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 was told gabapentin is an automatic disqualifier for obtaining a cdl class b DOT licensure from the doctor at my physical testing facility. if i have an explanation from my neurologist, does that allow me to qualify?
@April
As long as the CME understands why and for what purpose you are taking this medication, then it is up to him to make the final decision. A medical release form from your neurologist will be a big help, but not a sure fact to be DOT qualified.
Im a driver and i also have worked on trucks and trailers for over 30 yrs i broke my neck in 96 went back in 09 passed a driving school 4.0 average taught the instructors a few things they never knew when i first started driving i trained. Myself to urinate be4 i got in the truck if I had the urge to go again i could make it go away till i was done. I’ve been urinating at 4am for the last 35yrs like clockwork wake up out of a dead sleep and can go right back to sleep then i cant go until late-night everyone says they can urinate any time they want i cant turn it on i can turn the urge off …
I went for a urine sample told them i had to go real bad my appointment was at 9am they made me wait till 9:45 and handed me the cup my mind and body went into drive mode that ended it i drank water was there 5 more still couldn’t go closing time at 5pm still couldn’t go.
Said i failed to test they said i had to take a shy bladder test next day i went the dot dr the next day gave me a reg exam like you take to get your med card he said i failed to test and the only thing DOT will except was renal shut down for failing to give a sample if i had renal shut down id be almost dead and shy bladder test please tell me what is done in the test ? I Read in the DOT reg. The Dr is supposed to give me the test within 5 days they said i had to take it the next day no test just a reg exam the next day ….can you explain test and was i right about the 5 days
@Robert
Was this a test for your DOT medical card or for a drug screen? One can be redone at anytime, but no medical certificate until you perform the urine test. The other is a pass/fail based on your ability to urinate and the test is sent out to the lab.
I am a Independent transport driver of empty vehicles. (Etc) new Rvs, busses, sometimes cdl units that require a Class b cdl. I do not transport any kind of passengers. I recently had to have a Pacemaker for a electrical issue that I was not aware of. I have until July 21 2017 before it expires. My question is do I have to get a new CDL Physical and Medical Card. MY cardiologist said I could drive in two weeks. I have notified the company I deliver for and they have no issues with a letter from the Cardiologists.
I forgot to mention. There is no underlying condition. All blood woek is exceptional and no blockage whatsoever.
@Edward
If the pacemaker install is new, then yes you need a new medical certificate to keep your commercial drivers license valid. Get a medical release form from your cardiologist and take it with you. You should be good to go if all else is OK.
i got a 3 month medical card cuz the doctor said i need a sleep study and expires july 29th well i got that but they cant get me in until aug 17th what do i need to do can i go to another doctor or phyiscian and get a new one until i can get a sleep study? thanks
@Eric
Well if you need the sleep study, based on true necessity, then you should be able to talk to your CME and explain your situation.
Since there were no new rules regarding OSA, you may want to get a second opinion from another CME. Also check with your primary care physician and get an opinion from him too.
See these articles for more information on the sleep apnea screening issue.
I have chronic kidney disease. I have been a driver for 17 years. Passed all my medcards no problem, went in March and passed, received my year. Went in and tested again (medcard) for a new job a couple weeks ago and failed. High amounts of proteins in my urine. They gave me a 3 month medcard and said I need to come back in 3 months. If I get a release signed from my doc stating I’m just fine to drive,will I receive my year medcard back? How does that work? I am fine to drive, I am not on dialysis, just on meds, but have never had an issue. Completely clean driving record, again for 17 years. Its my livelihood. thanks.
Also, I’m in stage IV renal failure. Would I be able to drive still with a intra-state CDL license? I’ve read that previously in this forum. How do I obtain that in KS? thanks
@Bob
Since your condition is progressive and you would be best served by driving intra-state, you really need to check with your state drivers license department and see what the state variances are for your situation. A medical release form would be very helpful for any CME so he has the best and most up-to-date information to base his final decision on.
So if I get a release from my doc stating I’m good to go, will I still be able to pass my medcard? I don’t see any reason for me to be on disability because I can perform my duties just fine, never had an issue. Seems stupid for the government/taxpayers to pay for me to be on disability if I can still work…stupid actually, I want to work.
I just need to know if my doctor provides the necessary documents, I can still drive. I don’t think now researching it, intra-state is an option here where I am employed. So a release is the option. Thanks for your time and answers.
@Bob
If your doctor is certified to do DOT examinations and he wants to pass you off as OK to drive, then that decision making process is up to him.
As an interstate driver in stage 4 renal failure, not sure any CME is going to pass you off without a lot of further testing and supporting information from your primary doctor. It’s in the FMCSA guidelines that your issue resides, not in your doctors opinion. He is really good at what he does, but it’s the FMCSA guidelines that will question this.
I feel that the dr and medical should be the ones to determine not The FMCSA.
I have a question I’ve had 2 dot physicals and passed both of them I had a liver kidney transplant 4 years ago no problems at all first physical had to have clearance from doctors and they passed me for one year then when time was up I had my second one do e they said they don’t need another letter from doctor and passes me that one still has 1 year on it but got new job they sent me to a place blood pressure was 143/98 never had blood pressure problems at all I have a cdl a she said I need to get her a letter saying I’m able to work another clearance letter and blood work and did not even give me 3 months can they do that it’s for a new job
The other two I had was done at 2 different dr offices and the second was passed for 2 years and I still have a year on it but the job was wanting me to go ahead and get a new one
@Robert
All depends on what the company policies are.
So if you want to pass this examiner’s physical, then you will need to jump through her hoops. Not real sure why they would hold you from work when you are already working, but a medical release form from your doctor with a copy of your last blood workup should be satisfactory. You will only be good for one year at the time due to the liver transplant, but the blood workup is for confirmation that all is well with you.
could congestive heart failure keep from driving with a CDL? I don’t have one yet, but want to get one. I’m healthy and condition is under control.
@Daniel
With a medical release form from your cardiologist with an expected prognosis in hand at the time of the examination and you should be pretty good to go. Your condition is not an instant disqualifier, but has to be supported with additional documentation from your cardiologist.
Im on dialysis can i get my class b licence i want to drive busses?
@Neil
First check with your local drivers license department to make the state requirements known. You will most likely need a waiver to do any driving of this sort and the state is the one that will issue it to you.