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 have a driver who recently was denied a medical card because he has a defibrillator. He has driven with this for several years with no problem. Can he obtain a medical release form from his doctor regarding this issue?
@Melissa
Tough one. The FMCSA has decided that defib’s are an instant disqualifier. You could try, but not real sure that it’s going to work. If the driver is traveling intra-state only, then you would want to check with the state DLD and see what their stance on this issue is. In some states where the driver is intra-state only and maybe downgrade to a class B license, might be a chance there. Check with your state DLD for that information.
My primary care provider is not the doctor I receive medications from that may be in question by the examiner. How should I proceed? Is there another form or will the examiner accept a letter from the doctor? I do not see my primary care wanting to fill out a form based on another doctors plan of care.
@Raymond
Your primary care provider is not going to fill out a medical release form based on someone else’s treatment.
So go to the prescribing doctor to get your medical release form filled out by that physician. That is the information that the CME is going to be looking for.
Thank you
I went to a doctor two and a half weeks ago, complaining about sleep problems. He prescribed me Trazodone to help me go to sleep. Now I’m trying to get into Prime’s trucking school, and they tell me that I will likely be disqualified if I am taking Trazodone, and need to get a Dr.’s note stating that I’m off the meds before I will be able to pass the medical exam. Is there anything I can do so I can keep taking Trazodone, I feel like a new man already, or do I need to find a new med or get off sleep meds completely?
@Trent
You could start with a medical release form from your prescribing doctor explaining the needs and usage of the present medications that you are taking. With a proper explanation and proper usage, you may be able to continue using what is working for you. The big issue is the possible re-actions and /or side effects to a new medication. Or how you may act under a medication that is new to you. You could also ask your prescribing doctor what other medications you could possibly use.
Hi i have a pacemaker, recived it oct 7 2014. i had a dot physical done to day with a release form and had to have doctors office fax over my medical reasons why and my pacemaker reports, i have to find out tomorrow but i did receive a 2week card till they get the rest of the report to get my 1yr card, told i have to do a one year follow up and dot physical every year. my question is they did not say i may receive a card yet and i want to know if i may get denied. in 8 months i have had this my reading have been good about 11% that the pacemaker worked and 98% left on batteries and is set to not go no less then 60 bpm. i ment on this that 11% of the time the pacemaker was operational in those 8 months.
@Robert
This is the normal process for pacemakers and DOT. With all of the proper documentation, you should receive your medical card for one year and you will need to have a recertification done each year thereafter.
I drive a truck with GVWR under 26k and travel almost exclusively within a 200 mile radius. Because of frequent kidney stones and nerve damage in my shoulder, and a mildly herniated disk in my lower back, I take Percoset up to 40 mg a day. It does not make me sleepy, it actually has the opposite effect most of the time, and I don’t take it while driving just to make sure. I went to get my medical card renewed and they said having Percoset prescribed to me is an automatic disqualifier. They said the only way they will give me my card is if I get a letter from Dr. stating that I will stop taking this medicine and the Dr. will not prescribe me any more. They said it was a DOT rule and they had no control. My quality of life will suffer as I have weaned myself off before and got next to no sleep because of the pain and had to sit with a heating pad and take more ibuprofen than directed just to not be in tears, so not having the Percoset is not an option. I don’t abuse it, I use it as a tool to make my quality of life better.
@lbzdually
This is not a RULE and the CME seems to be over-stepping the CME’s boundaries. You drive and are home every evening and you should not be held to an interstate drivers rules and regulations.
Get a medical release form from your doctor explaining your situation and issues. That should answer any questions that the CME should have. I would take my next examination somewhere else. Your situation is going to pose questions, but with proper documentation you should be good to go.
Hi
I just recently applied for a new job so part of the pre employment physical was to have a urineanalysis dot doctor said i have high protein in my urine that i need medical clerance from my primary doctor got checked out and my doctor said i have high protein also wont sign off on my clearance did he can do all sort of follow up test… I have one week for the job offer to take of this? Is there anything i can do or im i officially disqualified from getting said job?
@ Robert
Your medical doctor needs to find out why you have a high protein count. Once he gets a handle on your situation, then all he will need to do is complete a medical release form for you and you should be good to go. But without knowing what is causing the situation, no one is going to sign off on this issue.
I was involved in an accident on a city bus the brakes failed and I steered away to avoid a fatality and was knocked out due to the impact was taken to the er had an extended hospital stay now they are trying to say it was a syncopal episode the video from the bus shows I was awke and alert until the impact had a dot card removed three days after issued for further records review was released by PCP and CME now off in limbo for maybe one year been misdiagnosed and railroaded been a bus driver 15 yes 1st accident and not my fault!
@ marc
Start with the ER doctor and have him write a medical release form stating the facts. Then have your primary doctor do the same thing. This should over-ride the CME’s opinion because he has two other physicians stating the cold hard facts. That should take care of the issue.
I have a valid cdl health card until October 2015but I had a heart attack and had to have open heart surgery in march 2015. Do I have to reapply for a new health card before returning back to work.
@Curtis
Yes, and you will need to be fully healed with a medical release form from your cardiologist and a recent stress test in hand.
Your medical certificate will be good for one year at a time and you’ll need a stress test done every two years for you to continue driving.
Last week I took my husband to renew his CDL now his own doctor says that he has a good bill of health for someone with diabetes however this doctor is looking at his BMI and says that he needs a sleep study. What? His own doctor, my laywer , the federal dot and the ohio dot which I called. All say that their guidelines are not a rule let alone a law so how can these doctors do this and get away with it. I just read the ohio and the federal does not require this. Now this is funny, why this place is going by these guidelines is because some doctor wrote a book saying that it’s dot guidelines for commercial drivers. Isn’t that like going the law and taking matters into your own hands ?
@Carrie
Sleep apnea screening is a much misunderstood issue in the world of DOT medical certification.
To better understand this issue read these articles in our blog on Sleep Apnea Issues Affect Commercial Drivers.
I drive school bus, I have been diagnosed with congestive heart failure and coronary artery disease. Also have Emphysema, Cataracts on both eyes, will I be able to continue driving a bus.
@Jackie
That is really going to depend on the extent of your conditions and the state that you drive in. A bus load of children and a driver with a multitude of conditions that could render you as an unsafe driver is going to raise some serious question.
I live in Nys an just got my physical , been on suboxone for 12 years. Why is it I can take Xanax an klonopin or narcs! But not that? He gave me a med form for my klonopin to be filled out by my physican yet he totally disqualified me for my suboxone. No form nothing. It does not affect me in any way like taking a vitamin. Is there still a waiver I can get ? I am awaiting a call back from my doctor, this doctor was super unreasonable when it came up . Wouldn’t hear me out not one bit . Should I talk to my doctor an then go an hope to see a more reasonable doctor . I was straight up honest an unless I taped off for the next 2-5 months I am screwed… Help please an yes I tried to read the above messages an help but didn’t see any that pertain to my specific predicament if you will.
@Andy
You must get your primary prescribing doctor to fill out a medical release form for you to take to the next DOT examiner. Your doctor must explain the dosage and the need for such a medication, as well as the length of time that you have been on these meds, and its side-effects to your driving, if any. Without proper documentation, you are going to be flagged without the DOT examiner’s understanding what is going on.