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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 been driving a CMV for 8+ years now and have had dot medical cards and even a cdl now but I just went for my dot exam and was told because I had 1 seizure 13 years ago and have been on medication I can not get a dot card the dr said she would have to call and invalidate that card I was not aware that was a disqualifying issue how ever I was never diagnosed with epilepsy my main concern is once she calls to say that card is no good will I lose my other dot card that is valid and wil I lose my cdl?
@Brian
It may go into the FMCSA system, but should not effect your drivers license.
What you need to do is get your primary doctor to complete a medical release form for you and take it back to the CME. That release should answer the CME’s concerns and it may prevent the invalidation process.
Took my dot physical Feb 23 2015. I’ve been taking suboxone for 9 years haven’t been in an accident in over 9 years. I drive 14 hours a day 6 days a week. I asked the examiner if I could a waiver or exemption she said no. I had a 6 month leave of absence to get off suboxone. 2 weeks before the 6 months was up, I took physical passed physical and drug test. Told H.R. I was ready to go then was told by the examiner out of the blue I had to be monitored for 6 months to a year. End result is I lost my job. She asked you for help you told her she could give me 3 to 6 month certificate if I do good, then give me my 2 year certificate. Why did she do that.
@Thomas
Since I have no reference regarding this issue, I’m at a loss.
The CME should not make a determination on your medications. The CME needs a medical release form from the prescribing doctor. Once you do that you should have been OK. But that being said, some CME are very cautious about drivers and their medications. Can’t explain someone else thinking for you.
I take tramodol for my back pain. Can I still pass my dot physical in Mn. ?
@Ron
It will depend on a number of other factors. First, bring a medical release form from your primary prescribing doctor, that will answer many of the questions that the CME will have. The CME needs your doctor’s explanation to help him determine your safety as a commercial motor vehicle operator.
After that you will need to follow the DOT examiner’s request for supporting information. Good Luck
Can i take xanax and pass dot drug test?
@Derek
If you take it as prescribed and have a written prescription for the medication, then yes you can pass the DOT drug screen.
Can I certify driver for CDL, who is on long term Suboxone treatment
@Narinder
Only if you have supporting information from the primary doctor along with a medical release form indicating that the primary prescribing physician understands the full and complete job description of the driver. After that it is up to you to make the final decision as to whether you feel that this driver can perform his duties in a safe manner.
I had a medical completed and was granted a 2 year medical card. I was diagnosed by my own DR of hypertension and take medicine now. Do I have to report this to my employeer or get a new medical certificate? In my employee handbook it states i need to notify them of RX changes. What does the DOT require?
@Tom
Each company has its own policy, so we can’t answer for the company.
FMCSA wants to know, at the time of the examination, what meds you are taking and how you are responding to them. As long as you are not having any aberrant reactions with the meds, then there is no issues from them. You will need to have a medical release form completed by your primary prescribing doctor when you take your next DOT examination and you will be limited to a one year medical certificate since you are taking HBP medications.
My pain management doctor prescribed me methadone for back pain and has told me he would be glad to sign off on anything I need him to. I am not a CDL driver. I only drive an intra-state rollback/wrecker locally and need a DOT card to do so. If I get the release filled out can I still take my medication? It’s flippin crazy to me that some of these docs will allow people to drive on oxy and morphine but not methadone. It’s idiocy at it’s finest. Thanks for answers.
@Matt
Since you are not a class A driver, your rules are really just your state’s rules.
So if your state allowed you to drive intra-state only and take your presently prescribed medications, then there should be no problems. Just have your prescribing doctor fill out a medical release form for you and you should be good to go.
This doctor told my company that he couldn’t qualify me at all and they fired me. Should I have an attorney look into it?
@Matt
Guess it depends on what you think the value of the job is worth.
The CME is not reading the information and guidelines correctly, so you could get another opinion, explaining your type of work and your driving requirements and responsibilities.
Hi i am on risperdal 0.5 mg at bedtime i passed my physical but i was wondering can companies still refuse to hire me even if i have a dot medical release form and note from my psychiatrist and psychologist? should i get this medication changed?
@Joshua
If you have a doctors note explaining your need for these medication and it leaves you in a position of being safe while at work, then there should be no problems. Just get a medical release form from your doctor.
I just took a leave of absence from my trucking company to address a mental illness that I have avoided treating throughout the years. I have previously been diagnosed as Bipolar 2 and prescribed with a drug called Depakote(although I didn’t take this drug more than a few days and never followed up with additional treatments). I want to get a handle on this ongoing struggle with manic behavior, and was curious to know if by doing so, I will be disqualified from driving for any period of time.
