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.
Hi,
I am 27 and want to get my CDL. When I was 7 years old I had brain surgery for an arachnoid cyst because it caused migraines/headaches. They placed in a shunt. The shunt is not functioning anymore, they said it’s harmless plastic basically and it doesn’t need to be removed. I haven’t had any symptoms since before the surgery. After the surgery, once a year I had to get a CT scan. I think I was 16 when the neurosurgeon said I didn’t need to have anymore scheduled CT scans unless I had any issues. I haven’t had any issues since. No severe headaches or migraines.
I am wondering if an arachnoid brain cyst/surgery with shunt would cause an issue getting a cdl DOT physical. Should I get a cdl dot physical before starting a cdl school. thanks for any info – chris.
@ Christopher
Get the physical before starting school. You should not have any issues, but the examiner may request additional documentation from your doctors.
I was on a 10 mg nlood pressure pill for 30 days that my doctor wanted me to try. I have not taken the pill anymore after 30 days as my blood pressure went to low with it. Its been 5 montgs since sll of that. Can i still get a 2 year card or am i gonna be stuck with a 2 year card ?
@ Randall w
Get documentation and a medical release from your prescribing doctor. If you are no longer on the bp meds and your doctor supports the information with documentation, you should be fine for a two year.
Hello,
I take sertraline for depression. Would this disqualify me to get my CDL class A?
Thanks
@ Kristy McC
Your examiner is going to request additional information/documentation from your prescribing doctors. You will need a medical release form and supporting documentation from your doctors and you should be OK if all else is normal.
I went to citymd for my DOT and my status is pending. But when I went to check in the FMCSA registry his name is not on it. Is the dot physical still valid? I logged in to my citymd site, and not much is in my medical records. I come to discover that a Staci (physician assistant) is registered with FMCSA to perform dot physicals. Shouldn’t she have been the one to perform the physical?
So again, is the DOT physical still valid from a dr. who is not registered with FMCSA? and will it show up in the records? if I decide to go with a DOT registered cme will that be considered “shopping around”?
Thanks!
@ Pedro J
The signature on your medical card must be by a FMCSA registered CME. If not, then it’s invalid. Getting a second opinion is not doc shopping.
I have a nerve and spine issue caused by cancer a few years ago that now keeps causing my legs to go numb all the time, does this disqualify me from a medical certificate?
@ Mike T
For a class A, over the road, interstate driver, yes. Intra-state only falls under the states guidelines and variances.
I have a bad nerve and spine issue that is causing permanant weakness in my legs. Is this a disqualifying matter?
@ Mike
If it limits your abilities to perform the duties of a class A driver, then yes it is a disqualifying matter.
I’ve had a complete reverse shoulder replacement due I tore all rotator cuff muscles. The range will never be 100 percent and will have weight restrictions so I’ll be released with some form of restrictions does this disqualify me??
@ Paul H
Class A driver, DOT/FMCSA guidelines are going to be strict and will need medical documentation and release forms from your doctors. Lesser class license fall under your states guidelines and variances and will be different than the federal DOT/FMCSA guidelines. Check with your local DLD for guidance.
I had a brain injury back in 2018 and was given a medical card at the end of that year. I went to renew my card and was told that I failed. Can I get one from the same place that gave it to me.
@ Phillip
Yes, you can always request a second opinion. The injury will need supporting documentation and a medical release from your doctors, but you should be OK. The CME needs the medical documentation and releases for risk factors and decision making process’s.
I have diabetic retinopathy. I have filled out all necessary forms for insulin dependent diabetic and supplied other forms required from my retina specialist. The examiner informed now that due to the retinopathy I can’t get a medical card. That the condition disqualifies me. I tried looking for it on the internet like she told me but can’t find it. Can you tell me if this is true or where I can find this information? Plus is there anything I can do to get an exemption. I’ve been driving at my present job now for 6 months but in jeopardy of losing my job. Thanks for your help.
@ Joe
Of course your condition is raising questions. According to the DOT/FMCSA guidelines:
• Vision Annual Evaluation Checklist.
o Exemption requires evaluation by an ophthalmologist or optometrist.
o The driver diagnosed with diabetic retinopathy is required to have an eye examination by
an ophthalmologist.
It requires the CME to read and understand the guidelines and do further evaluation and request additional information from your physicians, if needed.
