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 am hard of hearing and fail my dot physical exam. Can I retake my hearing test with temporary hearing aids?
@Jaliyl
To pass the DOT examination you will probably need to get a permanent pair of hearing aids.
Once you pass the test using a hearing aid it will be marked on your medical certificate that the driver must wear hearing aids at all times to operate a commercial motor vehicle.
I was diagnosed with minor sleep apnea while in the military. I’ve been using the CPAP for almost three years now prescribed by my military physician. Next month I retire from the service and I’ll be attending truck driving school to obtain my CDL class A. I was told a medical exam was a part of the class and I’d have to disclose medical information on some form. If I disclose my sleep apnea will I have to participate in another sleep study even though I’ve been compliant and still receiving treatment? I already have a machine. I’m already using it on a constant basis. Are they going to make me do another sleep study? It was a long process to get my sleep study done while in the military and I’d hate to go through it again. This is stressing me out. Is there an investigation done to see if everything on the medical form is truthful? Are they going to dig into my VA/military medical records.
@Scotty
Just have your primary doctor fill out your medical release form and have a recent readout from your cpap unit, showing full compliance and you should be good to go. Good Luck
More info:
See articles on Sleep Apnea
You must be truthful on the medical form.
I have been diagnosed with urgency incontinence and I will be taking Oxybutynin. One side effect of this drug, and an alternative (tolterodine), is “sleepiness.” Does taking either one of those drugs *automatically* disqualify, my CDL-A? And would this be a questionable drug requiring physician intervention/explanation? Thank you.
@Lawrence
Once you have been on these medications for a while and you see how you react to them, then you will know which way to go.
You will need a medical release form completed by your primary doctor so you can take it with you to do your next DOT physical. But the medical release form should answer the CME’s primary questions. Good Luck
I was diagnosed with a stroke last year which medically disqualified me for a year. That year has passed. What do I need to do to be qualified to pass my DOT physical.
@Brian
The wait is over, just have your primary doctor complete a medical release form for you and take it with you to your DOT medical examination. That release form should answer any of the questions that the CME may have. Good Luck.
Last November I had a sleep study done and I was put on a c-pap with oxygen only used at night. I went for my physical today and the PA-C told me that I had to 70% complaints but my doctor says I need 90% to drive a school bus. Is this something the DOT set or the doctor? I know to go back to driving I need a releases form made out but……who is right?
@Tracy
The DOT medical examiner is following the FMCSA guides, not sure what your doctor is following.
The main thing is use of the unit should reduce excessive daytime sleepiness and make the driver more alert.
Another thing to take into consideration is you are a school bus driver and not a full-time over-the-road driver. So check with your state DLD and see what standards they are operating with.
I am prescribed oxycodone 15 mg 3x day and 1 mg zanex at bedtime if my dr gives me clearance and a letter will I be able to get a CDL class b license?
I have a few herniated discs in lower back I’ve been on the meds for years how do I get my CDL class B?
@boo boo
Complete medical release form from your doctor, take that with you when you go for your medical certificate. You will be good to go.
@boo boo
Get your doctor to fill out your medical releasee form and take it with you to the medical certificate examination.
The release answers most of the questions the CME will have.
Please help,
I am attempting to get my CDL and I have sleep apnea. The DOT Examiner says I need a 30 day compliance report from my CPAP machine, however I just got my CPAP machine last week. Can I get a 30 day card until my compliance report is ready? I really need the job and I am afraid they are going to give it to someone else before my 30 day compliance report is ready. I have passed every hoop but this one and my family desperately needs me to land this job. My Primary Doctor says she is willing to write me a letter saying I have been on it for a week as long as I bring her the card out of my machine supporting the action.
@LB
FMCSA regulation states that you must be on the unit for at least 30 days before a medical card can be written. As a regulation, there is no getting around this for the moment. It’s a safety issue and I don’t think anyone will sign off until the 30 days are met. Good Luck
Hi! My husband was just presented with a job opportunity that is a blessing to our family. He would need to get his CDL and the only issue at hand is that he’s a diabetic. He takes Metformin and Glimperide currently. He’s taken insulin years ago, but not now–he’s managing with the medication and diet. We didn’t foresee this coming, and he hasn’t been great about checking his levels, but they’ve been stable. I know his doctor will fill out the form for him, but I was curious as to how they check these sugar levels. I know he could be under 200, but I’m not sure if he’s gotten up over that in the last few months-so I don’t know if that shows up as an average in your system–or if they check right there by a finger prick? Thanks in advance for your help–this is all so confusing to me and he Really needs this job!
@Heather
As a diabetic, you want your primary doctor to complete a medical release form before he goes for his DOT medical examination. If his condition is stable, according to his primary, then he will be restricted to a one year card, but should be ready to go. Good Luck