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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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Just so everyone knows just because you get a Fed Med card and have a CDLA or learner permit it does and are deemed fit to drive by the examiner and DOT it does not mean that company will hire you if you are honest about your health issues, they go into a report and company’s will ask for that medical examiner report, so let say 20 years ago you had cancer and for example that will show up in report and if company decides they don’t want to hire you due to blood issues even if its deemed cured they can use that as a reason not to hire you. for example, I had when I was 35 Lukimea, I had a blood clott form being in hospital all time in bed, now I am 44 I still take blood thinner just in case and I have had Mutiple med examiners sign off on my paperwork, but I still have issue with comes to company’s see preexisting illness run up insurance cost for their companies and they will use their own medical examiners to try to make it seem like you are unable to work so that turns into a medical examiner vs medical examiner fight which I have had happen. it just so people know stuff like this can happen and is one of biggest reasons a lot of people just do not report conditions to their company’s or medical examiners there no real good protection for you as a employee. special if you in WI which is a right to work state meaning you can be fired or terminated for any reason at all.
so you can be denied or fired for a health issue that DOT or medical examiner does not see as a big deal.
I have a old fashioned cold ( rhino virus), also have tube dysfunction, this was diagnosed by the ER at local hospital, they want to prescribe Flonase and Sudafed over the counter, can I take this medicine , any help in this is greatly appreciated.
@ James J H III
Both have side effects of dizziness and drowsiness. Not recommended for OTR, class A drivers.
What about Gabapentin for nerve pain on my leg? Is that a problem
@ Chris
The medication will be questioned, but the nerve pain will be a bigger question. Providing medical documentation and a medical release from the prescribing physician will be a big help to the CME.
How do I obtain a diabetic exemption? I got hired to drive for ups a huge break for me and my family only to be told I can’t pass the dot physical because im insulin dependent? Omg what A waste of everyone’s time I’ve had diabetes a long time never an issue that impacted my ability to drive so I lost our own this career opportunity
@ Timothy T
Our first question will be, what class cdl do you have. For a class A, you will need to check with a federal medical examiner on the national registry. They should have a copy of the formwork you need. Lesser class cdl, you fall under the states guidelines and regulations.
If you are class A, then follow this link:
https://www.fmcsa.dot.gov/sites/fmcsa.dot.gov/files/2023-08/InsulinTreated%20Diabetes%20Mellitus%20Assessment%20Form%20MCSA-5870_508.pdf
or google search MCSA-5870 for a PDF of the form you need.
I just got prescribed Topiramate for migraine prevention. It is on the “disqualified list” as anything prescribed for seizures is considered disqualified. Is this something I can get in writing from my doctor that it is not used for seizures and that I am safe to drive on it ?
@ Alexa
Depending on the class cdl you carry will determine the direction you need to go. Class A, will require that you be on this medication for a period to rule out possible side effects. Lesser class cdl’s fall under the states guidelines and regulations. Your medical examiner must know the difference for your qualification requirements. A letter from your prescribing doctor should be of great help.
Good afternoon, can someone post the link on the dot website showing where Suboxone is exempt with a doctors letter. The examiners office I went to says it’s a banned medication and I feel that they have outdated information. My doctor went above and beyond to vouch for me but until the examiner sees something in black and white, I am stuck, thanks in advance
@ Liam
Lots will depend on the class cdl you carry. Class A, falls under the federal government regulations. Lesser class cdl’s, fall under the states requirements and regulation. Go get a second opinion else where. There is no list of forbidden medications, only conditions which they are prescribed.
Thank you for the quick response!
@ Liam
You are welcome.
I take methadone everyday for Rehab and I was recently thinking about getting my CDLs but it just dawned on me that this may be a disqualifier I was wondering if there was any way around that I live in Georgia and it is prescribed by the way it’s not something I’m buying elicitly
@ Brannon
For a class A cdl, big disqualifier. Lesser class cdl’s, you will fall under your states guidelines and variances. Best to check with your local DLD for guidance.
