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 got a one year DOT certification due to taking ADHD medicine. When I go back to get another physical in the future I would like to not be on the medication and receive a 2 year certification. What is needed to get this and how soon can I go and get another physical so that I don’t have the one year one?
@ Dylan
You will need to be off your medications and you will need medical documentation from your doctors. Also, on the intake form you will be ask about past certifications and reasons why it was reduced to one year.
Hi there I’m going to see I have had back surgery about 4 years ago will I be ok
@ Sonja D
As long as there are no restrictions or limitations and you are able to perform the duties of a CMV operator, you should be fine.
I went down and had my dot physical and passed, gave me a one year due to blood pressure meds, went to dmv to turn in medical certification, next few days I get letter saying that I’m medically, physically, or psychologically unable to operate a cmv, said I needed something about complete review by medical review program, what is that and what type doctor signs off on it??
@ David P
This appears to be something the state has requested. You will need to contact the states drivers license department and ask them.
Thanks.
If a doctor has started a DOT physical but is waiting for information from a cardiologist and he will not be in the office for a few days to complete the exam can I go to another DOT examiner for the physical because my medical card will expire.
@ John
Yes
I suffered a back injury at work 14 months ago. I have a class A cdl. I’m due to get my medical card renewed but am unable to physically pass the exam. I’ve had surgery and am out of work on workman’s compensation. I do not want to forfeit my cdl. What are my options? I’m afraid if I fail I will lose it. If I pass it will say I’m capable of working currently which I am not. Is there any kind of waiver that could have it reinstated when I am able to pass it?
@ Don F
Your medical card was invalidated 14 months ago, when you first injured your back. Best bet is to talk with someone at your local drivers license department about your situation and see what their process would be to maintain your cdl.
I have had a class a cdl for about four years, my doctor just prescribed me adderall and I renewed my cdl physical a couple months before the prescription. I have a pre employment dot drug screen in three or four weeks from now, if my doctor signs off saying it doesn’t effect my driving and I go and renew my physical. Will I still have problems with passing the drug test next month? Is there any way I could get cleared for the prescription before the drug screen that way I can stop taking the medication if it won’t be approved. I can’t risk losing my job
@ Pete
Your medication is not going to be an issue with a drug screen. Even if it were, all you would need to provide the medical review officer with is the prescription.
Hi. I have bulging discs that are causing intermittent numbness in my hand. My work is requiring me to retake my DOT physical exam due to being out of work for the pain. Can I be disqualified?
@ TG
If the situation with your hands causes you to be unable to perform the duties of a class A driver, then yes it is possible.
Good morning,
I take Bupropion HCL daily, 200mg, J
just to keep depression in check. I don’t think this would be a disqualifying factor as is controlled by medication. I take Fish Oil for Elevated Cholesterol besides this, but that’s all. Any comments would be appreciated. Thank you.
@ Bill G
The CME may request additional information from your prescribing physician or a medical release form. Other than these possibilities, you should be good if all else is within normal limits.