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.
So my Regular Doctor won’t Fill out the Medical release form and the DOT clinic says he has to. So now I’m stuck without a Solution to paperwork even though I passed Physical and Drug screening. Just need the Doctor to verify my medication he prescribed and that it won’t impair my Driving. What a joke
@ Chris
Explain to your prescribing doctor that he is not placing himself under risk, that is the CME’s position. The CME needs the information so he can make an informed decision according to DOT/FMCSA regulations and guidelines.
I need to know if I can get a medical card to drive a 26 foot 25,999 pound box truck with a defibrillator.
@ Robert
If you are not a class A cdl holder, then it is most likely that you can. Confirm this with your local DLD.
Is leukemia in remission, currently working non CDL driving jobs 12 hours day, going to keep me from getting a CDL? I can pass physical, blood pressure, vision, blood levels all good. White blood cell level 9500.
@ Don M
It will raise questions and may require some supporting medical documentation from your physician. If all else is in good shape you could be OK.
Thank you!!
@ Don M
You are welcome.
Is this still a valid site?
@ Don M
All day long, every day.
I had quadruple coronary bypass surgery two years ago and.have a current medical card
I’m applying for.a.new.job thay had me.do.a.new.dot.physical which rhe doctor failed me.stating thay want me to get an infraction test done.y question os how often do.tou need.to.get.rhe test done ive found two.answers one.says first one five years after surgery the other says every two.years? and dose the new exam override the other medical card ? Thank ypu
@ Jason R
The CME needs to see a stress test results every two years for a LVEF reading.
I went to the doctor for CDL physical and everything was good then he checked my heart one more time and said he heard a fluttering and wants me checked out but as things are now I can’t get seen by a cardiologist till august because of back ups and my card expires in two weeks so what is my options!
@ Brad
Could get a second opinion.
I had epileptic seizures and I currently have my class D license. Haven’t had in two years since if have a doctor’s note can I get my CDL?
@ Rylan
Your cdl is a state issued document, so best to check with your local DLD for guidance.
i have a class A license and have a hearty condition my ejection fraction is under 40 can i down size my license to a class b and drive local, what is the state requirement for ejection fraction
@ hartsell v p
You will need to confirm with your local DLD. The down grade to a class B may do the trick.
I had to do a sleep test because of HP and my card expires in April. I went through my doctor to set everything up. The results came back with mild sleep apnea. My doctor did not prescribe a machine, she basically prescribed a lifestyle change she gave me the results along with a letter basically explaining that I’m under her care and taking a conservative approach for treatment. Can a CME override her ?
@ Michael
Your medical doctor has to operate on their knowledge of medicine. The CME has to do just that and follow DOT/FMCSA regulations and guidelines. The CME can over-ride your doctor based on regulations and guidelines from FMCSA. The CME should take your information into consideration in his decision making process.
I broke my ankle and had surgery. I can’t walk on it as of yet and my medical card is due at the end of March. What can I do?
@ Tracie
You will need to let your drivers license department know of your situation. Then follow their procedure until you are ready to take a new medical certification examination.
Have low ejection fracture. Under 40 cardiologist is willing to sign any type of waiver to clear me. Is there any type of waiver?
@ Ken D J
DOT/FMCSA has a set requirement of a LVEF of 40% or better, for a class A interstate driver.If you are a lesser class cdl holder, then you fall under the states requirements. We know of no such waiver for a class A driver.
rabbit. i was diagnosed with cirrhosis of the liver about four months about two years now,and i have a medical card. can i get a new one?
@ michael
It will depend on your physical and the CME who does the examination. The CME will make the final decision.
I had inguinal hernia surgery on 9/9/22. I had/have no other health conditions. I was advised by the surgeon the procedure went very well. After my 2 week check up, she advised it was healing well and there should be no problem with beginning CDL training and employment. I have not had any irregular issues since the surgery. I have a DOT physical exam scheduled and did not know if I should obtain documentation from the doctor prior to taking the exam. I am concerned about the process being delayed if I don’t have a release statement on hand the day of the exam.
@ Tom
Make sure you have a medical release form from your doctor at the time of your medical examination.
I don’t have a doctor or PCP…what then??
@ Christopher C
A note from your treating physician will do. If you do not have one, you may need to get one to supply the needed documentation.
I suffered a moderate tbi . After the injury I have balance issues with vertigo and light sensitivity. Will this disqualify me from obtaining a med card
@ Greg
For a class A medical certification, you are going to have some issues and it will require supporting medical documentation to get through it.
I was disqualified for my DOT because I’m currently taking suboxone. I’m in the process of being taken off of it. The medical examiner gave me a form to have my physician to fill out and sign stating that I’m stable on the medication and that it won’t effect or impair me in anyway. After getting the form filled out and signed I returned it to the medical examiner. She then said that she’s still disqualifying me because she recommended I be off of it even though the form she gave me stated that I just had to be currently stable. Which I am and my physician agreed with. Can I get a second opinion about me being stable and my medication not effecting my ability to drive?
@ Tiler
Go get a second opinion elsewhere.
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.