I was on a 14 day supply of Suboxone that was 3 month ago don’t take the medicine anymore it was a on time prescription can I get a medical card
@ Ray
It should not be an issue at this point.
I was on a 14 day supply of Suboxone that was 3 month ago don’t take the medicine anymore it was a on time prescription can I get a medical card
@ Brittany
It should not be an issue at this point.
I take Duloxetine for anxiety/depression. It’s a very common non narcotic medication that also treats fibromyalgia and neuropathy for some people. It doesn’t even fall into the category of a controlled substance. Any advice about this? And i used marijuana once in the last 6 months and the dr that did the DOT physical also wants a letter of letter of discontinuation. Wth is all that about?
@ Andrea R M
See previous answer. Your present medical examiner does not know the difference between your state regulations and federal DOT/FMCSA regs.
Will lyrica disqualify me receiving my med card if I had a note from my doctor
@ Sharon
The medication and the symptoms that are being treated will raise questions, but it is not a disqualifier all by itself.
Does anyone know if being on Ozempic for diabetes will affect qualifying for cdl health card
@ Craig
It is going to raise questions and you will need to provide additional information from your prescribing physician to the CME. With proper documentation you should be OK if all else is within normal limits.
Can Lidocaine 5% patch cause a false positive on my DOT drug test?
@ Teresa
If you have a prescription, then there is no issue. OTC should not test positive. There could be questions about why you take this medication.
Getting new doctor for medical card do I have to say I’m on insulin and will she automatically find out I am
@ Bruce H
Yes and yes.
My husband has been taking klonopin for 8 years for anxiety, well controlled, no side effects. Has been driving class e trucks for years. Got a new job that needs a dot card. Got denied and can’t get this job now. Seriously? Got the note from his doctor and everything and the med examiner said sorry.. I can’t just do this for you. Dr put no issues for driving on the paperwork and she didn’t even bat and eye or look at the paperwork and still turned him away.. sigh
@ Savanna
Part of the issue is this medication can/is used for seizures. But the PCP’s note explaining the situation should have been sufficient. You got an examiner that does not fully understand the DOT/FMCSA guidelines. Go get a second opinion from someone who does. Also, his class cdl will have a bit to play in this also. If he is a class A driver, the fed is much stricter than say a class B.
Can I still drive under medication BRILINTA
@ Moises G
DOT/FMCSA for a class A cdl, you will need to be on this medication for at least thirty (30) days and get a new medical certification examination. Supply some supporting medical documentation and a medical release form from your prescribing physician.
I use Afrin sever congestion relief, can that disqualify me with the drug test?
@ Tony J B
If you have a prescription for the MRO to work with you should be OK. If this is an over the counter medication, then you may have a few more questions to answer, but it should not trigger a positive result in a drug screen.
I have rheumatoid arthritis and take plaquenil and molixicam and also take lisinopril for blood pressure. Will I have problem getting medical card for CDL A in Alabama? And arthritis does not affect my ability at all.
@ Country boy
You will need some supporting medical documentation and a medical release from your prescribing physicians. Over all you should not have any issues with this.
If I’m only requesting a DOT physical because I’m getting my medical examiners certificate renewed is a drug test part of the protocol? I’m already employed my examiners certificate is just expiring.
@ Brian
No drug testing in a DOT/FMCSA medical certification examination, unless the employer request a separate drug screen.
I would need to be advised about a drug test being requested by my employer before i took the exam though, correct?
@ Brian
Most companies do a pre-employment drug screen to keep their insurance and workers comp to a minimum. They may let you know about it.
When I went to start CDL classes I told them I take buprenorphine and they denied me until I quit taking the meds. I stopped taking them but I think it is still in my system, do they test for this?
@ Zp
It will still pop positive on a drug screen, but with a prescription for the MRO, you may be OK. It is not a part of the medical certification examination.
Which company turned you down? Did you look into the ADA guidelines? Were you talking it for maintenance or something else?
It was a nurse that handled the physical for a CDL school here in Indiana.