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.
I suffered a back injury at work 14 months ago. I have a class A cdl. I’m due to get my medical card renewed but am unable to physically pass the exam. I’ve had surgery and am out of work on workman’s compensation. I do not want to forfeit my cdl. What are my options? I’m afraid if I fail I will lose it. If I pass it will say I’m capable of working currently which I am not. Is there any kind of waiver that could have it reinstated when I am able to pass it?
@ Don F
Your medical card was invalidated 14 months ago, when you first injured your back. Best bet is to talk with someone at your local drivers license department about your situation and see what their process would be to maintain your cdl.
I have had a class a cdl for about four years, my doctor just prescribed me adderall and I renewed my cdl physical a couple months before the prescription. I have a pre employment dot drug screen in three or four weeks from now, if my doctor signs off saying it doesn’t effect my driving and I go and renew my physical. Will I still have problems with passing the drug test next month? Is there any way I could get cleared for the prescription before the drug screen that way I can stop taking the medication if it won’t be approved. I can’t risk losing my job
@ Pete
Your medication is not going to be an issue with a drug screen. Even if it were, all you would need to provide the medical review officer with is the prescription.
Hi. I have bulging discs that are causing intermittent numbness in my hand. My work is requiring me to retake my DOT physical exam due to being out of work for the pain. Can I be disqualified?
@ TG
If the situation with your hands causes you to be unable to perform the duties of a class A driver, then yes it is possible.
Good morning,
I take Bupropion HCL daily, 200mg, J
just to keep depression in check. I don’t think this would be a disqualifying factor as is controlled by medication. I take Fish Oil for Elevated Cholesterol besides this, but that’s all. Any comments would be appreciated. Thank you.
@ Bill G
The CME may request additional information from your prescribing physician or a medical release form. Other than these possibilities, you should be good if all else is within normal limits.
had a heart attack 6 months ago they put one stent in, my LVEF shows 30>35 . is that a disqualification for a CDL medical card
@ bill k
DOT/FMCSA for a class A driver has a required LVEF of 40% or better. 30/35% will not pass a DOT/FMCSA medical certification examination for a class A cdl.
had a heart attack 6 months ago they put one stent in, my LVEF shows 30>35 . is that a disqualification for a CDL medical card
@ bill k
DOT/FMCSA for a class A license is 40% LVEF. Lesser class cdl’s are state guidelines and variances, not federal guidelines.
I had a stroke 6 months ago. All my doctors have cleared me. Neurologist, cardiologist, optometrist and physician all feel safe with me driving a cdl. Do I still have to wait a year?
@ Zack
Class A cdl’s, fall under the federal DOT/FMCSA and their regulations are a one year wait. Check with your local drivers license department to see if you can go intra-state only for awhile. That puts you under the states guidelines and variances, not the fed.
Yes a minimum of one year. I’m still waiting for my nerologists to get off his behind to give an opion it’s been 13 mounths since my TIA and this individual doesn’t know anything about DOT or FMCSAguide lines for giving an opinion essentially my career is in his hands. I have not had another TIA and have been take rigerment of meds etc. I passed the DOT exam but no opinion yet. Do I sue the nerologists.
@ Martin W
See if you can get a simple medical release form from your neurologist. He does not need to know DOT/FMCSA regulations, that’s the CME’s job. Simply released to return to work without restrictions or limitations.
Hi, currently have a medical card my doctor put me on topamax for weight lose. Will this disqualify my from driving
@ Mike
Yes, the side effects and the uses of this medication are going to raise safety issues with DOT/FMCSA.
I went for physical in January blood pressure was high so the doc gave me three month card.
Went to my personal physician she put me on meds blood pressure is now down and stays down ,, my question is I am now going for another job and they are set me to their physician which is not the one who gave me the three month card , so if they pass me am I good or do I have to go to original doc who gave me three month card to get cleared?
@ Ls
You will be good for the one year that the new examiner will give you.
Hi I have a acoustic neuroma, deaf on my left side. Vision problems ,vetergo tinnitus my acoustic neuroma is pressing on my brain and causing a buildup of spinal fluid. Getting ready for my surgery date. Will I be able to drive after 33 years 🤔
@ Lady j
If everything turn out for the better and there are no restrictions or limitations, you should be able to return to driving.
