Updated: May 2020
One of the complications of getting your medical certificate is if you have a medical condition that may pose a risk to safety while operating a commercial motor vehicle.
How does this play into the FMCSA DOT physical exam?
Here’s what the DOT doctor is checking for:
- Have you had a medical condition which poses a risk to safety?
- Do you have symptoms that may indicate an undiagnosed condition?
- Do you currently have a diagnosed condition?
- Is the condition being treated?
- Is the treatment effective, and safe, for you to drive a CMV?
- Is the medical condition stable, and safe, for you to drive a CMV?
If a medical condition is a concern, the medical examiner must evaluate whether the condition is a risk for incapacitation:
- Is the onset of incapacitation symptoms so rapid as to interfere with safe driving?
- Is the onset so gradual that you may be unaware of diminished capabilities?
Medical Release Opinion
To ensure that the medical examiner can complete the DOT physical exam at your appointment you should bring a Medical Release Opinion letter from your treating physician. You can download instructions and a letter template here, or refer your treating physician to this page for the necessary information.
If you do not have the necessary documentation with you, for the DOT physical exam, the medical examiner may have to temporarily disqualify your medical certificate. You will need this documentation before you can be reconsidered for qualification for a medical certificate.
Medical Conditions
These are the medical conditions listed on the FMCSA long form for which you should have supporting documentation for the medical examiner:
Illness or injury within the last 5 years • Head/Brain injuries, disorders or illnesses • Seizures, epilepsy • Eye disorders or impaired vision (except corrective lenses) • Ear disorders, loss of hearing or balance • Heart disease or heart attack; other cardiovascular condition • Heart surgery (valve replacement/bypass, angioplasty, pacemaker • High blood pressure • Muscular disease • Shortness of breath • Lung disease, emphysema, asthma, chronic bronchitis • Kidney disease, dialysis • Liver disease • Digestive problems • Diabetes or elevated blood sugar controlled by diet or pills or insulin • Nervous or psychiatric disorders e.g. severe depression • Loss of, or altered consciousness • Fainting, dizziness • Sleep disorders, pauses in breathing while asleep, daytime sleepiness, loud snoring • Stroke or paralysis • Missing or impaired hand, arm, foot, leg, finger, toe • Spinal injury or disease • Chronic low back pain • Regular, frequent alcohol use • Narcotic or habit forming drug use
Role Of A Commercial Driver
It’s important that your primary care physician, who is treating you for the medical condition, also understands the physical, mental, and emotional demands of your job, as well as the responsibilities, work schedule and job stresses you have to deal with.
These are extraordinary factors that a family practice physician or specialist does not encounter when dealing with their general patients. These factors must be considered in the doctor’s Medical Opinion Release letter. See Driver’s Role – FMCSA 49 CFR 391.41 (responsibilities, work schedules, physical and emotional demands, and lifestyles, etc).
Qualification For Your Medical Certificate
The DOT doctor, aka certified medical examiner, has been certified for evaluating the special circumstances of a commercial driver.
The Medical Opinion Release letter from your primary care physician helps the DOT doctor to evaluate your medical condition in view of the safety risk in driving a commercial vehicle. However, the decision to qualify or disqualify you for a medical certificate rests with the DOT doctor, not your primary care physician.
Additional Resources:
Guidebook: How To Take The Stress out of Getting Your DOT Medical Card
Comments Please! (not Questions)
Your comments are welcome in the Comments section below.
Please do not post questions about medical conditions below. If you have questions about specific medical conditions related to the DOT physical, please go to the Frequently Asked Questions section, and post your question in the appropriate category. Trucker Docs™ will answer your question as soon as possible.
P.A. At Doctors Care denied my DOT medical card due to a heart condition even though I had a Letter from my cardiologist saying that I am cleared to renew cdl and from cardiac standpoint I am at low risk and is appropriate for cdl I have had this condition for three years in the pass I presented my letter from cardiologist and was give medical card for one year the P.A. Never examined me just said I hate to bring you bad news but I am granting you your medical card. How should I handle this?
@ Chuck
Go else where for a second opinion.
( I am a newbie trying to become a Class A operator) My PCP will not do a write-up for the DOT medical examiner to verify my health status. She states that she does not feel comfortable doing so. I am generally healthy (no heart disease, diabetes, sleep disturbances, seizure disorder, or other high-risk medical conditions). I saw her for the first time in August for my annual physical. I use the VA for my health care services. It seems I have a new/different provider every year (high turnover rate). My BP was a little high (140/90) during this visit. I have never been diagnosed with hypertension. I have been taking my BP daily since my visit. It has been WNL. I also take two types of psychiatric drugs. My psychiatric provider has written a note for the DOT medical examiner that my condition is stable on these medications. I am stuck between a rock and a hard place on what to do at this point in time. I sincerely any assistance that you may be able to give me concerning my situation. Thanks!
@ Dwayne M
All you need is to set an appointment with a DOT medical examiner. Take whatever medical documentation you have with you. If there is any further information needed, the CME will let you know.
I recently just had a DOT physical. Doctors saying I need a CPAP machine but due to the national shortage of them my current DOT card expires next week. My CDL expires in October but I can’t even work without the DOT card. What are my next options? Also they are telling me that I have 45 days to submit a CPAP results for 90 days so I can get a 1 yr DOT card.
@ Michael H
Depending on which doctor told you that you need a CPAP machine would determine your next step. It is not the CME’s place to make this decision. He can request a sleep study be done, if he see’s multitude of signs and symptoms of OSA. Otherwise go else where for a second opinion.
I have 2 doctors and called a third one they all telling me I can go to any doctor but they telling me I need a CPAP machine but due to the national shortage and a recall now I am out of a job and I don’t have money just laying around for a CPAP machine.
I was given a three month med card with orders to get a sleep study. I was not able to get appointment for sleep study until med card expired ( Covid restrictions sleep study centers shutting down). Is there anything I can do to get extension/ waiver until I can get study results
@ Robert
If you do not feel as if you suffer from a multitude of OSA symptoms, go else where for a second opinion.
I went and did my dot physical 0n 9/14/2022 i pass everything told all of my meds i was on then she told me she can give me my med card because i take suboxin i have been on it for five years i take it at night win iam home can i get med record from my doctor telling why iam on it
@ William g jr.
Yes, and see above.
Several years ago I was failed by the medical examiner…due to him finding hydrocodone. I had a prescription for it but I didn’t put it on the form. I wasn’t employed at the time. He said I need to get a medical letter from my Dr that says I’m not addicted to it. This was several years ago. Now I am off the hydrocodone. I am going to go back OTR. Do I still need the letter from my Dr?
@ Russell
No.