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 have a-fib and take valsartan and metoprolol. What if any restrictions are there for intrastate drivers of commercial vehicles.
@ David
Your medications are going to cause questions and will need supporting documentation for the DOT examiner to move forward. Make sure you have a medical release form from your doctors and from your prescribing doctors explaining your need and usage so the examiner can make an informed decision.
My doctor prescribed Methocarbamol daily and said it should be O K to drive on if taken two hours before I drive. He also prescribed Meloxicam for times I am off duty. He is treating inflammation in my neck and shoulder. I’m confused! Everything I have read says Metocarbamol is a big no,no? He felt that Meloxicam is more worrisome and may have more side effects. From what I read Meloxicam is acceptable and Metocarbol is not. Can I use either one of these medications and would they show up as a banned substance in a urine sample?
Thanks, Jay
@ Jay
If you are being treated with these medications and suffering from neck and shoulder pain, then you are not qualified to drive at the moment. Both of these medications are red flags for a DOT examiner, so be prepared to answer questions and provide supporting documentation.
Okay I have been driving for 5 years now. I was diagnosed with ADD and bi polar disorder when I was in my early teens. I took meds for a short time durning that time. Then stopped taking them I recently went back to the doc and he confirmed again the diagnoses of bi polar and put me on Lithium. I have contuined to drive a truck since being diagnosed and on tretmant and have no ill effects. I am gonna be switching company’s here shortly and will have to take another physical. My question is will my being bi polar and the fact I am on Lithium disqualify me from get my medical card cause I have been driving for 5 years now and havent had any issues
@ Steve
Just make sure you take a medical release form from your prescribing physician along with his explanation regarding your overall situation. You should be fine, but there will be questions and a need for supporting documentation.
Would I have to notify the recruiter if I have very mild psoriasis?
I’m a driver of more than 20 years. Last September I had a stroke (CVC). I have made, what I feel, is a remarkable recovery over the past year. No risk of seizure. Is it possible for me to regain my Med Cert?
@ Stephen
It requires a one year waiting period and then medical release forms from your doctors, but it is ppossible
My husband was just diagnosed with cirrhosis of the liver. Will this affect him getting his CDL renewed.
@ Kathy S
It will require a medical release form from your doctor and the examiner may ask for more supporting documentation before making his final decision.
From Idaho – Last year I only got recertified for 1 year as my blood pressure was 137/89. – (White coat syndrome & waited 2 hours to see the dr.. I was ticked)
Just went to get recertified and again blood pressure was 140/82. I see my Dr. regularly and we’ve discussed this issue as I DO NOT have high blood pressure ever at her office. I usually run 117/82-84. Dr. told me I have to come back 3 months and if its not lower at his office, I will not be certified any longer. No options.. Is this correct??
We do tend to get a bit excited when going to drs office, since about 1995ish every dot doc is an ALARMIST to the extreme, see, I know and trust what you’re saying. Really do.
I was on a hiatus in 2012 and 13, I had my 30 yrs and millions logged, I wasn’t thinking and hadn’t kept up with all the SISSY ARSE RULE CHANGES in ref to physicals and CDL in my pocket. In 2014 I strolled into a license agency to renew my classA CDL and this examiner, we’ve ( my family) seen for years, asked for my medical card, I told her it lapsed and unless a good local job opens, I’m partially retired. She didn’t say hey, go get your medical, no, she kept and downgraded me to operator. Strange stuff,
Good luck driver
@ busdriver 50
No. But he may be looking for an improvement placing you below 140/90, which is a FMCSA reg.
My husband is starting radiation and chemotherapy for his cancer diagnosis. He’ll be undergoing this treatment for 6 weeks. His dot med. certificate expires end of August. He doesn’t want to lose his class A license because of a delay in getting his certificate renewed. If he gets his med. certificate renewed at a later date, how will that affect his license?
@ Aubrey B
You will want to talk with your states drivers license department for your best answer.