Hi I was just wondering if an a1c of 6.6 will disqualify me for getting a cdl
@ Kim
Much will depend on the class cdl you are striving for.
Class A drivers fall under federal guidelines. Less class cdl’s are under the states guidelines.
Hi!
The ME that did my DOT Physical fort a CDL Class A disqualified me immediately and gave zero leeway with regard to an Opiod that I am prescribed (and have been on for about 20 years). I told her that the 5 panel test was supposedly to look for illegal and non-prescribed drugs (according to this website) but she wasn’t having any of it. Flat out refused to discuss any possibility of qualifying me even with a letter from my physician. Is there any hope of my passing my physical? If not, how long do I have to be of the medication before I can do the physical again?
Thanks in advance, we all appreciate everyone’s help here.
@ Diana
Any CME is going to have questions with this situation. A prescribing doctors letter and explanation will be of great help in the decision making process. Take all available medical documentation to any “Driver Friendly” CME for a second opinion.
I have very bad anxiety and take medication for it and for ADHD. I personally do not feel comfortable getting my CDL but it is required by my job. Would these stop me from passing my DOT?
@ Michelle
We suspect you are not going for a class A cdl. If that is true, then you fall under the states guidelines and variances, and should not have any issues.
Hi I wanna get my cdl I have a few questions, 1. I have a lung disease called cystic fibrosis, I use nebulizer medication and do a vest therapy to loosen mucus from my lungs twice a day. 2. I am diabetic my last a1c number was 6.6 back on 12/14/2021. 3. I’ve had 2 surgeries last year first I had part of my thyroid removed and second I had my gall bladder removed so far dont seem to have any issues from either. For my cystic fibrosis I have a neb machine and a machine I use with a vest that pumps air in 1st if these wont be an issue would I be able to use those? And second are any of these issues gonna disqualify me from getting a dot card and a cdl?
@ Kim B.
Highly unlikely to pass a class A medical examination and you are going to have to provide medical documentation. If you are going for a lesser class cdl, you will fall under the states regulations and variances. It will be much easier, because it is not Federal DOT/FMCSA.
I have a defibrillator put in 2016 i have no problem with it its 2022 now i go see my heart doctor every year everything good can i go back as a over the road truck driver.Thank You
@ Terry
According to DOT/FMCSA for a class A OTR interstate driver, No. You may be able to drive intra-state if your state allows it.
Hey there,
hope to get some help.
So i went to have my physical yesterday and today, I had abnormally high blood pressure while I was there. when I went yesterday I saw my pcp first and I was 129/83 all is well and I go to the physical and I was at 170/90. figured it was because i had some coffee in the morning and it wasnt long before I had my physical. We tried having me rest for 20 min and etc but was still high. So I tried again this morning, didnt have coffee or eat anything went to the docs office, theyhad me waiting for about 1.5 hrs, I go and take the exam again and pressure is back at 170/100 now. waited a few min and re took it and it went to 156/60. tried waiting again and it was aroubd the same. So whats frustrating is that my BP is just abnormally high at this office, maybe i have white coat syndrome but seems to only happen here, i dont have this issue at other doctors offices. I got a letter from my PCP stating I was medically clear to have the DOT phyiscal done and I got a print out of all my conditions and any meds I took which was just flonase and was prescribed lunesta which i dont take anymore along with all my vitals within the last 3 years, all show me to be under 140/90 and I have the resding form a few days ago showing the 129/83 as well. would this be sufficient for the doctor to accept ?
i have mild sleep apnea which my dr said should be controlled with weight loss and no cpap needed at this time ( i have a letter from my ent )
thank you and hope ill be ok
@ Joe F
First question would be, are they taking your blood pressure with a stethoscope and blood pressure cuff or an automatic bp reader? If they are using a reader, are they using the proper cuff size for your body? Also, if they are using a reader, ask if they can take it old school. The letters should be helpful, but it is up to the CME to make that judgement call.