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.
2012 – a friend of mine who’s been a long time Tractor Trailer Class A in good standing driver, was tricked into visiting a mental health institute by his sociopathic brother – stating its “go there and get checked out or leave my house for good”, so not wanting to cause trouble he went unaware that his brother had called ahead stating my friend was saying he’s “hearing voices and waving a gun around” and when my friend got there the doc said here this will ease any anxiety you might have during this interview and gave him two pills to take – so not wanting to ruffle feathers he gullibly took the pills- it was haldol that immediately rendered him a zombie and he was then held for a month unknowingly. He’s not schizo, never was, and isnt on meds and I wish I was in state when this happened to have helped him. My questions is does he HAVE to put this incident on the forms for his DOT med card renewal while he’s trying to get it reversed?
@Kim
It would be best to be honest. If he was ultimately released without further incidence, then a note/medical release form from the treating physician should be all that is needed.
4 seizures in a short amount of time 6 years ago, been controlled on medications since then. Trying to get a medical examiners certificate for an ambulance gig, but marked as not qualified. Any tips?
@Forest
You’ll need information from your neurologist along with a medical release from him. Drivers on seizure medication are going to have a tough time due to the medications and the seizures. It’s mostly a safety issue. But the information should be helpful for the examining CME to make the best decision across the board given your situation.
Hello, i was recently diagnosed with Lupus. And was wondering if this would pose a flag at passing my medical test?
@Josh
It is a progressive condition, so make sure you take a medical release form from your doctor explaining what level your condition is in. That way the CME has the available information to make the best decision. In and of itself Lupus isn’t an instant disqualification.
Can I not be hired as a CDL driver if I take 20 MG Narco per day as prescribed by my doctor?
@David
Due to the effects and possible side effects of this drug, you will need to have been on the medication for a good period of time and you will need a medical release form from your prescribing doctor. With a proper explanation from the doctor, you may pass the DOT medical examination. But it will require supporting paper work from your doctors.
I recently had to undergo a sleep study to determine if I had sleep apnea. it turns out I do and I’m now under treatment of a cpap machine. I recently got a citation for speeding so I decided to check my mvr. here’s where I find out my cdl is canceled supposedly indefinitely because I failed to report medical/disability but I’ve had follow ups with my dot doc and everything else is going well. so I’m confused as to what this could mean
@Antonio
This has to do with your state drivers license department, so check with them. They should be able to answer your questions.
My boyfriend twisted his ankle and the doctor put him in a cast for a few weeks. No breaks, just tendon damage. He has a year before his next dot physical is due, but his company is saying that when he’s released to go back to work, dot regulations state he has to get a new dot physical. He’s upset because they cost $ and he still has a year. I just want to verify this. Can you point me in the right direction for answer or help verify. Thank you.
@Sarah
FMCSA states that any injury that takes a driver from behind the wheel, for any reason, must have a new DOT physical before returning to driving. Check FMCSA website. It’s not about the time left on the medical card, it’s about the ability to perform the duties of a CMV operator.
I had one of my disks in my back herniate a few years ago. When I got it checked out they told me 2 of my disks were messed up. one had herniated awhile before which cause the other one too. I never received any surgery. I got the steroid shots done in it. I usually only take motrin for the pain if it causes me problems. In the military it has caused problems because of wha I do. I do not feel it would effect anything as a driver. Would this cause me to fail MY CDL medical exam?
@Douglas
No, as long as you can perform the duties of a commercial driver then you will be just fine.
I’m taking ambien for sleeping at night when on break. Dr knows I’m a driver. Is this ok to have in truck ?
@Walter
FMCSA will have a ton of questions and so will the DOT. Too many of the wrong type of side effects with this medication. DOT will, most likely, have a very negative outlook on the medication in the possession of an OTR driver on the road.