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.
If I had a very mild stroke rececently,but have made a full recovery(no neurological or physical deficits) from the stroke am i still disqualified for 1 year from being allowed to drive? Is it possible to receive a variance if a board certified neuroligist gives me a clean return to work statement?
@Joe
That’s only a possibility.
Are the guidelines different for intrastate and interstate driving
@Joe
Each state has their own, different, intrastate variances.
I have been diagnosed with heart failure and HB. i had a heart procedures on right and left heart catheterization. I am currently on carvedilol and lisinopril. My cardiologist says I will not pass the DOT physical. I need to recertification for my job. My cardiologist is giving me 4 weeks to see if the medicine is working. With a medical release form from him will I get cleared? I only have 5 months until retirement. Thanks
@Maureen
You may clear at an intrastate only level – maybe.
You will not clear at a federal level.
I am recently a dialysis patient. My kidney doc says my kidneys work, just not enough on their own. Is dialysis alone,enough to disqualify me. I passed every test but when I mentioned dialysis to the examiner, he immediately failed me.
@Chris
You will be limited to driving intra-state only, but can have a cdl and work within the state. You want to confirm with your local drivers license department as to what the policy of the state is for you to continue to drive within the state only.
I’m a struggling diabetic with out of control diabetes. I take insulin. If my A1C’s have been over 10 for over a year would this disqualify me for a DOT
You would be automatically DQ’d for taking insulin. You must also have an A1c under 10.
I have some medical issues issues that I am concerned might throw up some red flags for the CME:
1. I have had a history of major depression for the last 15 years, but it has been well controlled by taking an SSRI (was fluoxetine, now is sertraline and bupropion).
2. I had surgery for diverticulitis a few years ago, which was completely resolved. Since then, I have had a couple of recurrent ventral hernias. They have been repaired, and I had mesh installed to help prevent future ones. I have some weakness in the abdomen as a result (I cant really do sit-ups) but can function OK in everyday situations.
3. I was diagnosed with psoriasis and psoriatic arthritis a couple of years ago, but it has been well controlled by taking bi-weekly shots of Humira.
I am at the point now where I am only exploring the possibility of becoming an OTR / long haul driver, and would love to know if this might disqualify me before I spend thousands on driver training.
Thank you for being so generous with your time on this forum. I have learned a lot by scrolling through and reading the questions and your responses.
@Brett
Long before you need to spend any serious money the trucking school should ask for a valid medical card.
To get started on that you want to have medical releases from your prescribing doctors explaining your situation and need for the medications that you are taking. The meds for your depression and the condition are going to raise questions. So when you get your medical release from your doctor make sure he explains that you have been on these meds for a while and that you have no residual side effects from their usage. All conditions are stable and your medication usage is also stable.
With these supporting information in hand you will have done all you can to be pro-active.
I got a defibrillator and if it don’t go off with in 6 mo.can I go back driving a cmv again on interstate
@Terry
Defibrillator is a disqualifier for class A interstate drivers, even with the doctors note.
But you may be able to driver cdl intra-state only and be just fine. Check with your local drivers license department and ask them for full verification.
I am going through a school for cdl. I went in for a d.o.t test i let them know i used to take ambian but i have stopped all my meds. She disqualified me. My dr said he would fax them a letter, i didn’t realize i was going to need one. They wont take it and they say its gonna be 6 months before i can take another physical. I didn’t test positive or anything. What do i do now?
@Chrystal
Get a medical release from your doctor and then go somewhere else for a second opinion. If you have been cleared from this medication usage, then you should not have any issues with proper documentation in hand with a new CME.
Who does the skill performance evaluation the CME? I was born with a hand missing there are NE restrictions on my class d licence I can drive a manual transmission car and want to get my class a will that be difficult or do I just pass a test? And I have worked my entire life no liability I can do pretty much anything anyone else can do.
@James
You want to check with your local drivers license department to see who they recognize as a SPE doctor. That way you get it right the first time. The CME does not do this test.
Hello and thank you so much for any help you can give me. My name is Brandon and i have mild ADHD. I am prescribed 20mg of Adderall twice daily. I am about to go to a company sponsored CDL training and i am very concerned on whether i will be cleared by the medical examiner. I am planning on taking a letter from my family doctor who has been my doctor for the last 6 years. He says it will in no way impair my driving. My concern is if i am not cleared by the companies medical examiner i will have to pay back 7000 dollars that i do not have. The information online is very vague and unhelpful. I leave in a week and any information would be a great help at this point. If necessary i am willing to discontinue the medicine. What is the best way to move forward? I want to drive over the road more than anything!
@Brandon
A medical release form and a brief explanation by your primary doctor should be all that is needed at this point. Have all of this in hand before you show up for the examination.
Get medical release form from DOT website. Currently taking same medication no problem. Good Luke