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.
NOW THE RULES AND REG HAVE CHANGED, I’M HAVING PROBLEMS GETTING RE CERTIFIED FOR A DOT PHYSICAL. THE DOCTOR I HAVE SEEN IN THE PAST FOR THE PHYSICAL IS NOT A CERTIFIED DOT DOC. SO I HAD TO USE A DOC. THAT DOE’S NOT KNOW ME OR MY MEDICAL HISTORY. I HAVE GONE THROUGH THE MVA MEDICAL ADVISORY BOARD AFTER HAVING BRAIN SURGERY IN 2000 AND HAVE BEEN ON ANTI-SEIZURE MEDS. FOR THE PAST 15 YRS. NOW THIS IS A PROBLEM. I OWN A TOWING COMPANY AND DO NOT TOW ON THE INSTATES I TOW LOCAL, WITH IN A 25-30 MILE RATIOS AND BEEN IN BUSINESS FOR THE PAST 20YRS. ANY IDEAS THANK JESSE
@Jesse
Start with your local drivers license department.
You should not be trying to pass a class A interstate test. You are in a class which requires a medical certificate, but not a class A certificate.
Each state has specific rules and examination requirements that are different than the class A drivers.
You should not be having any problems, especially since you have been doing this for quite a while. Get a medical release form from your doc and explain to the DOT medical examiner what has been, and what is going on.
Thanks for the Info. I printed my compete history from 2000 to date of everything with doc. names, address,phone #,, dates. I passed everything until he read anti-seizure med. on the back of the dot physical form and also pointed it out. One more thing at the time of the surgery in 2000. i turned in my B -CDL’s down graded to a C license – non CDL. The tow trucks are all under 26,0001lb. We Tow for the State Police ,Baltimore co. and Harford Co. the state police are the only one to ask for a dot medical card. I still have the letter from the Maryland Medical advisory board say to go to the local MVA a get your down graded license.
Is a person disqualified from getting a medical card if he is on fentynal patches for chronic pain?
@John
Start with a medical release form from your doctor explaining the needs and usage of the patches. There are going to be questions, so you may as well start with your doctors explanation.
You are also going to test positive on any drug screen, so you will still need your doctor’s prescription and notes.
I HAD BRAIN SURGERY IN 2000, HAVE BEEN ON DILAN TEN ( ANTI-SEIZURE MEDICATION) FOR THE PAST 15YRS. I OWN AND DRIVE TOW TRUCKS (LOCALLY,NO INTERSTATE) MAINLY FOR THE POLICE DEPARTMENTS.I HAVE DONE ALL I WAS ASKED TO DO. I TURNED IN MY B -CDL’S AND JUST HAVE C LICENSE AFTER THE MEDICAL ADVISORY BOARD HAD COMPLETED ITS REVIEW AND I DID AS THEY ASK OF ME . AND NOW WITH THE NEW REG. MY DOC. IS NOT ON THE LIST AND I’M HAVING A PROBLEM GETTING MY MEDICAL CARD. I’VE BEEN IN BUSINESS SINCE 1995. WHAT SHOULD I DO THANKS
I just had a Heart attack.. can I still work? What are your regulations on this?
@Carter
FMCSA regulations – You will need to be completely healed and released by your doctor, with a medical release in hand, before you can retake your medical examination. Once you pass a new medical examination, then you are good to go.
Why do the psychiatrists do not give the clearance letter to people with mental illness, doctor’s office manager say there has been new policy that they are not required to give clearance letter any more basically its up to the doctors to give you a clearance letter or not. My question is what should a mentally ill person do if he\she do not get the clearance letter from the doctor for his\her CDL license? please explain in plain english.
Thank you. . .
@Ahmad
All of the certified medical examiners, CMEs, are looking for a medical release form for any and all conditions that a driver may have. That request for medical explanation from the primary doctor is only to provide supporting information that the driver is ‘fit for duty’ mentally, physically, and emotionally. That release can come from any of your primary doctors. As far as why your doctor will not provide you with a release is beyond me. I have no explanation and there is no new rule or regulations that point in that direction.
