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 am a disabled veteran with a service connected hearing loss. I have been a truck driver for over 30 years and have had no accidents, tickets or any other problems. My current employer for the past 9 years has recently indicated that they don’t feel it is safe for me to drive. this is 9 years after having no tickets, accidents and getting excellent reviews from them. I went to see an ENT who indicated I am ok to drive as long as I wear my hearing aids. The employer still indicates they don’t feel It is safe for me to drive a truck.
@Cruz
This sounds more like company policy.
If you pass the DOT examination with the use of hearing aids, then there is no issue with the federal requirements.
So check with the company as to what policy they are using. Companies are allowed to have stricter requirements than the federal requirements. If it’s company, then you know where you stand.
I have stage 4 renal see a kidney specialist on a regular basis and preparing for dialysis.
I have a class B license in California driving a 18 person transport van for elderly and disabled. No strenuous work about it just pick them up and drop them off at store or day programs.
I was told once I start dialysis I would lose my class b per the dot dr after jumping through hoops for 3 months to get him to approve me for another year when I went it for renewal.
My question that I can not get anyone to clearly answer is when I go on dialysis do I lose my class b or can I still drive for a living?
@Jeremiah
This is a state related question. If you have an intra-state only license and the state of CA says you can operate the bus and still have dialysis then you are good to go.
Check with California driver’s license department to confirm.
I was just denied recertification because it was discovered that I have some osteoporosis in my back. The Dr. who gave me my examination said that in order to be DOT certified, I have to be found able to drive a truck cross-country and load and/or unload any cargo I’m transporting. Is that accurately Interpreting DOT regs? I am employed as a transit bus driver and am not even allowed to help any passenger, who may have fallen, get to their feet. It seems unreasonable to expect me to do more than my current job expects me to do. Thanks for your input!
@Joyce
If you are a class A driver, then the examiner is correct.
But if you are not a class A driver and only operate a transit bus, then he is off base.
Each state has different class driver and different specification for the varying classes. Check with your state DLD and get those specs for your class license and then go get your medical card.
Driver at my company had pacemaker installed on June 17th. Must he wait 3 months before returning to driving?
@Jeff
He has a waiting period of three months and he needs to be fully healed before returning to work.
Make sure he brings a medical release form, filled out by his doctor, to his next medical examination. He will have to have a new medical card before he can return to work, along with a return to work note from his primary doctor.
Recently had a drug test that reported out as negative but since I am taking an amphetamine based medication need a medical note from doctor saying safe to drive. How often will I need to provide this note to my employer – how long is it good for? Thanks!
@Trisha
You will need that note until you are off the meds. But one note, one time, until retested again. The MRO review officer will need to see the prescription each time you are drug tested, until you are off the meds.
Quick question. Went in for a new dot physical and am told I have to go take another sleep test. I have already taken a test 3 years ago and results came back with no sleep apnea. Am i required yet again to go spend more money and take another test? Or are my results still good?
hi I am off work right now due to an illness, my question is if I am on warfarin and I have a heart problem and now possibly a lung problem that I am waiting to here back on should I even try to get back a medical card to drive or based on what’s going on with my health should I just not even try to get it back.
@Joel
Potentially your conditions sound like they may be taking you off the road. The medications are going to cause problems too. So if you have another choice, I would be investigating those options. Best wishes.
I recently went in to have my DOT physical, now I won’t lie I have a wrestler type body. I took a sleep study about a year ago and was told I had mild sleep apnea but not cpap required. when I hand the results to the N.P. I was told that those results are useless and per DOT rules you must have a new sleep study done every year and I could not have temporay card too get it done per DOT rules. lost three weeks of pay dealing with it. is this true you cannot have a card while you are getting a sleep study done?
@Richard
Sounds like it’s time to go somewhere else for your examination. The NP is kinda overstepping boundaries on this one.
Get a note from your MD and have him fill out the medical release form for you.
Then go somewhere else for your examination and take the medical release form to the DOT doctor.
For more information see our blog articles on sleep apnea.