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 work for an ambulance service. I had a black out spell in September of this year. I went to see a neurologist and he stated that all of my tests come back completely normal. He told me that I’m not allowed to drive for 6 months though because of the one time episode. I am just wanting to know if this is true or not? My job does not require me to have a CDL, my regular drivers license is all that is required for my job. So, am I allowed to drive the ambulance or not?
@Trisha
It’s not the cdl that is in question with you, it’s the medical certificate.
As a class A driver running interstate you would be disqualified to drive.
As a class D/standard drivers license, you fall under the states rules and regulations. Check with your local drivers license department to make the final decision.
1)I was advised earlier this year I have an A1C of 6.1. I was given metformin as preventative measures and to help lose weight. I stopped them about 1 1/2 months later. Will I need a dr release form?
2)I have a thumb (right hand and I’m right handed) that cannot bend all the way, only slightly. It has been this way from birth.I have never had any problems performing any tasks. Will this disqualify me? Do I need a release letter?
3)I had asthma since age 4/5, and used to have many issues as a child. I had a nebulizer machine and inhalers. I have not had any issues with it in the last few years, nor do I have any current meds. Will I need a release form?
4)I have only been seeing my current dr since February this year. Last dr was about 2 years or so prior. Will the release form (if needed) be creditable/valuable from the current dr?
5)Does the examiner need to be advised if you have HSV1 or 2 and take med’s (rarely) for it? Do I need a release form?
Thanks in advance!
@ very concerned
1. Yes.
2. No, as long as you have a good grip and grasp you should be fine.
3. Medical release form would put the CME’s mind at rest and have an emergency inhaler as a backup, just in case.
4. Should be OK if the new doctor is functioning off of your older doctors records. If not working off old records, make sure he has a working knowledge of your physical condition and get him a job description for a driver. (check FMCSA for that)
5. Should not be an issue, but a medical release would not hurt.
I have recently went and passed my DOT physical examination and obtained my 1 year card for a pr employment opportunity. On my paper work I put that I take Tyenol 3 and Lysinpril. They sent out my drug test and it came back positive for codeine. The medical Examiner called me up and asked if I had a prescription for this drug and I told him that I did. He asked for me to have my DR fax over a paper for the prescription on what it is etc. I usually only take this is in the evening and doesn’t require e me to take it all the time. I have already started my training with the company prior to this drug test other than the actual driving part. Will this now stop me from getting this job or should the documentation from my Dr be enough? Im worried that Examiner is going to hold me back from driving for this company.
@Cory
Should not be a problem as long as you can support the medication use with a properly prescribed RX. You could also have your doctor complete a medical release form for you explaining the medications usage and dosage.
Question.
I had a brain surgury 10 months ago i have not gotten any seizures i have no issues what so ever. My dot was denied right after surgery when my dot expired. Would i be able to get a dot after almost a year?
@ Oliver J
Make sure you bring supporting medical documentation, along with a medical release form from your doctors, before going for the DOT medical examination.
Iw as just diagnosed with hemiplegic migraines which have caused some sensory deficits on the right side of my body. I have loss of strength and cant tell hot/ cold or sharp/ dull and other issues. Nuero doesnt see anything at this time that will prevent me from hopefully making a full recovery but if I dont I am worried I wont be able to work for my company anymore becasue we are regulated by the DOT but we dont use CDL unless we are over the road drivers. Any help would be greatly appreciated. Also i had tremors during this episode that would last 30 minutes and leave me stroke like. When the migraine is beginning I have been losing strength on the right side.
@Christopher
You will need to be examined by an examiner that understands your states variances. You could be OK, but it falls under the states regulations, not FMCSA.
Hi my name is Jimmie,
I moved from Colorado to Kansas a little over 1 year ago and had a doctor that I saw for everything I needed her for. I find myself here in Wichita Kansas and had to have a referral to a pain clinic concerning my ongoing pain I have in my back and shoulders. I recently got a job driving a bus on a contingency basis providing I can pass all the CDL training they are offering. I explain to them the only problem I will have here that I did not have in Colorado is the little PA from the pain clinic will probably not fill the form out for me.
I have taken Percocet 10/325 and a muscle relaxer for years. Of course I would not take the short acting meds at all except for after my day ends and only 6 hours before. I can certainly see the risk in taking these kinds of medicines but I am tolerant to them and they do not impair my judgment as they do some people.
This is going to be my livelihood as I have a hard time with other kinds of work. I am disabled and on Social security disability income but recently gat a letter from them stating I can test my ability to work. Driving does not bother me like other kinds of work. Any suggestions would be appreciated.
Thanks
@Jimmie
Get a medical release from your original doctor explaining your medications and their needs. That should help the CME make an informed decision. Also check and see if your driving is going to be over the road or intra-state only. Intra-state only falls under state variances and not FMCSA/OTR driving.
Hi, I’m only intra-state in Washington. What are the prescription meds restrictions for a school bus driver. I’m having trouble securing my medical card do to meds I’ve been on for years. I’ve also been driving for 31 years for the same company.
Thank you
@Judith
If you have always cleared in the past, then you need to explain to the examiner that you drive intra-state only and that you fall under the states variances and not FMCSA interstate rules.
I’ve had controlled lupus for 14 years and I take medication everyday I’m on hydroxycloroquine twice a day that doesn’t cause drowsiness and I’m on 10-325 hydrocodon as needed for lupus pain I don’t have to take it every day and it doesn’t cause drowsiness or blurred vision or anything like that with the stop me from getting my CDL?
@Estrella
The medications are going to cause questions.
The CME doing the medical examination is going to need supporting documentation from your prescribing doctor. Have the prescribing doctor explain the length of time that you’ve been on this medication, and what if any side effects you’ve experienced.
It’s still up to the CME to make the final determination.
My husband had 3 strokes on 09/06/2016, has fully recovered but we are both worried about his CDL. He’s been cleared from his PCP, NEURO, and CARDIO to return to work full duty.
With their clearances is there still a possibility he wouldn’t be cleared with a DOT physical?
Thanks,
Julie
@Julie
Minimum of a one year wait to be cleared for an interstate medical card.
Check with your local drivers license department about their requirements for intrastate.
I have Trigeminal nerve damage since 1980. The pain never ends… I take four Norco and two oxycontin daily to control the pain so I can have a life and work. I’ve been own these meds for about ten years now. I have never mentioned it on my DOT forms, I’m afraid to open up a major can of worms now and lose my job.
Has anyone out there been approved for a DOT cert on these meds? I have a non CDL driving job but I do need a DOT physical each year. (i’m on blood pressure meds) I’m thinking just keep my mouth shut and keep going as is and hope I never get asked for a drug test urine.
Does anyone know a DOT Doctor on Long Island, NY that would give me a DOT cert with these meds if I get the proper forms from my neurologist?
Fast acting narcotics are OK Aa long as you take it after work or 6 hours before your shift . time release is not allowed at all. It’s better to be honest then get caught for falsifying. Good luck wish there were more research done on how safe these are with people who are tolerant
Thanks for your reply Bella. I’m really getting conflicting answers for this question. I read a lot that if I just get a letter from my Dr stating that I am under his care and that I have no serious side effects from the meds that I will be ok.
Now you say that the time released meds (oxycontin) is no good. This is the first I’m hearing of this. I wish the Dr would give his opinion. I get 5 norco a day, most days I only need 4. If I say I only take it after work that may be a red flag. I seriously don’t know what to do.