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 quadruple coronary bypass surgery two years ago and.have a current medical card
I’m applying for.a.new.job thay had me.do.a.new.dot.physical which rhe doctor failed me.stating thay want me to get an infraction test done.y question os how often do.tou need.to.get.rhe test done ive found two.answers one.says first one five years after surgery the other says every two.years? and dose the new exam override the other medical card ? Thank ypu
@ Jason R
The CME needs to see a stress test results every two years for a LVEF reading.
I went to the doctor for CDL physical and everything was good then he checked my heart one more time and said he heard a fluttering and wants me checked out but as things are now I can’t get seen by a cardiologist till august because of back ups and my card expires in two weeks so what is my options!
@ Brad
Could get a second opinion.
I had epileptic seizures and I currently have my class D license. Haven’t had in two years since if have a doctor’s note can I get my CDL?
@ Rylan
Your cdl is a state issued document, so best to check with your local DLD for guidance.
i have a class A license and have a hearty condition my ejection fraction is under 40 can i down size my license to a class b and drive local, what is the state requirement for ejection fraction
@ hartsell v p
You will need to confirm with your local DLD. The down grade to a class B may do the trick.
I had to do a sleep test because of HP and my card expires in April. I went through my doctor to set everything up. The results came back with mild sleep apnea. My doctor did not prescribe a machine, she basically prescribed a lifestyle change she gave me the results along with a letter basically explaining that I’m under her care and taking a conservative approach for treatment. Can a CME override her ?
@ Michael
Your medical doctor has to operate on their knowledge of medicine. The CME has to do just that and follow DOT/FMCSA regulations and guidelines. The CME can over-ride your doctor based on regulations and guidelines from FMCSA. The CME should take your information into consideration in his decision making process.
I broke my ankle and had surgery. I can’t walk on it as of yet and my medical card is due at the end of March. What can I do?
@ Tracie
You will need to let your drivers license department know of your situation. Then follow their procedure until you are ready to take a new medical certification examination.
Have low ejection fracture. Under 40 cardiologist is willing to sign any type of waiver to clear me. Is there any type of waiver?
@ Ken D J
DOT/FMCSA has a set requirement of a LVEF of 40% or better, for a class A interstate driver.If you are a lesser class cdl holder, then you fall under the states requirements. We know of no such waiver for a class A driver.
rabbit. i was diagnosed with cirrhosis of the liver about four months about two years now,and i have a medical card. can i get a new one?
@ michael
It will depend on your physical and the CME who does the examination. The CME will make the final decision.