Can be re-certified once a year, if all other areas are within normal limits.
You, DOT Physical Doctors all assume that all CDL drivers drive Class A Tractor trailers and that we all drive 12 to 14 hour days. Well That’s not true and I feel that I’m being scrutinized and discriminated against for Holding a Class B and only driving sometimes 4 to 6 hours a day. I ‘am a CPAP user and have used one for over 10 years now and it has done wonders for me But, every year and not every 2 years because of WI. Law, I have to take a DOT Physical because you think that I’ll be falling a sleep behind the wheel. You assume, you have no proof of this and yet I’m still being scrutinized. If all you DOT Doctors feel this way then Why not test all drivers for sleep APENA. People that drive Cars, Trucks, Motorcycles, etc.. God knows that I have seen people on the roads that could probably use it the way they drive. Maybe yourself. I agree, we all want safer roads. But why just punish just the few that don’t drive Class A’s. I’m tired of this political B.S.
Well Mike we will say that there are those of us who understand the differences between DOT/FMCSA class A guidelines and state regulations and variances. Unfortunately too many individuals saw an opportunity to become CME’s and still don’t understand the differences. Best bet when you go in for your next medical card examination, explain to the examiner that you are a class B driver and that you fall under the states variances, not FMCSA. If the examiner does not understand the difference, get up and leave.
Thank You for your output on my concern regarding this situation. Wouldn’t it be nice if they had a form asking you on what kind of class that your applying for to avoid this. Also the clinic that I go to requires payment upfront before any testing is preformed, thus just getting up to leave because he doesn’t recognize the differences between state and federal guidelines would be costly of over $100.00. Suppose I could ask if the examiner understands the difference between the two before the exam. Thanks for your output.
@ Michael
Best bet is to get your answers first, before you pay anybody anything. Or go else where for your examination, these guys can’t be the only game in town.
My husband had a stroke in 2018. We live in Ohio. He needs a dot physical to drive for a company he is to start with in April. He went to get a dot physical a few days ago and they told him that he needs to take the call test both written and driving over again since his stroke. He has waited the one year and he has all the letters from neuro and cardiology and even pulmonologist and pcp saying he is good to drive, etc. he keeps getting the run around and they have told him twice when they slap this big boom in front of him that he is not meeting the guidelines to get his dot physical done..??? But yet when we ask for specific and where and who to talk to no one can seem to help ?!
@ Tisha B
If the state is saying he needs to redo the cdl testing, written and driving, then his issue is with the state. Go up the supervisors chain within the state drivers license department for further assistance. It sound like he can provided the medical review officer with the proper documentation, so do not see where the holdup would be. A CME can perform the DOT/FMCSA medical certification examination without a cdl license.
All this BS to keep a CDL I been out of work for over year because my heart doctor will not sign one paper till I pay Thousands of dollars for test been a driver for 43 years Bo not no what to do
My husband’s cardiologist signed a cardiac release exemption and concentra is rejecting it and disqualifying him regardless. Am I correct that he is entitled to an exemption due to cardiologist making the exemption?
@ Amanda
Get a second opinion from another CME. Not sure what class drivers license or exemption you may be dealing with. Unless your cardiologist is FMCSA certified, then his exemption must be cleared by another DOT/FMCSA certified medical examiner.
Had a mini stroke in aug of 2019 then again oct 14 2019 i was cleared by my doctor to return back to work my job wants me to renew my dot physical the mro says i have wait a year ive read up on it says recommend but not required what can i do to really find out
@ Jeff
Two strokes in 2 months, not good. Nearly all CME’s are going to hold to the one year wait following the last stroke. The risk is far too high for the examiners to try to justify a new medical card. If you drive intra-state only, you may fall under the states variances, check with your state drivers license department for their guidelines and regulations on this issue.
I have been a truck driver 2 years before the start of the cdl program i have been the same size for the last 15 years last week went in to the same Dr. i went to last year he knew my size and medical history told me last year bring paper from My DR. did what he said i went in he took my $100 he ran me through the exam then he hit me neck size and over weight then here it comes the sleep Apnea study i cant afford to go through the study and dont want to be a gov lab rat i think we are being scam looks like my career is over
@ dave
Go elsewhere and get a second opinion. Neck size and bmi are not part of DOT/FMCSA requirements, they may be a small indicator of issues, but not requirements.
