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 had my prostate removed due to cancer 4 weeks ago and I need to take a dot medical exam before returning to work in 3 weeks. I am now incontinent and can not give a on demand urine sample at my exam. It all leaks out on its own and I cant fill my Blatter full enough to give a sample. Also will incontinence disqualify me from driving? I ware a depend and it controls leakage just fine.
@ Kim
Don’t try to take the DOT medical certification examination until you are fully released, without restrictions, from your doctor care. The DOT examination does require a very small amount of urine to check for blood, protein and sugar, so a very small amount is all that is necessary. The situation does not disqualify you.
Contact a medical supply store for something called a Texas Catheter. It is a rubber-like condom that has a plastic connection on the end to hook up to a drain bag. You can also find a special drain bag at the same place to connect to the condom catheter that has straps to hold it on your leg, under clothing, not noticeable. The drain bag has a petcock opening in the bottom so that you can fill the sample jar from the drain bag. Google ‘Texas Catheter kit’ for pictures and suppliers.
I have bipolar II disorder and take Geodon and Welbutrion to control it. I want to drive, but the examiner at the location the CDL school sent me to seemed confused about my circumstance and after he researched online denied me because of the Geodon. My psychiatrist didn’t see a problem with me driving on the medication when I brought it up. Could this be something my psychiatrist or primary care could sign off on and be re-examined?
@ C. R
The medications are not a disqualifier for a medical card. What’s required of you is to provide recent medical documentation from your prescribing doctors. Have a medical release form from your prescribing doctor too.
Hello I had brain tumor removal surgery in August 2017. I got my recertification last July. However, I have recently started at a new job. Went to the medical center for my newest medical card. Now the examiner is saying that she cant give me a medical card until 2 years post surgery. Never had any seizures, no medications and have been in remission since last April (2018). My oncologist and primary doctor has signed off. What gives?
@ Daniel
FMCSA guidelines recommend a 2 year wait following your surgery. With proper documentation and additional information from your doctors, the CME could reduce the wait from 2 to 1 year.
I took a dot physical for my union job and was told because I didn’t include I was taking Suboxone it was a automatic fail. I do go to a doc and I’m on a very low dose because I’ve been weening down. The drug has really changed my life and now they say I need a doc note saying I’m completely off this medication. I got a taper plan from my doc to come off but it’s much quicker do to me not working. I have mortgage and bills. The examiner did say me not listing it on my dot form was the major violation not necessarily Suboxone. I gave them note showing 2 week taper plan from my doc with my current dose but even that she said may not be good and couldn’t give me clear info how to resolve this. My boss also said he received email saying not only did I fail but i was a danger behind the wheel which he announced in front of all my coworkers. I thought some of this stuff was confidential. Anyway I would appreciate any help figuring out what I need to do next.
@ Steve
The CME needs to know why your on the medication, his job is to look for any possible risk factors for both you and the public at large. Check with your companies human resources department regarding the confidentiality issue, your boss is out of line.
How did the Dr find out you were on suboxone if you didn’t list it ?
I am a disabled veteran I am currently taking two medications, 1st is Bupropion HCL 150mg for depression and the 2nd is Divaprolex 500mg for mood swings, I have been on these medications for over three years and have had no side effects and neither cause drowsiness for me. If my VA doc fills out the paper work and gives me the head nod do you think I will be able to obtain my CDL A or is this going to be a disqualifier? Thank you for any input.
@ Ricky A
With proper medical documentation and a signed medical release form from the VA, you may be OK. As long as there are no other limiting factors.
I had a kidney transplant in Sept 2016 and have a letter from my doctor stating that I had a successful Kidney transplant and I can return to full duty immediately with no restrictions.
On my current long form medical certificate, certified by a FMCSA medical examiner, it is written that I, “Meet standards, but periodic monitoring required for Other – Renal Transplant *can not drive within 12 hours of taking insulin for steroid induced hyperglycemia”. My medication and medical history is fully documented on my long form.
It is now April 2019 and I recently obtained my CDL class A. I was about to be hired by a company until my medical information was reviewed by the company, at which point they dismissed me as a candidate because “I had a kidney transplant”.
Q: My dream job is in this industry but am I not able to drive because I had a kidney transplant in 2016? Maybe it has to do with my medication? Please explain what the issue is, and how long until I can work as a driver.
@ CD C
Sounds like a company policy and not a medical disqualification via FMCSA. The situation and condition are going to raise questions with the CME and will need supporting medical documentation, be prepared.
I have A fib with a icd trying to drive intrastate will that effect me getting my medical card, I have medical release from okaying me to operate a cmv
@ Brandon
Since you are going to be driving intrastate only, you fall under your states variances. Check with your local drivers license department regarding your medical card requirements.
I’m a school bus driver in the state of Michigan and am having heart valve replacement surgery soon. Will I be able to retain my cdl and pass a dot physical.
@ P. B
Once fully recovered, you should be fine.
Hello! I just bought a CPAP machine because the doctor/DOT said I have to. How can I obtain a one year card. I am just trying to start CDL school. I have a 3 month card only right now.
@ Lakesia
Just before the end of your three months. get a reading off your CPAP machine showing a 70% compliance and you should be good to go.