My husband is not getting re-certified for CDL but a lower one, driving a truck for Frito Lay. He has hypertension and reads even higher at the doctors office, he has been on drugs to control the BP for the last 3 1/2 weeks but they are still telling him conflicting information at Nextcare where the DOT exam is being done. They keep saying he has to have THREE “good” readings in office?
@cherryglam
If he is on medication and has been so for over one year, then he must have multiple reading below 140/90. That’s a Fed regulation.
I just received a Temporarily Disqualified status on on physical exam due to being on light duty from a shoulder injury. I must renew my CDL soon. Will I lose my CDL when I renew. How can I get it back?
@Mark
Your state should not revoke your cdl due to a shoulder injury, yet you can not qualify as a fit for duty cdl driver.
Just let the state know what the situation is, and they will have some policy that takes your situation into consideration.
If I’ve been diagnosed with schizophrenia but it’s controlled with medication should I even bother to apply for a DOT card or am I wasting my time?
@Christian
With a properly controlled conditions such as you describe, you can go for the CDL.
There will be lots of questions regarding your condition and how it is being controlled. Make sure you take a completed medical release form from your prescribing doctor. That will answer most of the questions that a CME will have regarding your condition and what your physical, mental and emotional states are.
Ok thank you. My condition is mild and is controlled with medication so as long as I’m on them I’m fine.
My situation too.
I just had my DOT physical. They found sugar in my urine but my blood sugar was under 200. They restricted my license to 3 months (in NC). I know it is high but I thought as long as it was under 200 I could get a normal 1 year license. Does this sound correct to you?
@Robert
No matter what level your blood sugar is you cannot have sugar in your urine.
The CME is giving you 3 months to get your sugar under control, you could have been disqualified on the spot.
Get it under control, go back and have a clean urine sample and they will take you to a one year card.
Hi there
I have. been a class b driver for 14 years now just doing inner city driving for a sanitary district…I have been currently seeing a councilor for marriage counseling where she basically diagnosed me with PTSD…she is private practice and has not put this in my transcript…I would like to look into medicating but don’t want to open up a can of worms???? What do you think???
@Adam
Check with your doctor. If they feel that the meds will be of help, then check it out. You may need a bit of time off to see how the medication effects you and you will need a medical release form completed by the prescribing doctor for your DOT medical certification examination.
Do you think if I get officially diagnosed PTSD it will cause me problems with keeping my california Comercial drivers license? And when you say a bit of time how much is a bit?
@Adam
On average about 90 days on the meds before you know what effects they will have on you.
The diagnosis will need to have a medical release form with it and the use of the medications.
After cardiac bypass surgery, what information is needed to take with you for a new DOT medical exam. There seems to be some confusion about whether a stress test is needed now or later. One doctor is saying it is not needed until 5 years after the surgery but her associate is saying one is needed now. Both doctors are in the same office & both are certified to do DOT exams. What info is required at DOT exam?
@Judy
FMCSA is requesting a stress test every two years, once fully healed. There is a 3 month wait following the surgery.
I was on proxac for a few yrs for ocd but have been taken off of it by my dr. Since I’m no longer taking it will i have to disclose this info? Also will I need the forms filled out by my prescribing dr?
@Rob
If you have been taken off the medications and the condition is under control, then you want to tell the CME that that is the case. He may request a note from your primary prescribing doctor stating that you have been taken off the medication. So you could do that in advance of the DOT examination.
I just got the opinion letter signed by my doctor in regards to BP pills which makes my BP completely normal, and another opinion letter about diabetes. I take pills right now for my diabetes and it makes my glucose completely normal. This is my 1st time getting a DOT physical card will I be limited to 1 year or should I qualify for a 2 year?
@Bryan
Your medical card will be limited to one year as long as you are taking medications. The DOT and FMCSA want to keep a close monitor on anyone taking medication such as yours.
My ejection fraction is at 40%. Will I have a problem with my physcial????
@allen
Make sure you have a medical release form completed by your doctor, with a copy of you last test results. You should be good to go from there.
I had stoke 5 years ago, I gave up my class A cdl when it was up for renewal 2 years ago and have my regular DL.
I am still in the business and still cable of driving a semi, but I only have use of one arm. would I be able to get my CDL back if a doctor passed me physically able?
bob
@ bob
With your present limitations you would need a medical release form from your doctor and the DOT examiner is going to want a SPE (skills performance examination). Otherwise you would not be granted a class A medical card or license.
