I have had 4 back surgeries but doing much better now with a cage. And got diagnosed with osteoporosis in my hip and spine but am doing a treatment for that called tymlos and a bone growth stimulator of which will be a 4 yr treatment. Also I take EMGALITY for cluster headaches.
@ Ben S
The CME is going to want some additional information from your prescribing physicians. But if you can perform the duties of a class A cmv operator, you could be fine.
Hi, I recently had back surgery and I am now prescribed diazepam (valium). Do i need a new DOT physical with medical certificate? And does the drug testing facility test for diazepam or do they only test for the 5 panel DOT drugs?
@ Trevor
You will need a new medical certification examination, once fully released to return to work. There is no drug testing during a DOT/FMCSA medical examination, unless the employer request an additional drug screen. If you have a prescription for the MRO, you should be OK.
Is clonidine a disqualifer
@ Erik W
No, it will need some supporting documentation from your prescribing physician.
I have recently had a doctor prescribe me 10mg of Ritalin to help with my anxiety, focus and mood. I haven’t taken it yet and don’t want to if it will cause a medical examiner to fail my dot certificate? Is this something that a dot medical examiner would allow within reason or is it an absolute no go? Also I’ve been driving for a little over two years now without it but am wondering what would happen if I popped a drug test for it with dot and my employer?
@ Trucker B
You will need to be on the medication for at least 30 days before retesting for your DOT medical examination. With a medical release form and a prescription from your prescribing physician you will have no issues with the CME.
My doctor just prescribed me Modafinil for shift work sleep disorder. Will this affect my ability to be recertified for my Dot physical?
@ Anthony F
It will raise questions due to its potential side effects. It would be best if you are on this medication for 30 days or so before re-certification. If the CME needs additional information, he will request it of you.
I am prescribed Hydrocodone Acetaminophen 10-325 for Herniated Discs in my Back. Is this a disqualifier for my Medical Rectification ? I have been recertified every time since I started driving in 2016.
@ Mark
If you have been certified each time since 2016, then continue the same process again.
What do you mean you were recertified every time? Do you mean you took urine teats and the physician knew you were on them and still let you drive? I’m really trying to figure this out bc I take them too for my back and knees and I’m afraid of losing my job.
I have pre-anaphylactic symptoms (scratchy throat, coughing) with one food that i can easily avoid. How will this affect my CDL and can i be prescribed an epipen just in case?
@ Sharon
Some things will depend on the class cdl you hold. Class A will be more difficult and will require supporting medical documentation from your prescribing physician. Lesser class cdl’s will fall under the states guidelines and variances. For these you would check with your local drivers license department (DLD) for guidance.
Is suboxone tested for on the DOT screening? Also can I carry a CDL while being treated with suboxone? There are varying answers all over the internet. Some say yes other day no.
@ John
For a class A interstate driver, you will have difficulty passing a DOT medical certification examination. It will not be tested for on the medical certification examination, only on a drug screen. This is requested by the employer. Lesser class cdl’s may be acceptable due to state regulations and not federal regs.
Hello, I was laid off yesterday however, they offered to bring me back on as a CDL truck driver which means I would then need to start the schooling process for that. I am taking a prescribed weight loss medication called phentermine which is categorized as an amphetamine so my question is, if my doctor gives me a medical note stating that it’s prescribed and will not affect my ability to drive, will I pass with the medical examiner and be ok? my other option is to stop the medication but i only have a few days before i would need to take the drug test so, i’m not sure I would pass as it may still be in my system for up to 4 days. please help, I can not find a clear answer. Thank you! P.S I live in GA
@ Tonya L F
For a class A cdl medical certification, you will have some difficulty, even with a doctors note. Lesser class cdl, maybe not such and issue. If they do a drug screen (not part of the medical certification exam) all you will need is a prescription for the MRO.
My doctor has diagnosed my with adult ADHD and has put me on adderall will this disqualify me from driving ? Some say yes and then some say no what’s the real answer !
@ Saundra
The medication will raise questions, but with proper documentation and a medical release form from your prescribing doctor, you should be OK.
My doctor also just prescribed it for me. Just wanted to clarify a comment above. A random drug test will be ok as long as I have a script, but the concern is just when I do my DOT physical?
@ CJ
There is no drug testing done during a DOT/FMCSA medical certification examination.