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 had my prostate removed due to cancer 4 weeks ago and I need to take a dot medical exam before returning to work in 3 weeks. I am now incontinent and can not give a on demand urine sample at my exam. It all leaks out on its own and I cant fill my Blatter full enough to give a sample. Also will incontinence disqualify me from driving? I ware a depend and it controls leakage just fine.
@ Kim
Don’t try to take the DOT medical certification examination until you are fully released, without restrictions, from your doctor care. The DOT examination does require a very small amount of urine to check for blood, protein and sugar, so a very small amount is all that is necessary. The situation does not disqualify you.
Contact a medical supply store for something called a Texas Catheter. It is a rubber-like condom that has a plastic connection on the end to hook up to a drain bag. You can also find a special drain bag at the same place to connect to the condom catheter that has straps to hold it on your leg, under clothing, not noticeable. The drain bag has a petcock opening in the bottom so that you can fill the sample jar from the drain bag. Google ‘Texas Catheter kit’ for pictures and suppliers.
I have bipolar II disorder and take Geodon and Welbutrion to control it. I want to drive, but the examiner at the location the CDL school sent me to seemed confused about my circumstance and after he researched online denied me because of the Geodon. My psychiatrist didn’t see a problem with me driving on the medication when I brought it up. Could this be something my psychiatrist or primary care could sign off on and be re-examined?
@ C. R
The medications are not a disqualifier for a medical card. What’s required of you is to provide recent medical documentation from your prescribing doctors. Have a medical release form from your prescribing doctor too.
Hello I had brain tumor removal surgery in August 2017. I got my recertification last July. However, I have recently started at a new job. Went to the medical center for my newest medical card. Now the examiner is saying that she cant give me a medical card until 2 years post surgery. Never had any seizures, no medications and have been in remission since last April (2018). My oncologist and primary doctor has signed off. What gives?
@ Daniel
FMCSA guidelines recommend a 2 year wait following your surgery. With proper documentation and additional information from your doctors, the CME could reduce the wait from 2 to 1 year.
I took a dot physical for my union job and was told because I didn’t include I was taking Suboxone it was a automatic fail. I do go to a doc and I’m on a very low dose because I’ve been weening down. The drug has really changed my life and now they say I need a doc note saying I’m completely off this medication. I got a taper plan from my doc to come off but it’s much quicker do to me not working. I have mortgage and bills. The examiner did say me not listing it on my dot form was the major violation not necessarily Suboxone. I gave them note showing 2 week taper plan from my doc with my current dose but even that she said may not be good and couldn’t give me clear info how to resolve this. My boss also said he received email saying not only did I fail but i was a danger behind the wheel which he announced in front of all my coworkers. I thought some of this stuff was confidential. Anyway I would appreciate any help figuring out what I need to do next.
@ Steve
The CME needs to know why your on the medication, his job is to look for any possible risk factors for both you and the public at large. Check with your companies human resources department regarding the confidentiality issue, your boss is out of line.
How did the Dr find out you were on suboxone if you didn’t list it ?
I am a disabled veteran I am currently taking two medications, 1st is Bupropion HCL 150mg for depression and the 2nd is Divaprolex 500mg for mood swings, I have been on these medications for over three years and have had no side effects and neither cause drowsiness for me. If my VA doc fills out the paper work and gives me the head nod do you think I will be able to obtain my CDL A or is this going to be a disqualifier? Thank you for any input.
@ Ricky A
With proper medical documentation and a signed medical release form from the VA, you may be OK. As long as there are no other limiting factors.
I had a kidney transplant in Sept 2016 and have a letter from my doctor stating that I had a successful Kidney transplant and I can return to full duty immediately with no restrictions.
On my current long form medical certificate, certified by a FMCSA medical examiner, it is written that I, “Meet standards, but periodic monitoring required for Other – Renal Transplant *can not drive within 12 hours of taking insulin for steroid induced hyperglycemia”. My medication and medical history is fully documented on my long form.
It is now April 2019 and I recently obtained my CDL class A. I was about to be hired by a company until my medical information was reviewed by the company, at which point they dismissed me as a candidate because “I had a kidney transplant”.
Q: My dream job is in this industry but am I not able to drive because I had a kidney transplant in 2016? Maybe it has to do with my medication? Please explain what the issue is, and how long until I can work as a driver.
