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 just put on a low dosage prescription for high blood pressure . Will getting a one year card jeopardize getting the new job I’m taking the physical for ?
As long as your treated it with a physician you have no problem getting a new job and or physical
I am 73 and diabetic but not taking insulin. I had my physical exam done at Concentra on Nov. 15th and the Medical examiner gave me this letter (clearance form) to be signed by my doctors at the VA, particularly for my heart and knees. I just did my stress test at the VA and I was given a go signal to go back to work and even provided me with her notes and reports that I could show to DOT medical examiner. I showed the note/report but it was insufficient and told me to have the letter signed by my cardiologist. I have yet to hear from her on the letter.
Re my knees, the medical examiner saw me limping and asked me to bend, squat and touch my toes and passed the test, too. I have bilateral osteoarthritis of knees. I could walk without difficulty and pain. I don’t have a VA specialist for my knee since there was no work to be done). My PCP found no problem that will hinder me from driving a truck.
I have been going to VA for my check-ups and has all my medical records and test results. My problem is my Primary Care Physician is at the VA and wouldn’t sign the DOT letter for my knee because it’s functional work and I should go see another doctor.
Your advice will be greatly appreciated.
If I were to become a living liver donor, would that effect my ability to certify for my CDL and medical card after recovery. I HAVE NO CURRENT MEDICAL CONDITIONS.
I broke my leg and noticed my dot medical card is going to expire before the my leg gets better and reahabilitation of my leg? What can i do i dont want to loose my license or anything. Thank you
I had a very small heart attack in 2000 with minimal damage that does show up on ECG…that resulted in a CABG of the LAD using the Mammary artery to bypass…I am completely symptom free and have been since then…and am on no meds…So, my question is…Can I still qualify for a 2 year DOT medial card?
Hi my name is Bill I’m trying to obtain a physical for commercial driver’s license I take no medications have only one medical condition I am on dialysis I have no restrictions other than going to dialysis 3 days a week is there a way around getting a physical card for somebody on dialysis
@William
You will be restricted to “intrastate only” and with proper documentation from your primary physician you shouldn’t have any problems. You fall under state variances, not FMCSA.
Motor Carrier does not recognize any form of dialysis you are deemed disabled your only option is probably a kidney transplant
No form of dialysis it’s acceptable I’m going through dialysis myself if you get lucky enough to get a physical card you’ll be slipping through the cracks if you’re able to get a kidney transplant that’s probably your best option then he’ll be able to return to work
Hello all,
I slipped on ice in the parking lot 5 and a half years ago. The doctor talked me into removing a minor amount of blood off of the back of my brain. Since that surgery, I have taken no meds, had no issues, and passed fed med card stuff every year(due to my original Dr. Examiners request).
I stopped in last summer, my Dr was busy, so some crazy pants lady examined me, I passed everything as usual, then she read through med history, and went berzerk, shutting down my cert, demanding I get cleared by a neurologist, then telling me I would only be cleared for 3 months at a time!!
Is this true? Also, since it has been over 5 years now(almost 6), and I have had zero issues, do I still need some silly neurological clearance?(when I passed the first four years after the surgery no problem)…
@Uncleared
You may want to go elsewhere, for a second opinion, or go back to your original doctor.
two years a go i went to company paid doctor who looked at my neck and said i need to take apnea test. so i did, as I believe everyone has it to a degree as mine is very slight. now with all the uproar and confusion I have my DOT physical coming up and wondering if I went to another doctor with a good bill of health would I need to still produce proof of cpap usage
@Dennis
If you’re not using a CPAP machine now then you should not have a problem as long as you do not present with any health conditions that may indicate you have sleep apnea. BMI and neck measurements are not to be use as sole indicators for sleep apnea testing.
I take a low dose 1/2 pill of 0.5 Zanex daily for last 20 years. Since I started driving a truck 6 years ago and am on the road for long periods of time my doctor writes my prescription for 2 pills daily so don’t have to come in every month. On my recent med card exam I was told this is inexcusable. What are my options.