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 been a truck driver 2 years before the start of the cdl program i have been the same size for the last 15 years last week went in to the same Dr. i went to last year he knew my size and medical history told me last year bring paper from My DR. did what he said i went in he took my $100 he ran me through the exam then he hit me neck size and over weight then here it comes the sleep Apnea study i cant afford to go through the study and dont want to be a gov lab rat i think we are being scam looks like my career is over
@ dave
Go elsewhere and get a second opinion. Neck size and bmi are not part of DOT/FMCSA requirements, they may be a small indicator of issues, but not requirements.
I have been in recovery for 2 years in a methadone maintenance program and am currently going through a slow taper to detox out. I just got a job offer where I have to take a dot physical. I’m not required to get a cdl as I will just be driving a cmv basically like a uhaul. Does methadone disqualify me?
@ Wayne
Check with your local drivers license department before going for the medical card. Most CME’s are doing examinations for class A drivers and you would not pass the requirements. But, your state variances may allow you to get a medical card. Find an examiner that understands the difference between class A, federal, and state variances.
I have a class A cdl but I drive a pickup truck for work everyday, is there a form so I don’t have to take physical for medical card? Or do I need to just get class D license?
@ Jeff
Most states require a valid medical card to maintain a class A license. There is no form, unless it is from the state drivers license department. Check with your state first.
I am taking Lamictal and Amitriptyln. I needed a Letter of Clearance from my doctor for the medical examiner for the company. My doctor gave clearnance to drive. I submitted to my doctor and it wasn’t good enough. He told me exactly what needs to be in the letter and a list what needs to be answered for the clearance to drive. Again, gave it to my doctor and she did as requested what the medical examiner asking for. It still wasn’t good enough for the medical examiner. The medical examiner keeps changing changing what’s he’s requesting. This is the third time I have submitted what he has requested AGAIN for letter of clearance STILL wasn’t good enough.The first time when he reviewed the letter he said exactly, “I need your doctor to give clearance to drive a commercial vehicle. My doctor forfilled his request. STILL not good enough. He wants more medical terminology in the letter for clearance to drive when received the frist letter almost 3 months ago and did not tell this additional information. I been waiting for almost three months to work at this company. My doctor has delivered on his demands and depleted all the questions answered. She cannot do anymore for me. I feel discrimnated against when I am completely competent of obtaining a CDL. Can I apply to other trucking companies or will this issue be on my record for DOT. I have my clearance from my doctor.
@ Chris O’T
Get a second opinion from another examiner. You have the right to obtain a second opinion anytime you feel the examiner is being unfair or unreasonable.
If i take abilify 400mg can a doctor at ugent care sign off on my dot physical saying im ok to drive
@ Earl
The CME is going to question the medication and its reasons for use. Most likely the examiner is going to want a medical release form from the prescribing doctor.
I have a question, my medical examiner didn’t give me my medical card for my CDL because my DIABETES / SUGAR LEVELS / LIB blood work results came back high and my current medical card expires in 2 day . Would they allow me some time to get on a diet to bring it down to their requirements without loosing my CDL License ?
@ Carlos R
You could check with your examiner and hear what he has to say on an extension, but don’t count on it.
Hello, I drive a semi locally and I was diagnosed with TIA just over a year ago and was told by my company I had to be off a year with no further incidents before I could return to work. The is up and when I went last month for my DOT test the Dr. looked at my release form and diagnosis and said it was a stroke and I would have to wait 5 years. He said the Neurologist had to be trained in the DOT regulations. Is this true and should I get a second opinion. I would think the neurologist knew what he was talking about!
@ Paul P
Your neurologist does know neurology, but may have no idea about the DOT/FMCSA guidelines. Go get a second opinion with your medical release form in hand from your neurologist. If all your test results indicate a good recovery, then the one year wait may be sufficient, it will be up to the CME. Explain that you drive locally, only, and have had no issues.
Hi, you have a great website and it’s sources of information like this that help me learn about DOT physicals. I’m looking for a new psychiatrist to get a second opinion before I take the physical. My former doctor was prescribing me anti psychotic medication. So I have medical records that say I have bipolar or schizophrenia. I’m not exactly sure what they wrote down because I was never told what the illness was I was just given medication. I’m currently waiting for my medical records to be given to me so I can see what they say. So my question is, after I get a new psychiatrist can I get a new diagnosis and a medical release opinion letter that says I am stable without medication? I’m asking because I don’t have any symptoms and I can hold a job fine. But the last time I tried the medication it made me very drowsy and it was hard to make it through the day. I feel much better without the medication and i really don’t want to go back on any.
@ MrNick
New diagnosis, no medications and a medical release form from your new doctor should help the examine CME in his decision making process.