@ CD C
Sounds like a company policy and not a medical disqualification via FMCSA. The situation and condition are going to raise questions with the CME and will need supporting medical documentation, be prepared.
I have A fib with a icd trying to drive intrastate will that effect me getting my medical card, I have medical release from okaying me to operate a cmv
@ Brandon
Since you are going to be driving intrastate only, you fall under your states variances. Check with your local drivers license department regarding your medical card requirements.
I’m a school bus driver in the state of Michigan and am having heart valve replacement surgery soon. Will I be able to retain my cdl and pass a dot physical.
@ P. B
Once fully recovered, you should be fine.
Hello! I just bought a CPAP machine because the doctor/DOT said I have to. How can I obtain a one year card. I am just trying to start CDL school. I have a 3 month card only right now.
@ Lakesia
Just before the end of your three months. get a reading off your CPAP machine showing a 70% compliance and you should be good to go.
I have a torn rotter cuff , should I not consider driving a 18 wheeler cause steering might become painful , the doctor did not do any thing to it , just stuck his scope in my shoulder & looked around ,& told me it looked like a mess ,& 3 of 4 tendons are torn , another doctor said that he would like to bring two ends of the muscle together by sewing a piece of human skin between the ends ,do you think I should not consider getting my CDL license after all ,abandon the idea of becoming a truck driver.
@ Dale F.
At present you can not fulfil the duties of a commercial motor vehicle operator. Once shoulder repair is completed and fully recovered, without restrictions, then you may continue your journey.
If I have Nephrotic syndrome that is being treated with rituximab once every four months, would that disqualify me from getting my DOT Medical card. I could bring all the necessary paperwork from my doctor. Don’t need the CDL for my new job, but want to make sure I will qualify
@ Robert
Make sure you bring supporting medical documentation from your physicians, the CME will need it in his decision making process.
My husband has been refereed for a sleep study by a CME because his BMI is 39 and his neck is 18 inch. He had to get the referral from his primary physician and his primary physician said he does not need a sleep study. So now how does my husband get his DOT card for longer than 3 monyhs?
Question.so i had my physical dine a couple days ago.i had put my medications down on the form (narco.for chronic pain in my leg dur to having metal rod and pins in leg.and my ambians do to hard falling asleep at night..i had ti take a driver medication form to my primary doctor to fill out.he did n i go back soon to turn the paper in ..will i be denied my medical card.
@ Jason
For a class A, interstate driver, you are not going to qualify. As a lower classed license holder, you would fall under the states variances. You may try intra-state only cdl.
What’s up doc! It will be 1yr in about two months that I had a loss of concisness at work.im a class a driver here in california.i started seeing a neurologist as soon as the episode happened! And what it was exactly is unclear.i had an eeg it was clean of seizure activity.i had never had a seizure in my life nor in my 20 yr career as a professional driver.my doctor had put me on a mild presription.the dmv had sent a letter to me saying I’m no longer on medical probation! When I called the dmv they told me I may never get back my cdl.how can I fight the dmv on this!or am I missing something
@ James
If you were to have a valid DOT medical certification examination card, in hand, then you should be able to get your cdl back. Check with your local drivers license department for more details.
I have narcolepsy without cataplexy and have been treating for the last 7 months. No accidents or even history of problems behind the wheel even before being diagnosed. I’m being told I can’t obtain a DOT card for CDL with S endorsement because of my diagnosis because I’m a “hazard” to other drivers. Why am I able to hold my regular drivers license with no record of driving issues but not able to obtain my CDL? I’m tired of disability telling me I don’t qualify because my symptoms aren’t severe enough yet employers say my diagnosis alone is too severe for employment.
@ Veras
You may have a couple of options. Start with your local drivers license department and ask if you can obtain a cdl with your diagnosis. If yes, then ask if you are restricted to intra-state only or could you drive interstate. Interstate, class A, will be difficult with your diagnosis, but with good medical documentation from your doctors and a medical release form from them you expand your possibilities. Intra-state only cdl falls more under the states variances and not DOT/FMCSA. So you would need to find a CME that understands the differences and knows your states variances.
