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 a dot about 14 months ago. They put me on warfarin and installed a small filter to “catch” any clots that might go to my heart or lungs. I have had zero issues since. Would any of the above disqualify me from a Class A CDL?
Thanks.
@Todd
More questions than answers. Why are you on warfarin? Why did they install a clot catch?
Without these questions answered, it would become a guessing game to figure out the answer to your question.
Both of these situations will require a medical release form completed by your primary doctor. That will help the CME make his final decision.
Hip surgery on May 9 2014. And I’ve been on lithium and 100 milligrams of seroquel for 7 years..With no problems. .will this affect me getting DOT card ?
@Kathy
Have a medical release form completed by your prescribing doctor explaining your meds usage.
Do that before you go for your examination and it will explain any questions the CME should have. Good Luck.
I went to get my physical renew. for my C D L When the doctor ask what medicine I was taking I told him I was taking Chantix to quite smoking, I was told I couldn’t get my CDL because this is a drug that I can’t take while I am driving a school bus.
I have a pacemaker in upper left chest area, does that make me medically disqualified to drive under dot regulations. I have c d l class b license. I drive school bus only.
@Luster
This is a state-related question. You’ll need to contact your state licensing department to clarify this answer.
I do not believe you will have any problems.
@Betty
For class A drivers traveling interstate, this may be true. If you are less than a class A driver and driving a school bus, then check with your DMV. I do not believe that this medication is on their “no drive” list.
my co-worker had an accident resulting in brain trama he wants his c.d.l back so he can return to work(class a) what tests will he need to pass so he can be reinstated.his problem is his short term memory,he’s getting better every day with his memory
@Steven
This will be tough for a while. He will need to have his neurologist complete a medical release form stating that the driver is physically, mentally and emotionally stable and can be safe behind the wheel of a class A vehicle.
Brain injuries are required to have a stabilizing wait period before returning to operating a commercial motor vehicle. It is do-able, but may require a little more patience to get it done. Good Luck.
My son recently had a stroke. We have progress notes from his cardiologist and the neurologist that say they have released him to go back to work. The company sent him to a dot physician to get another physical even though the one he had was still good. Can he qualify for a medical certificate or is there a waiting period for him to go back to work? We brought all of the records we had to the DOT that said he had been released. From what I am reading a cerficate is different than the medical card that the cdl drivers carry. I understand also that the medical examiner can limit the time that the certificate is good for and that he would need to be recertified. When I looked on the fmsca website there was a form for the certificate and a different form for a physical. Do we need to go to the DOT and just request a certificate?
@Missy
First, regarding the stroke. There is a one year waiting period from the point of release before he can get a medical card/certificate.
Second, without knowing what his drivers class is, I can’t tell you what his requirements are going to be. But the examiner should have all of the correct paperwork you would need. So check with them first. Good Luck.
DOT Physical Forms
2 forms are needed. The DOT doctor will have the forms, so you don’t need to worry about that.
1. The Medical Examiner’s Certificate is the same thing as a Medical Card, also known as a DOT Card. The driver must carry this with him/her at all times whilst driving.
The Medical Examination Report, also known as the Long Form, is completed by the driver and the doctor during the DOT physical exam.
For more information see our blog article What do I need for a DOT physical exam.
Thank you so much. It will be a long road for him but he is doing great. It’s kind if got him down because trucking has been the only thing he has been allowed to do. Thank you so much for your help. I’m keeping this bookmarked just in case I have other question….thanks
@Missy
You are very welcome. Best wishes.
I have sleep apnea, doctor gave me a 1 month medical card when I went to renew my card contingent upon me bring a copy of my Sleep study. My most recent sleep study was 2 years ago and he will not accept it. My insurance won’t cover cost of another study since I haven’t met my deductible. I have the study that shows the AHI and the read out that shows I’m in compliance with my CPAP.
@Daniel
Looks like everybody is between a rock and a hard place.
You could try getting your primary doctor to fill out your medical release explaining your compliance and see if the examiner will accept it, along with any other documentation you may have. Good Luck.
Hi i took a dot random drug test, the medical reveiw dr called me about a drug i am taking, it is generic adderall, i gave him all the information they needed to confirm it, it was confirmed i have a prescription for it, it is used for adah, they still called my employer don*t think they said name of drug but said i was adah, i drive a transit county bus for mrdd adults, been driving over 25 yrs, never had trouble like this before for random drug tests, they would call, i gave info and was always passed, they never called my employer before, but they called this time, can they do that when they say i passed negative this time and told my employer my personal issues, i live in marion ohio 43302 work for marion county mrdd, thanks
@Yvonne
It seems a bit out of line to me. Call and ask – By what permission did they have to do such a thing? and why?
I don’t know but they have me working at different depts til sept 18 2014 where they are sending me to be evaluated, I think this is wrong, they say something about a 327 code, or maybe some kind of code that started with 3. Well I guess I will go for valuation, I don’t get it but I have to do as they say, thanks, have a good one”
I am going to have open heart surgery for a bicuspid aortic valve and aortic aneurysm. Will I be eligible to keep my cdl? If not, is there anything I can do to keep it?
@Kevin
Once you have completely healed and your cardiologist completes your medical release form, you should be able to continue your driving career. You will need a new DOT physical exam. Take the medical release form for the DOT medical examiner.
Your medical card will probably be good for a year at the time, but you’re still driving. Good Luck.