@Circus Bill
At present it appears that you are not in a driving situation. So once you have your condition under control, just have your doctor complete a medical release form for you to take to your next DOT examination. That release will answer most of the questions that the CME will have. Good Luck
can i take sertraline if i have a cdl licence and i don t wanna get in some kind of a trouble?!
Thanks
@Nick
You want to have your prescribing doctor complete a medical release form for you. That release will answer most of the questions the CME will have. That should be all you need to do.
I disqualified a driver today because he was taking lorazepam 1mg twice a day for anxiety. He has been taking this medicine for 15 years. Could I have cleared him with a letter from his pcp stating that he could drive while on this med? I still wouldn’t feel comfortable clearing him even if he had this letter but wanted to check. I thought benzodiazepines were an automatic disqualifier
@Patti
It’s kind of hard to call it an automatic disqualifier if he has been driving for 15 years on the medication.
Your best bet is to start with the pcp medical release and then make your decisions based on that information, along with what you feel is right. It falls to you to make the final decision and you are also dealing with a person’s livelihood. Keep them safe and monitor closely.
hi, I am in a quandary. I have a patient who has tapered off of Suboxone with the help of his provider, but his last dose was less than a week ago. How long should I wait before certifying him (no other significant issues) and for how long? This gentleman was on Suboxone for many, many years. Any insight would be much appreciated. He has agreed to bring documentation from his provider.
@ Peabody NP
As long as the driver is being evaluated and monitored by his primary doctor and you have a completed medical release form from the prescribing doctor, then you can move forward.
Use good judgment. If you want to also monitor for a period of time, then limit his medical card to 3 or 6 months and re-evaluate. After the first re-evaluation, if the driver is doing well, then you can move him on to his two year card if he meets all the other criteria. You can certify for up to two years if there are no other limitations.
Thank you for your insight, much appreciated.
I am a diabetic trying to renew my medical card. I took the physical examination and was passed by the Physicians Assistant I went to. This PA is registered on the national list and is part of the staff at the medical group I go too.
Here is my problem : I have been taking a new drug called Invokana, it is a new type of diabetes drug that works differently than older diabetes drugs. Instead of sugar being dissolved in the bloodstream ,this drug causes sugar to be released by by urination instead. Now my blood sugar levels have been in the 103 to 120 range which is where they need to be for over two months now, however the urine test showed a high amount of sugar in my urine, of course this is the result of how the drug works. California DMV office I went to did not accept my medical exam paperwork and sent it to Sacramento for review. What the heck can I do, because my medical card expires on Feb 27th ?. Also how is it that a DMV field office can go against the qualified medical opinion of a medical professional ?.
@Tom
At this exact moment we have not had any word from the FMCSA or the DOT regarding changes in the sugar in the urine. Their standpoint is and has been, there is to be no sugar in the urine.
So until the governing authorities suggest another means of determining your diabetes is under control, you may be caught between a rock and a hard place. Your California DMV is set to follow the same rules and regulations that the CMEs have to follow at this time.
An update on my situation : For any driver taking Invokana, I will suggest that before you do your DOT medical card physical that you get with your primary care doctor and have them write a letter stating what Invokana does and how it works. There also should be forms available for that purpose available in all state DMV offices. My doctor filled out a Ca DMV form stating the reason for the presence of sugar in my urine. My blood sugar levels since taking Invokana have dropped to the 90 to 115 range, so this medication works well. Ca DMV didn’t understand the numbers for some reason. Sugar level in urinalisis was 1000 and that would mean a blood sugar level in the 300 to 400 range, They figured things out and approved my new medical card.
@Tom
Invokana will cause a positive test for glucosuria. Some examiners are aware of this problem, others are not.
The only way around the problem you will have with a urinalysis positive at your DOT exam, is to take recent blood glucose evaluation records, A1c, etc information for the medical examiner. A medical release form from your treating physician should certainly help.
I straightened things out with DMV. My regular doctor said he should have told me when my medical card was due for renewal and he would have filled out the required form for DMV. Yes some know about it and some don’t, it certainly was new to the field people at my local DMV office. At least next year I will be better prepared.
I use to have an addiction problem but luckily never got into much trouble. Now I have been taking suboxone. I am a delivery driver and I was wondering if this can interfere with my eligibility in any way to drive commercially.
@Matt
Without a medical release form completed by your primary prescribing doctor, you will have issues.
With the proper release form you should be OK, as long as things are being used correctly.
What does the A1C level have to be to pass the DOT physical? Also, do they do a prick test for glucose in the office? If so what does that have to be? And finally, if the urine reli-on test strips show just a slight indication, the first one after none, does that disqualify? Thanks so much.
@Mary
All you have to do is give a urine sample in a cup. If there is sugar in your urine, then you are disqualified until you get it under control.