I have been in recovery for 2 years in a methadone maintenance program and am currently going through a slow taper to detox out. I just got a job offer where I have to take a dot physical. I’m not required to get a cdl as I will just be driving a cmv basically like a uhaul. Does methadone disqualify me?
@ Wayne
Check with your local drivers license department before going for the medical card. Most CME’s are doing examinations for class A drivers and you would not pass the requirements. But, your state variances may allow you to get a medical card. Find an examiner that understands the difference between class A, federal, and state variances.
I have a class A cdl but I drive a pickup truck for work everyday, is there a form so I don’t have to take physical for medical card? Or do I need to just get class D license?
@ Jeff
Most states require a valid medical card to maintain a class A license. There is no form, unless it is from the state drivers license department. Check with your state first.
I am taking Lamictal and Amitriptyln. I needed a Letter of Clearance from my doctor for the medical examiner for the company. My doctor gave clearnance to drive. I submitted to my doctor and it wasn’t good enough. He told me exactly what needs to be in the letter and a list what needs to be answered for the clearance to drive. Again, gave it to my doctor and she did as requested what the medical examiner asking for. It still wasn’t good enough for the medical examiner. The medical examiner keeps changing changing what’s he’s requesting. This is the third time I have submitted what he has requested AGAIN for letter of clearance STILL wasn’t good enough.The first time when he reviewed the letter he said exactly, “I need your doctor to give clearance to drive a commercial vehicle. My doctor forfilled his request. STILL not good enough. He wants more medical terminology in the letter for clearance to drive when received the frist letter almost 3 months ago and did not tell this additional information. I been waiting for almost three months to work at this company. My doctor has delivered on his demands and depleted all the questions answered. She cannot do anymore for me. I feel discrimnated against when I am completely competent of obtaining a CDL. Can I apply to other trucking companies or will this issue be on my record for DOT. I have my clearance from my doctor.
@ Chris O’T
Get a second opinion from another examiner. You have the right to obtain a second opinion anytime you feel the examiner is being unfair or unreasonable.
If i take abilify 400mg can a doctor at ugent care sign off on my dot physical saying im ok to drive
@ Earl
The CME is going to question the medication and its reasons for use. Most likely the examiner is going to want a medical release form from the prescribing doctor.
I have a question, my medical examiner didn’t give me my medical card for my CDL because my DIABETES / SUGAR LEVELS / LIB blood work results came back high and my current medical card expires in 2 day . Would they allow me some time to get on a diet to bring it down to their requirements without loosing my CDL License ?
@ Carlos R
You could check with your examiner and hear what he has to say on an extension, but don’t count on it.
Hello, I drive a semi locally and I was diagnosed with TIA just over a year ago and was told by my company I had to be off a year with no further incidents before I could return to work. The is up and when I went last month for my DOT test the Dr. looked at my release form and diagnosis and said it was a stroke and I would have to wait 5 years. He said the Neurologist had to be trained in the DOT regulations. Is this true and should I get a second opinion. I would think the neurologist knew what he was talking about!
@ Paul P
Your neurologist does know neurology, but may have no idea about the DOT/FMCSA guidelines. Go get a second opinion with your medical release form in hand from your neurologist. If all your test results indicate a good recovery, then the one year wait may be sufficient, it will be up to the CME. Explain that you drive locally, only, and have had no issues.
Hi, you have a great website and it’s sources of information like this that help me learn about DOT physicals. I’m looking for a new psychiatrist to get a second opinion before I take the physical. My former doctor was prescribing me anti psychotic medication. So I have medical records that say I have bipolar or schizophrenia. I’m not exactly sure what they wrote down because I was never told what the illness was I was just given medication. I’m currently waiting for my medical records to be given to me so I can see what they say. So my question is, after I get a new psychiatrist can I get a new diagnosis and a medical release opinion letter that says I am stable without medication? I’m asking because I don’t have any symptoms and I can hold a job fine. But the last time I tried the medication it made me very drowsy and it was hard to make it through the day. I feel much better without the medication and i really don’t want to go back on any.
@ MrNick
New diagnosis, no medications and a medical release form from your new doctor should help the examine CME in his decision making process.