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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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Nuvigil was prescribe to help me keep alert as I have sleep apnea ( I am using a CPAP) and Strattera (atomoxetine) for my diagnosed A.D.D. by my psychiatrist. I can not find a verification on whether or not I can use these medications. Please help me I miss my meds
@David
All you will need now is to have your prescribing doctor fill out your medical release form and take it with your when you get your DOT certification done.
With the info in hand, you already answer all the questions your examiner will have.
I am on Prozac 40mg once a day and klonopin .5 mg 1 pill twice a day. Would this keep me from getting my medical card or what would be the best thing for me. I go Friday to take drug test and dot physical. Thanks
@Brandon
Make sure you have your prescribing doctor fill out your medical release form before you go.
That will answer any questions that your DOT examiner will have.
If your medications pop positive on the drug screen, the MRO will call you to confirm your prescription.
These two steps will help you qualify for a medical card.
I have a CDL and have a legitimate prescription for oxycodone 5mg. The prescription is for two 5mg tablets every eight hours. This medication was prescribed by a Dr for lower back pain due to bulging g discs and degenerative disc disease. I do not use the medication when I’m at work. I only use it while at home and not driving. I have read different things and been told different things. Does this medication show up on a DOT UA? If so do I just supply the MRO with the script when they call? When I go for a random UA do I tell them about it possibly being in my system? Your response is appreciated.
@Lennard
Just be ready to provide the MRO with the script and you should be fine.
I am on the same thing and have been for 12 years. It doesn’t make me drowsy or affect me in any way. . My Dr gave the medical letter and it says I can take it three times a day as needed not to be taken within eight hours of driving. They denied it. Yet last year I was on 4 5mg three times a day and passed. Is there someone u can talk to above them. The medical director denied without seeing me and refused to even talk with my Dr. Can they do this? I’m a single mom and will be losing my job. Can I go somewhere else with new letter since were in process of decreasing? And do I have a period of wait to retest?
@Sheri
Start with a medical release form from your prescribing doctor and have him explain your condition and the needs and usage of the medications that he is prescribing.
With that information in hand, go get a second opinion somewhere else. CME’s are supposed to look at all the available information before passing or failing a driver for any reason.
If I am on a prescription for Vyvanse wich is an amphetamine, And I have the form from my prescribing doctor stateing why I take it, and that I am able to operate a Commercial motor vehical safely. The medical examiner agreed and passed me so I have my DOT medical card now. I am now applying for jobs when the vyvanse shows up on the drug test will the companies hire me because I have this approved or will they not because I didn’t pass the drug test because the vyvanse showed up?
@Ryan
Basically the Medical Review Officer MRO, will be the final determiner here.
Just do the test and have your prescription ready for the MRO when he calls to confirm your prescription. A positive test now becomes negative, due to proper usage.
Due to mild anxiety, my Dr. prescribed a dose of 10mg Escitalopram taken daily. I’ve been taking this med for about 4yrs with no adverse side effects. Is there any reason I would not be allowed to get my CDL and drive commercial vehicles? Thanks for your advice!
@John
Get your medical release form completed by your medical doctor explaining your meds and their usage, before you go for your DOT examination. You shouldn’t have any issues after that. Good Luck
Can my husband keep his cdl while taking victoza.
@Tina
As I understand the medication, it is a non-insulin injection. If this is true, then have a medical release form completed by your primary doctor explaining this medication to the CME doing your medical examination. I believe that you would be able to continue holding your cdl.
I recently had my physical for driving and the doctor said that I couldn’t take Zoloft and drive. He said I would need a note from my primary care doctor saying I was off of it. He didn’t give me the option of getting the medical release form. I can find nothing in my research saying that this drug can cause problems. Did he make a mistake?
@Ann
Start with a completed medical release form completed by your medical doctor explaining your condition and need for the medications. Make sure that you take that form with you when you go back.
The examiner is just looking for an explanation regarding your med needs and proper usage. Good Luck
I have been taking Norco 10/325 for 4 or 5 years. Prescribed (4 a day) Along with Tramadol (2 a day). I have none of the side effects described by any one I can find, in fact I experience the opposite, I get more energy abut my primary care giver is afraid to sign off on any thing, afraid if I should have accident he will get sued. I am 80 years old he has probable been my doctor for 40 or 50 years. I hardly know what to do about that. Change doctors?
I have a legitimate prescription for hydrocodone/acetaminophen, 10/325 mg. Also carisoprodol 350mg. Do I need a physicians release form to pass a urinalysis for dot regulations, or are these strictly prohibited as per fmcsa
@John
Medications are not tested for at the time of your medical examination. But you should have your primary prescribing doctor complete your medical release form before you go for your DOT examination. That way the examiner has all the information he needs to make his final decision.