I started treatment for adhd/ depression earlier this year. I take vyvanse in the a.m. along with wellbutrin and adderall in the afternoons. Currently I am a relief driver cdl a tractor trailer and 24ft box trucks, but I started out OTR truckload.My original doc thought it was unsafe for me NOT to be on treatment driving etc. I have become a much better driver since starting treatment, however now I am in need of a new medical cert. and want a new job. My original physician is not covered under my insurance so how do I go about being cleared as an eligible driver on medication? intrastate or interstate? thank you
@ebony
Just make sure, before you go for your next DOT exam, that you have your prescribing doctor complete your medical release form for you. That will answer most of the questions that the CME will have about your medications and your present condition.
I was told today by the fmsca by email that it is not there rule that you must take a year off after a stroke.but that is what is in their guide line book for drs. to use .I had a letter from my nurologst but dot dr would not even look at it.this should not be the case . how would you fight this?.
@Mark
Then go to another facility and ask them about your situation. The first doctor has you flagged in some way and apparently is not going to change his mind. So go somewhere else and ask them.
I damn near passed my physical and they asked me why I was on Coumadin. I had a stroke in November and as of last week I failed my physical cause of comadin. I got a doctors appointment in 1 week and hope I get better results . Mike
@Mike
You are not being held for the use of a properly prescribed medication. You are being held due to the fact that you had a stroke. That waiting period, depending on what type of stroke you had, can vary from 1 to 5 years before returning to work as a driver of a commercial motor vehicle.
I also had a mild stroke in nov2014 after being out on disability for hip replacement surgery in sept 2014. Now at the end of my 6 month disability. Went for dot phys and nurilogist cleared me for work but dot doc says guidelines tell him 1 year wait. So what do I do for 7 months now ? Unemployment with a $2400 cobra!!! O try for disability n Medicare ? I live in n. J. Thanks Charlie
@Charlie
Depending on where the stroke was, it could be an even longer wait period.
You may be able to do intra-state only. At least you could work. Check with your state Drivers License Department to make the final determination.
In Ohio What would be the waiting period and criteria to return to interstate commercial driving for a 34 year old male diagnosed with A-Fib with RVR, neurocardiogenic syncope, status post cardiac pacemaker procedure ?
@Mom
Once fully healed and with the primary doctors completion of a medical release form, he should be able to return to work. Once he completely medically fit to safely operate a commercial motor vehicle. This may require a stress test before he tries to return to work.
Someone told me Neurocardiogenic syncope is an automatic disqualified in Ohio even with pacemaker- do you know if this is true?
@Mom
Don’t know about your home state. But, according to the FMCSA, you would get a one year medical certificate. Just make sure your medical release form is completed by your primary before you go for your DOT examination.
I just had heart surgery to stop Afib. I was told by my surgen I was fit to return to work. I had to go get a return phyical at some place our company uses and they said I had to wait a month. It was NOT open heart or in my vein type surgery. I cant find a thing about having to wait a month to return to work.
@Pete
Not sure what type of surgery you had, so I am limited in the response. If you had a pace maker installed, then there is a one month waiting period. Other wise more information is needed.
Hello, I’m a 38yo male with a pacemaker and a mitral valve replacement as a result of childhood rheumatic fever. I’m currently taking Bystolic and Coumadin. I asked my cardioligist if this would affect me being able to obtain my class A and drive interstate, but he wasn’t sure. Would any of this prevent me from truck driving?
@Shannon
Until you are very stable on the medications that you are taking right now, you will have trouble passing the DOT medical examination.
Once stable on the meds and your doctor is willing to state that he feels very comfortable with your medications and your condition, then have him complete your medical release form for you to take to the DOT examiner. That will answer most of the questions that the CME will have. Good Luck
I have a pacemaker/difribulator implant. Can I get a dot medical card?
@Mark
The defibrillator will be a dis-qualifier for interstate driving of a class A driver.
You may be alright with an intra-state only license. Just check with your state DLD and see what they have to say.
@Mark
The defibrillator will be a dis-qualifier for interstate driving of a class A driver.
You may be alright with an intra-state only license. Just check with your state DLD and see what they have to say.