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 very bad anxiety and take medication for it and for ADHD. I personally do not feel comfortable getting my CDL but it is required by my job. Would these stop me from passing my DOT?
@ Michelle
We suspect you are not going for a class A cdl. If that is true, then you fall under the states guidelines and variances, and should not have any issues.
Hi I wanna get my cdl I have a few questions, 1. I have a lung disease called cystic fibrosis, I use nebulizer medication and do a vest therapy to loosen mucus from my lungs twice a day. 2. I am diabetic my last a1c number was 6.6 back on 12/14/2021. 3. I’ve had 2 surgeries last year first I had part of my thyroid removed and second I had my gall bladder removed so far dont seem to have any issues from either. For my cystic fibrosis I have a neb machine and a machine I use with a vest that pumps air in 1st if these wont be an issue would I be able to use those? And second are any of these issues gonna disqualify me from getting a dot card and a cdl?
@ Kim B.
Highly unlikely to pass a class A medical examination and you are going to have to provide medical documentation. If you are going for a lesser class cdl, you will fall under the states regulations and variances. It will be much easier, because it is not Federal DOT/FMCSA.
I have a defibrillator put in 2016 i have no problem with it its 2022 now i go see my heart doctor every year everything good can i go back as a over the road truck driver.Thank You
@ Terry
According to DOT/FMCSA for a class A OTR interstate driver, No. You may be able to drive intra-state if your state allows it.
Hey there,
hope to get some help.
So i went to have my physical yesterday and today, I had abnormally high blood pressure while I was there. when I went yesterday I saw my pcp first and I was 129/83 all is well and I go to the physical and I was at 170/90. figured it was because i had some coffee in the morning and it wasnt long before I had my physical. We tried having me rest for 20 min and etc but was still high. So I tried again this morning, didnt have coffee or eat anything went to the docs office, theyhad me waiting for about 1.5 hrs, I go and take the exam again and pressure is back at 170/100 now. waited a few min and re took it and it went to 156/60. tried waiting again and it was aroubd the same. So whats frustrating is that my BP is just abnormally high at this office, maybe i have white coat syndrome but seems to only happen here, i dont have this issue at other doctors offices. I got a letter from my PCP stating I was medically clear to have the DOT phyiscal done and I got a print out of all my conditions and any meds I took which was just flonase and was prescribed lunesta which i dont take anymore along with all my vitals within the last 3 years, all show me to be under 140/90 and I have the resding form a few days ago showing the 129/83 as well. would this be sufficient for the doctor to accept ?
i have mild sleep apnea which my dr said should be controlled with weight loss and no cpap needed at this time ( i have a letter from my ent )
thank you and hope ill be ok
@ Joe F
First question would be, are they taking your blood pressure with a stethoscope and blood pressure cuff or an automatic bp reader? If they are using a reader, are they using the proper cuff size for your body? Also, if they are using a reader, ask if they can take it old school. The letters should be helpful, but it is up to the CME to make that judgement call.
Hi,
I am 27 and want to get my CDL. When I was 7 years old I had brain surgery for an arachnoid cyst because it caused migraines/headaches. They placed in a shunt. The shunt is not functioning anymore, they said it’s harmless plastic basically and it doesn’t need to be removed. I haven’t had any symptoms since before the surgery. After the surgery, once a year I had to get a CT scan. I think I was 16 when the neurosurgeon said I didn’t need to have anymore scheduled CT scans unless I had any issues. I haven’t had any issues since. No severe headaches or migraines.
I am wondering if an arachnoid brain cyst/surgery with shunt would cause an issue getting a cdl DOT physical. Should I get a cdl dot physical before starting a cdl school. thanks for any info – chris.
@ Christopher
Get the physical before starting school. You should not have any issues, but the examiner may request additional documentation from your doctors.
I was on a 10 mg nlood pressure pill for 30 days that my doctor wanted me to try. I have not taken the pill anymore after 30 days as my blood pressure went to low with it. Its been 5 montgs since sll of that. Can i still get a 2 year card or am i gonna be stuck with a 2 year card ?
@ Randall w
Get documentation and a medical release from your prescribing doctor. If you are no longer on the bp meds and your doctor supports the information with documentation, you should be fine for a two year.
Hello,
I take sertraline for depression. Would this disqualify me to get my CDL class A?
Thanks
@ Kristy McC
Your examiner is going to request additional information/documentation from your prescribing doctors. You will need a medical release form and supporting documentation from your doctors and you should be OK if all else is normal.
I went to citymd for my DOT and my status is pending. But when I went to check in the FMCSA registry his name is not on it. Is the dot physical still valid? I logged in to my citymd site, and not much is in my medical records. I come to discover that a Staci (physician assistant) is registered with FMCSA to perform dot physicals. Shouldn’t she have been the one to perform the physical?
So again, is the DOT physical still valid from a dr. who is not registered with FMCSA? and will it show up in the records? if I decide to go with a DOT registered cme will that be considered “shopping around”?
Thanks!
@ Pedro J
The signature on your medical card must be by a FMCSA registered CME. If not, then it’s invalid. Getting a second opinion is not doc shopping.