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 torn rotter cuff , should I not consider driving a 18 wheeler cause steering might become painful , the doctor did not do any thing to it , just stuck his scope in my shoulder & looked around ,& told me it looked like a mess ,& 3 of 4 tendons are torn , another doctor said that he would like to bring two ends of the muscle together by sewing a piece of human skin between the ends ,do you think I should not consider getting my CDL license after all ,abandon the idea of becoming a truck driver.
@ Dale F.
At present you can not fulfil the duties of a commercial motor vehicle operator. Once shoulder repair is completed and fully recovered, without restrictions, then you may continue your journey.
If I have Nephrotic syndrome that is being treated with rituximab once every four months, would that disqualify me from getting my DOT Medical card. I could bring all the necessary paperwork from my doctor. Don’t need the CDL for my new job, but want to make sure I will qualify
@ Robert
Make sure you bring supporting medical documentation from your physicians, the CME will need it in his decision making process.
My husband has been refereed for a sleep study by a CME because his BMI is 39 and his neck is 18 inch. He had to get the referral from his primary physician and his primary physician said he does not need a sleep study. So now how does my husband get his DOT card for longer than 3 monyhs?
Question.so i had my physical dine a couple days ago.i had put my medications down on the form (narco.for chronic pain in my leg dur to having metal rod and pins in leg.and my ambians do to hard falling asleep at night..i had ti take a driver medication form to my primary doctor to fill out.he did n i go back soon to turn the paper in ..will i be denied my medical card.
@ Jason
For a class A, interstate driver, you are not going to qualify. As a lower classed license holder, you would fall under the states variances. You may try intra-state only cdl.
What’s up doc! It will be 1yr in about two months that I had a loss of concisness at work.im a class a driver here in california.i started seeing a neurologist as soon as the episode happened! And what it was exactly is unclear.i had an eeg it was clean of seizure activity.i had never had a seizure in my life nor in my 20 yr career as a professional driver.my doctor had put me on a mild presription.the dmv had sent a letter to me saying I’m no longer on medical probation! When I called the dmv they told me I may never get back my cdl.how can I fight the dmv on this!or am I missing something
@ James
If you were to have a valid DOT medical certification examination card, in hand, then you should be able to get your cdl back. Check with your local drivers license department for more details.
I have narcolepsy without cataplexy and have been treating for the last 7 months. No accidents or even history of problems behind the wheel even before being diagnosed. I’m being told I can’t obtain a DOT card for CDL with S endorsement because of my diagnosis because I’m a “hazard” to other drivers. Why am I able to hold my regular drivers license with no record of driving issues but not able to obtain my CDL? I’m tired of disability telling me I don’t qualify because my symptoms aren’t severe enough yet employers say my diagnosis alone is too severe for employment.
@ Veras
You may have a couple of options. Start with your local drivers license department and ask if you can obtain a cdl with your diagnosis. If yes, then ask if you are restricted to intra-state only or could you drive interstate. Interstate, class A, will be difficult with your diagnosis, but with good medical documentation from your doctors and a medical release form from them you expand your possibilities. Intra-state only cdl falls more under the states variances and not DOT/FMCSA. So you would need to find a CME that understands the differences and knows your states variances.
I drove 33 years grandfathered in pre CDL, Now on permanent disability in 2010. Renewed my CDL in 2015 for 5 years. Now my CDL license shows inactive because of DOT Medical exam not being taken. If on permanent S.S. disability would my disability be denied and stopped if getting a DOT exam? In worst case scenario if I had to resume driving again I wouldn’t have my CDL , is there any options? Thank you
@ old school driver
Best check with your local DLD. As a class A driver, you will not pass a DOT medical certification examination while on permanent dis-ability. Your state DLD should present you with the other options.
Hi. My question is a bit off the topic here, however, I’d appreciate any feedback!!
My boyfriend Joe is required to get this letter from his doctor, listing all of the medications he is prescribed. (No biggie, we all understand the reasonings behind that)
Yet, when he handed it in to administration, she called him back, claiming the letter was “no good” as it was missing “certain words/verbiage”.
The issue we have with this is, now the document is late and has to pay an additional $50 fee. Not to mention the time it’s going to take to get to the doc office r which is NOT CLOSE. He goes to school 6 nights a week and has a full time day job. C’mon you all know the gig! Lol
Isn’t it the employers responsibility to get in touch with the doctor office?? Or at least waive the fee, considering she didn’t bother to mention anything about these words that needed to be in the letter???
Lastly, I’m shocked a psychiatry office, that’s been in business 39 years, doesn’t have particular templates/documents etc. approved by HIPPA, ODC, Medical board etc…
Seems so unprofessional! Also, she said to him on his way out “you have to pay cash directly to me” ALTHOUGH HE ALREADY PAID THE PROPER AUTHORITIES
Also, pardon my ignorance. I work in computer software, and all of this is so new to me!!!!
Thoughts, comments???
Thanks everyone!!
Hello. I have a non painful inguinal hernia. Will this prevent me from passing my DOT medical test? I’ll be sure to have my primary doctor sign off on it. I’ll be driving a cargo van for a expeditor. Thank you.
@ Matt
As long as you have your PCP sing off with a medical release and you are able to perform the duties of a cmv operator, with out restrictions, you should be OK.
I’ve been drive the last 5yrs with a one year medical card this year the doctor disqualified me because I’m on dialysis I don’t drive over the road I’m a city drive how can I get my medical card back
@ Walker05
You need to have your medical card exam done by a CME that understands the difference between a class A interstate driver and a intrastate only driver. FMCSA guidelines and your states driver variances are different state to state, so check your states information from the drivers license department.
What if your come and primary dr are in the same building? Can the come and your primary care exchange information with your concerns and to resolve any issues ? In order pass the dot physical if any issues arises and are taken care. Between the driver and pcp and cme during the time to get resolved if any medical issues are found and to be corrected?