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.
so i had an unprovoked siezure 1 year ago today i stepped away from my garbage man job due to it because i didnt know what the future would bring now ive had clean eegs and no siezures prior or since should i be worried about failing my DoT physical now that im trying to go back to my job since i have my PCP clearing me and backing me? i live in illinois and i know some rules vary state to state i just know it is what im good at im 26 and without the job ill lose everything i have
@ Richard G
Just make sure you have a medical release form from your doctor and have him explain that your seizure was unprovoked and any supporting information that the CME may request.
Thank you for all the information. It’s great to find a resource such as this. One question I have which I haven’t found an answer to is: If a CMV driver who holds a current Medical Certificate is prescribed a Schedule IV drug (Phentermine to be specific) are there any steps that must be taken to insure continued compliance?
@ Chris M
The medication will pose questions, so make sure you have a medical release form from your prescribing doctor when you go for your next DOT physical.
I have a question regarding my husband. He had a mild heart attack in 2012, there was zero damage and a stent was placed. He was under a cardiologist’s care for 2 years and released to go be monitored by our GP. 2 years ago when he went in to renew his card, he was surprised with a requirement to take a stress test, which he did and passed. He’s coming up on needing to take one again this year, and we’re wondering if there is any way that we can get a waiver to not to have to go through the expense of this ever again. Who would we contact? He tried calling NDOT who told him to call the Dr who does his exams who told him to call NDOT.
@ Ann W
FMCSA has set the guidelines for this at a new stress test every two years for class A, OTR drivers. You may find out about a waiver by contacting the FMCSA.
If I have a regular prescription from my doctor for oxycodone which is part of my treatment regimen and does not impair me at all does that automatically disqualify me for getting my cdl?
@ Mitch
CDL and medical certificates are two different things. You need a valid medical certificate to maintain a valid class A drivers license. Oxycodone disqualifies you according to the FMCSA.
You can have your doctor sign a release that it does not affect you’re being able to drive. I have been on Oxycodone for 7 years and hold my Class A and FedMed. I have to do a physical every year though.
Had a recent physical to get medical card renewed unfortunately gotnit denied due to a recent questionable TIA in November. 2weeks after this incident went to neurologists as instructed by Dr. she gave me the all clear to return to work as well as Drive with no neurological deficit.
I had taken release form to physical and unfortunately the PA-C would not release me due to diagnosis of TIA on assessment from neurologist. Pa-C advises me that neurologist needed to change diagnosis on assessment to clear me for my renewal which has now expired on 1/15. Mind you I had also gone back to neurologist within the past week to do another assessment on me with no sign of any sort of TIA symptoms. And again wrote a formal letter to the PA-C stating that she has released and cleared me of working and driving without limitations. Unfortunately yet again PA-C would not renew cause of this whole TIA diagnosis previous. I had also gone to see a chiropractor who had diagnosed me with a pinched nerve in my neck/shoulder which would have given me the symptoms of an apparent TIA. I had also given that to the PA-c with no avail as well. Of course this non renewal of my dot medical card has cost me my job because of this. And I don’t feel that waiting a year to be able to try to renew is ludicrous. Any other options? Please help
@ Jas
Get full clarification from the neurologist, did you or did you not have a TIA? If you did then you are held back by the FMCSA guidelines, and the PA-c is correct, and they make the final judgment. The wording of the FMCSA guidelines can be gray in some areas, have them re-read the FMCSA guidelines and see if there is any areas of question.
If you have a pain pump inplanted in your back for pain from a pain dr.does that disqualify you from driving semi.I have my cdl class a already.
@ Rick W
Your situation is going to raise lots of questions. So make sure you bring as much documentation and a medical release form from your doctors to the examining CME. He is going to need as much information as possible to make his final decision.
My husband is trying to obtain a CDL in Ohio he is a veteran with a disability rating for PTSD. He has a letter from his physician that says “no tx needed and “not engaged in an ongoing medications tx.” regarding the PTSD dx. The DOT said that this was not good enough and he would not approve him. What do you recommend
@Nichole
If your husband has any supporting information from his treating physician, then we don’t see a problem. Ask the CME what further information would be required. In some cases the examiner is looking for a release form from the treating psychologist.
My primary care provider is a nurse practitioner. Can he sign a medial release?
I had my left knee replaced 11/01/2017 in Arkansas.
I last saw my doctor on 12/06/2017, he was pleased with my progress.
When I next see him on 01/03/2018, I’m going to try to go back to work.
I’ll have had 30 days of physical therapy, my last day is 12/29/2017.
What form(s) do I need to satisfy my employer in AR., and the state of AR?
My license and medical card are current.