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 am on a blood thinner Xarelto for parasoxmal Afib my PCP and my Cardiologist told me all is fine. according to the tests they do not see a problem. My job told me I cannot be on a blood thinner that I am taken out of service. The doctor told me it is not encouraged to pass people on blood thinners due to it being a federal mandate and ruling. I have searched high and low and have not the found anything which would agree with what he said. I think he is jerking me around. please advise.
@Mark
It isn’t so much a mandate or ruling, it’s more about the possible effects of the medication on a driver.
I would get a written medical release form completed by your primary care physician and take it with you when you get your DOT examination done.
You will, more than likely, only receive a one year medical card due to your condition and medications. Remember it’s about safety to you and the people around you while driving, nothing personal, just basic guidelines.
I had a stroke three years ago but have no issues in three years can I get a medical card?
@Derek
I would make sure you have a medical release form filled out by your primary healthcare provider and copies of your latest testing in hand when I went for the DOT examination. With everything in hand when you walk in the door, you shouldn’t have any real difficulties.
Just had a pacemaker implanted ninety days ago. Do you believe my cardiologist will allow me to return to my job as a city bus driver, here in Las Vegas?
@James
Not sure of the rules within NV.
As a class A driver you will have a waiting period following the pacemaker install. But if you are not a class A driver then the wait may be shorter.
Also, please be aware that once you were no longer able to operate a vehicle, due to surgery, that you need to acquire a new medical card. Or at least that is true with the class A drivers.
Make sure you check with your state DMV to get the best answers regarding your specific situation.
I am trying to get my CDL to be a bus driver, I went to see my PCP and got my physical. I am on Effexor for depression, which I have been on for years. And I am also on Suboxone due to a surgery that I had 7 years ago that caused me to have to come off of many pain medications in which my doctors failed to tell me how addictive they would be. Is this going to stop me from getting my CDL.
@Erica
I believe, that as long as you are on these medications, you will have difficulty passing your DOT medical examination.
What I would to is get your medical release filled out by your PCP and have that in hand when you go to take your DOT exam.
This information helps the examiner make a more informed decision. But the final qualifying decision remains with the DOT examiner.
So me even being on my Effexor is going to stop me from getting it then isn’t it. I thought so. Thank you for taking the time to answer my questions.
I am on Prozac and I have a cdl. It depends on why you take it, the cdl motor vehicle will send you a form after or if it’s detected during drug testing. Or the doctor can write on your physical paper why you take it and you will only pass if the doctor doesn’t think it will be detrimental in your duties, a hazaed during driving and your problem will be evaluated. But I was sent a letter and my doctor sent a reply on why I use it and I am allowed to use it.
No, its the suboxone.
If u have a stroke do u lose ur cdl the day u had the stroke?
@Kelly
If you have a stroke, you must wait for a period of at least one year from the time of medical release.
You don’t lose your CDL, just your medical certification for the next year.
Your company will probably send you to a doctor, theirs when you are well again and if you are cleared to drive you keep it, I was on disability and my physical came up, I lost my endorsements when renewing my license but they won’t take them premantly until after 2 or 3 years you have to ask your motor vehicle agency or call the dot like I did. When you are better and you take new physical papers to doctor and you are cleared then you can just go to motor vehicle and add them back on as long as the time lapsed is not over the amount allowed, you still have a drivers license just not the endorsement until you clear.
CME folllow Federal Regulations and the guide lines for the Fittness test. I believe CME’s have a huge roll in helping us CDL drivers with stay complient and healthy, just as we the driver has. It isnt like being lic. to drive a regular passenger car. Be healthy and know your job I say!
I am being sent for a sleep study after my medical exam for a dot medical drivers card. question: can I use the at home sleep study testing device from a certified sleep lab? this way I don’t have to go sleep in a lab.
@Mike
I believe that is correct, just make sure that the home study will answer all of the examiner’s questions and is a DOT approved testing process.
This can effect your cdl dramatically, if you fail your sleep test, they will give you a breathing machine, you cannot get one until diagnosed with a sleep study first. If you use it and they determine with another kind of test you are fine to drive they will clear you and you will have to go more frequently for physicals and bring results from sleep study doctor with you saying they cleared you to drive.
How can a DOT medical examiner be allowed to determine our careers. I think there should be no medical cards to drive truck! That’s our lively hood and now having a DOT saying we might not be able to drive why is that?? Just because we a health issue that can be resolved by our family dr.
I agree with you. They threaten our livelihood and careers. I am dealing with the threat of my job loss because my Dr who has been seeing me for 15 years now, has told the Dr at the place who did the Physical, that they will not give me a medication to bring my BP down TWO POINTS because it would be too dangerous for me and the DOT Dr that has seen me ONE time, says no that’s not right that it has to be lower. I don’t FEEL good when it’s lower than my normal. There needs to be some regulation protecting people from medical bullying like this.
It’s because DOT drivers and their health do not only affect them but every single person on the road.
The profile of the average truck or bus driver:
Male.
More than 40 years of age.
Sedentary.
Overweight.
Smoker.
Poor eating habits.
Statistically, drivers are:
Less healthy than the average person.
More than two medical conditions.
Cardiovascular disease prevalent.
Seems like common sense to me.
Reference: http://nrcme.fmcsa.dot.gov/documents/FMCSAMedicalExaminerHandbook-2014MAR18.pdf
I’m thinking it’s the DOT, and they just want safe drivers, so why would you think a person with issues which effect their driving should be driving long hauls with lethal trucks and school buses. Hey I am dealing with issues too now for my breathing, it doesn’t effect my job yet I might lose my med. cert if I cannot get resolve. I’m just as mad but well those are the rules. you might as well just hand out licenses to anyone if you don’t want to follow the rules.
I feel it’s not just CDL drivers that may or may not have health issues.
There’s other professions out that require the same amount of responsibilities.
Think about manufacturing and the auto industry. And may also pose the same health issues. DOT PHYSICAL are a money market and the cost for one. Can range anywhere from 55-250 dollars. Now we all know that the FMCSA will make our lives more complicated than it is already. They have no clue what this business is all about.