When you get drug tested by your employer, then you will need to have your prescription information available for the MRO when and if your test results come back positive.
can i get my dot card if i have a perscripton for oxycodone
@Duane
Get you prescribing doctor to complete your medical release for you and take it with you to your DOT examination. The release will answer a lot of the questions that the CME will have. Without the explanation, it is doubtful that you would be given a medical card.
Does an ICD disqualify you for a CDL?
@Ernie
Pretty much. Pacemakers are a stretch, but the defib unit is a CDL disqualifier for interstate drivers.
That being said, you may be able to drive intra-state. Check with your local Drivers License Department and find out for sure.
When a person goes for a CDL renewal, does the doctor have access to see what prescriptions you are taking?
@Ann
No, they do not have that kind of access.
The examiner depends on you to tell him/her about your medications and their uses. If you are taking medications for things like BP or diabetes, then make sure you bring a completed medical release from your primary doctor with you to the DOT exam.
I’m diabetic just got invokana 300mg to take once a day. Will this medication disqualify me. I also take metphormin ,glimipiride,lisonipril, and ganuvia
@Lina
As long as your primary doctor completes your medical release form and he feels that you can perform your duties as a commercial motor vehicle operator safely, then you should not have any issues.
I take morphine at night for a bad back injury and kolonopin for anxiety and to help me sleep can I still drive while on this I have been on both for yes and they do not affect my ability to drive I am also on adderal for ADHD as well have been on these meds for years
@Sheri
Before you go for your next DOT examination, make sure you have your medical release form completed by your primary doctor explaining your meds and the needs for your meds.
That will answer many questions that the medical examiner will have. Good Luck
I am CDL examiner and have a patient who takes Suboxone for pain. He does not have a substance abuse problem, but uses this drug to avoid addiction issues. Can I issue him a CDL based on the new standards?
@Joy
Make sure you have a medical release form completed by the prescribing doctor before you investigate any further. If his primary understands the driver’s job and is comfortable signing off, then you should be good to go.
But no medical release, make sure you can support your decision in writing.
I have been prescribed suboxone for 6 years now. It is a class 3 controlled substance. Can I have a cdl and be on this medicine?
@Anonymous
As long as you have your doctor complete a medical release form for you indicating the use and need for the medication, then you may be able to clear the DOT examination. Have the release form filled out first and then check on the medical examination.
If you are on prescribed oxycodone for pain, is that still a disqualifier?
@Sherry
You need some type of explanation regarding your need for this medication and a medical release from your doctor, that you can operate a commercial motor vehicle safely. Without that, the likelihood of passing the DOT examination is very thin. But with proper documentation and supporting information, then you may pass. Make sure you have all your ducks in a row before starting the process though.
I am a school bus driver. I had to stop taking Klonopin as DOT doctors said I can’t drive with this medicine. I been driving for 22 years. I take this medication for RLS. Now I am taking Requip..3 mg a night. Is Requip an accepted drug for driving a school bus?
@Cindy
Just have your doctor complete a medical release form, for you to take to the DOT medical examiner, and you probably won’t have any problems.
Ok so I want to take a transportation job, where I will be driving a mini van with a health transportation company, i posses a class d license and they want me to get a dot exam and drug test, I am prescribed pain meds (percocet 10/325 mg) also take anxiety med (Xanax) also have prn muscle relaxers. I have been on all these meds for at least 3-5 years and my question is will I be able to obtain a medical card as long as my dr fills out a form stating these are all stable medications and I’m safe to drive with no adverse reactions? Thank u for advice.
@Mindy
Yes, you shouldn’t have any problems if you can provide all that information to the DOT medical examiner.
I once drove a school bus, the examiner found my sugar at 210, I asked for an extension to give me a chance to change my diet to lower my sugar. She agreed to 90 days but 3 days later decided to revoke my certification, claiming dot required her to do so. I gave up arguing and wdnt on my way, but always wondered if she was lieing. I am now on injections and am disqualified, but when this Happened I was metformin, could she have let me have 30,60or 90 days to lower my sugar to determine disqualification?
@Reno
Yes, she could have, and with your diabetes not being under control as a driver it may have been the safest thing she could do.
Ahh, but not even 2 weeks after changing diet, my sugar went down to 150 then 135 then floats around 127 to 102, I decided to do injections because she removed my cert and I decided after 20years of driving (not all school bus, otr and local delivery had a cdl A), I had enough and the injections makes life easier on me. I was just wanting to know if I was being BS’d or not.
Thank You!! Reno
Hi just want.to know.about taking diet pills can discualify my cdl because are high caffein
Thanks.
@Jerry
When you take your DOT medical examination, your examiner will ask questions about over the counter medications. They just want to make sure that you are not taking something that would affect your ability to operate a commercial motor vehicle safely.
So as long as your ability to drive a CMV is not affected, and you qualify for all the medical certification requirements, you will be okay.