I drove 33 years grandfathered in pre CDL, Now on permanent disability in 2010. Renewed my CDL in 2015 for 5 years. Now my CDL license shows inactive because of DOT Medical exam not being taken. If on permanent S.S. disability would my disability be denied and stopped if getting a DOT exam? In worst case scenario if I had to resume driving again I wouldn’t have my CDL , is there any options? Thank you
@ old school driver
Best check with your local DLD. As a class A driver, you will not pass a DOT medical certification examination while on permanent dis-ability. Your state DLD should present you with the other options.
Hi. My question is a bit off the topic here, however, I’d appreciate any feedback!!
My boyfriend Joe is required to get this letter from his doctor, listing all of the medications he is prescribed. (No biggie, we all understand the reasonings behind that)
Yet, when he handed it in to administration, she called him back, claiming the letter was “no good” as it was missing “certain words/verbiage”.
The issue we have with this is, now the document is late and has to pay an additional $50 fee. Not to mention the time it’s going to take to get to the doc office r which is NOT CLOSE. He goes to school 6 nights a week and has a full time day job. C’mon you all know the gig! Lol
Isn’t it the employers responsibility to get in touch with the doctor office?? Or at least waive the fee, considering she didn’t bother to mention anything about these words that needed to be in the letter???
Lastly, I’m shocked a psychiatry office, that’s been in business 39 years, doesn’t have particular templates/documents etc. approved by HIPPA, ODC, Medical board etc…
Seems so unprofessional! Also, she said to him on his way out “you have to pay cash directly to me” ALTHOUGH HE ALREADY PAID THE PROPER AUTHORITIES
Also, pardon my ignorance. I work in computer software, and all of this is so new to me!!!!
Thoughts, comments???
Thanks everyone!!
Hello. I have a non painful inguinal hernia. Will this prevent me from passing my DOT medical test? I’ll be sure to have my primary doctor sign off on it. I’ll be driving a cargo van for a expeditor. Thank you.
@ Matt
As long as you have your PCP sing off with a medical release and you are able to perform the duties of a cmv operator, with out restrictions, you should be OK.
I’ve been drive the last 5yrs with a one year medical card this year the doctor disqualified me because I’m on dialysis I don’t drive over the road I’m a city drive how can I get my medical card back
@ Walker05
You need to have your medical card exam done by a CME that understands the difference between a class A interstate driver and a intrastate only driver. FMCSA guidelines and your states driver variances are different state to state, so check your states information from the drivers license department.
What if your come and primary dr are in the same building? Can the come and your primary care exchange information with your concerns and to resolve any issues ? In order pass the dot physical if any issues arises and are taken care. Between the driver and pcp and cme during the time to get resolved if any medical issues are found and to be corrected?
I have a-fib and take valsartan and metoprolol. What if any restrictions are there for intrastate drivers of commercial vehicles.
@ David
Your medications are going to cause questions and will need supporting documentation for the DOT examiner to move forward. Make sure you have a medical release form from your doctors and from your prescribing doctors explaining your need and usage so the examiner can make an informed decision.
My doctor prescribed Methocarbamol daily and said it should be O K to drive on if taken two hours before I drive. He also prescribed Meloxicam for times I am off duty. He is treating inflammation in my neck and shoulder. I’m confused! Everything I have read says Metocarbamol is a big no,no? He felt that Meloxicam is more worrisome and may have more side effects. From what I read Meloxicam is acceptable and Metocarbol is not. Can I use either one of these medications and would they show up as a banned substance in a urine sample?
Thanks, Jay
@ Jay
If you are being treated with these medications and suffering from neck and shoulder pain, then you are not qualified to drive at the moment. Both of these medications are red flags for a DOT examiner, so be prepared to answer questions and provide supporting documentation.
Okay I have been driving for 5 years now. I was diagnosed with ADD and bi polar disorder when I was in my early teens. I took meds for a short time durning that time. Then stopped taking them I recently went back to the doc and he confirmed again the diagnoses of bi polar and put me on Lithium. I have contuined to drive a truck since being diagnosed and on tretmant and have no ill effects. I am gonna be switching company’s here shortly and will have to take another physical. My question is will my being bi polar and the fact I am on Lithium disqualify me from get my medical card cause I have been driving for 5 years now and havent had any issues
@ Steve
Just make sure you take a medical release form from your prescribing physician along with his explanation regarding your overall situation. You should be fine, but there will be questions and a need for supporting documentation.
Would I have to notify the recruiter if I have very mild psoriasis?