I am recovering from knee replacement surgery and wish to return to driving after my recovery is complete. I still have some pain which can normally be controlled by ibuprofen. Occasionally, I need to take a Norco for pain as ibuprofen will not touch it. I had passed a DOT physical before my surgery but had not taken a drug test at that time. How long does Norco stay in your blood? Should I get something such as Tramadol for my pain as opposed to taking Norco?
@Rick
First and foremost you need to be completely healed before you are going to pass a new DOT examination.
So once healed, you should be off all your medications. If, at the time of your next DOT examination, you are still taking medications, just get your prescribing doctor to complete a medical release form stating your need for the meds at the moment. That will answer all of the CME’s questions.
I see many questions similar to mine so if it seems redundant I’m sorry but I don’t see a clear picture. I’m trying to obtain a class “B” cdl with P&S endorsement to drive a school bus. I have been taking dilaudid, morphine, and neurontin since 2009 do to a major back injury requiring surgeries to get me out of a wheelchair and cancer. I maintain a healthy diet, exercise, do not ever drink or do illegal drugs, or anything else that can possibly effect my mental or physical abilities. My medication is managed by a pain management dr and I see Dr’s regularly. I’ve tried many times to come off the medication or change to less of a medication and every time it fails. I do live with the help of disability now but I’m trying to work for my life as I have been taught and honestly can’t stand being out of work anymore. Do you think I can obtain this license and drive a school bus with these medications in me. Will I be required to have my Dr fill out a certain form?
@Little new
Start with a medical release form completed by your pain management doctor.
With that in hand, then go to the DLD of your state and see if you could and would be able to drive with these medications. They should be able to steer you in the right direction from there.
Don’t take this the wrong way but whoever is making the rules is an idiot. There is absolutely no data that correlates painkillers and benzos with driving accidents and deaths. Alcohol, yes, but the morons don’t test for that. They don’t have their feet on the ground. Good drivers are good drivers, no matter what they’re prescribed. Period.
I was put on neurotin 5 days ago can i get the doctor to take me off these so i can go back to driving
@Bobby
That is a discussion you need to have with your primary prescribing doctor. There must have been some reason for putting you on them in the first place. So check with him and explain that effects your driving career.
Also, a medical release from your doctor may be helpful too.
I have a question, I had a DOT screening this morning for a job. I have a prescription for Norco. I passed my physical but due to the fact that I take Norco they are requiring me to have a SAP evaluation. I’ve never had a DOT medical card. Ive provided them with a release form from my primary physician but they are refusing my card until I see the sap. The company I’m applying with will not pay the $400, What are my options?
@allen
The medication that you are taking will have lots of questions attached to it. The CME is covering his behind by asking for a SAP, even though you have a medical release form from your prescribing doctor. Take the medical release form with you to the SAP and see what they have to say. Can’t answer any questions about who should pay for what, and there are only one or two options. Don’t see the SAP and look for another job or find the money, but take the medical release form with you. You may find that the SAP is more understanding then the CME is.
Hell, I have been taking a narcotic called Percocet for several years. This medicine does not cause me any side affects except pain relief seeing how long I’ve been on it. I got temporary disqualified at my medical examiners office and was told by them to stop taking them. I need them to feel normal.Can they qualify me if I get a lbetter from my doctor that this medicine no longer give me side effects
@april
You do not have to stop taking your medications. What you need is a medical release form completed by your primary prescribing physician. The medical release will answer all the questions that the DOT examiner has. Like why are taking these meds, for how long, are you safe and are you having any known side effects?
Hello,
I have been taking an oxycodone and gabapentin regiment 24 hrs a day, 7 days a week since 2007. I have had a class B CDL since 1996. I have had numerous drug tests over the years and have never gone against my doctor’s orders or advice. I take 1800 MG of gabapentin a day and 60 mg of oxycodone a day, every 5 hours. I currently have been driving a school bus since 2013. I have been cleared by my DOT Physician and my Primary Care Physician. If I were to get into an accident, could I get into trouble? My M.D. says I could easily be on disability with my diagnoses of chronic pain, DDD, Nueropathy and Sciatica among others. Am I playing russian roulette taking oxycodoone every 5 hours? I have been taking this drug for over 10 years and have tried everything else after one laminectomy in 2009 and a discectomy in 2012. this is my second career. I had to quit working as an electrician after the surgeries. should i keep driving, or go for the disability? I am wheelchair/crutch bound without my meds.
@Jack
Tough call. If you are cleared by both the CME and your primary doctor then the only real risk is an accident. And under the influence of a properly prescribed medication, would be cause for questions. There is a risk and you seem to have the situation under control at the moment, So follow your gut and be safe.