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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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Can someone take prescribed Buprenorphine (Suboxone)?
@ Sally K
You can take it, but you are going to have difficulty passing your new medical certification examination for class A cdl’s
Can you take prescribed Diazapam and not have it affect your CDL qualification.
@ Richard
Everything will depend on the reasoning for prescribing this medication.
My doctor has prescribed me one termite for weight loss. Could I still be denied my DOT medical card even with a valid prescription? I’ve been taking it for a couple of weeks with no real noticeable symptoms or problems.
@ Caleb
One termite for weight loss should not be an issue with DOT/FMCSA.
My last A1C was 9.2. I currently do not have any retinopathy problems. Can I get a 3-month extension to my medical exam card for DOT?
@ Roberta Y
For DOT/FMCSA class A cdl, probably not. It will fall to the CME’s discretion and overall findings to make a final decision.
Is there a straightforward list of medicines (legal or illegal) which would likely disqualify a CMV driver? I only need a list. I can look up the reason.
@ Daniel CB
DOT/FMCSA has no set list.
Hello!
I am currently taking Topamax off label for weight loss (not for seizures and have no history of seizures) as I have been struggling to lose weight even on doctor monitored diet plans. Thankfully it has been really successful but I am concerned with my upcoming DOT physical having just realized this may disqualify me due to it’s normally intended use. I did get a doctor’s letter stating it is being prescribed off label, there has been great success with it, I am safe to drive on it and I also have no history of seizures, not prescribed for seizures etc. Also my doctor is not a GP and is an Endocrinologist if that makes a difference to the MRO. I have no history of high bp or diabetes though the sudden weight gain triggered the initial doctors visit and I have reversed prediabetes with the weight loss, all done in between DOT physicals.
Will this be an issue? My doctor can change the medication but since we have had so much success he would prefer to keep me.on it for a few more months past when I need to renew my card.
Thanks!
@ Kevin
You are right in getting a letter from your prescribing physician. The medical examiner is going to have questions about the medication, but with a full explanation from your prescribing doctor, you should be OK.
Can you pass a dot physical if you are on trazodone?
@ Rebecca
It will require some supporting medical documentation before the CME will make his/her final decision. The medication alone is not disqualification.
Can a person still have a CDL if they do ketamine infusion therapy? What about low dose daily ketamine therapy? Treatment of anxiety/depression with other meds have been ineffective so I’m curious if ketamine will auto disqualify a driver whether its IV infusion or daily low dose. Reside in Nevada, FYI.
@ Tami M
The CME is going to request additional supporting medical documentation to aid in his/her final decision making process. It will be more about its effectiveness for your condition, than the medication.
Hello, I’m trying to get my DOT med card. My question is. Up until November 2023 I’ve had REALLY high blood pressure. I’m currently on 5 different medications to control it, since November 2023. I take a total of 7 pills daily to control it. It currently is in a much better level. I know my reading would not disqualify me, but will the number of prescriptions do it?
@ Phillip
Both your blood pressure and the number of medications are going to raise questions. It will fall to the medical examiner to take all available information into consideration during the examination process, to aid in his decision making process.
I have just been placed on Eliquis ( a blood thinner ) due to AFib along with arrhythmia for extremely high heart rate accompanied by dizziness and passing out week ago and would like to know if I can still operate cmv?
@ Edmund
You will need to be on these new medications for 30 to 90 days to rule out negative side effects. Right now you are not medically qualified to operate a cmv. You will need a new DOT/FMCSA medical certification examination before returning to driving.
Are the new injectables for type 2 diebites allowed for a class A
@ John
As long as you have a valid waiver and notes from your treating physicians indicating your condition is stable and well maintained. The CME will take all information into consideration before making his/her final decision.
Can you take a semiglutide medication for Weight-Loss and still hold a cdl-a?
@ Kristina
You would need to be on these medications for at least 30 days to determine potential side effects and then have a new medical certification examination done.
Does Taking PRAZOSIN affect my school bus driver license
@ Anne
As a school bus driver with a lesser class cdl than class A, you should not have any issues. Best to confirm with your local drivers license department (DLD).
My Doctor prescribed me phentermine HCI 37.5mg. She knows I drive a city bus and have a CDL. She said, just take it for a few days to see how it affects you before driving. Even though it’s a stimulant, I’ve had no side effects other than the intended one, which is an appetite suppressant. I did completely cut out the one cup of coffee I drink in the morning just in case. But I have noticed nothing inhibiting at all. So I’ve now been on it for a month.
Am I supposed to report this to someone besides my work? My super and HR both know I’m taking it. I had my medical examiners physicial to renew, literally the week before I went to my doctor where she put me on this. Do I go back? Do I wait for a random and then show the prescription? Will it even show up? I’m so confused and can’t find any clear information as if I’m ok to take this or not.
@ Jay
Depends on the class cdl you carry. Class A has tighter requirements than a lesser class cdl, which is regulated by the state. Confirm with your local drivers license department (DLD) if you are a lesser class cdl holder.
I’m in the same boat. I’ve been prescribed phentermine as well and am worried i may not be able to pass my DOT physical coming up. Any updates?
I cannot find the form that I need on the website, Can you tell me if it is online or if I have to pick it up or if it can be mailed to me. I am looking for DOT Medical Examiner Letter to Clinician: Diabetes and DOT Medical Examiner Letter to Clinician: Elevated Blood Pressure/Hypertension.
@Louis
Here is the link to the official FMCSA Medical Applications and Forms.
Will methadone or Suboxone prescription disqualify my dot drug test?
@ Sergio
The MRO will ask for a copy of the prescription and then give a final report.
Hey bud I’m going through the same thing and I’m here to tell you the information in this site regarding methodne is wrong. It use to be that way but it’s changed and it’s a pain in the but because medical examiners seem to be unaware of it. I’m so frustrated because it’s like any other medication. You get a letter from your prescribing Dr and move on but if you get a medical examiner that just doesn’t like methodne then your screwed
Hey bud I’m going through the same thing and I’m here to tell you the information in this site regarding methodne is wrong. It use to be that way but it’s changed and it’s a pain in the but because medical examiners seem to be unaware of it. I’m so frustrated because it’s like any other medication. You get a letter from your prescribing Dr and move on but if you get a medical examiner that just doesn’t like methodne then your screwed
@ Fred
Your statements are somewhat correct. Methadone for the purpose of narcotic replacement for a class A OTR driver is a disqualifier, DOT/FMCSA. And, if it is prescribed by your physician for other conditions or situations, then it requires additional supporting documentation from your prescribing doctor. Too many doctors become cookie cutter docs, one size fits all, we try to see through the DOT/FMCSA guidelines and meet the driver where he is and with the situation he may have. We try not to generalize.
I’m a bus driver in Ohio can I take Adipex
If my doctor prescribed to me.
@ Pam G
Since you will fall under your states guidelines and regulations, best to confirm with your local drivers license department (DLD).
Can a pacemaker disqualify you for CDL Medical Certification
@ David M
Not in and of itself, no. If there is a defrib unit attached, then yes.
My husband wants to get a CDL but doesn’t want to have them touching his private. Can you deny that part of the exam or is it required? If it is required then why? I’m trying to help and make him as comfortable as possible.
@ Unknown
The question is ask as part of the examination and if he has never had a hernia, then the examiner can move on, especially if there is some resistance from the driver. But he must be honest.
My husband will be needing a hip replacement in the near future he was wondering how long before he can drive again legally and what about cortisone shots trying to wait till spring he has a class one license . Also what about medication like valerian use for now
@ Donna
The wait, following hip replacement, will be over when the surgeon releases him without limitations or restrictions. The valerian has side effects that would be risky for a driver, so not the best choice. Once released to return to work, he will need a new medical certification examination before returning to driving.