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 have had a cdl license for 30 years but let it lapse. I now have three artificual joints, both knees and left shoulder. can l reapply for a cdl?
@Kasey
Sure, you just need to make sure you will be able to fulfill the duties of a commercial motor vehicle operator.
IN OCT 2013 I FELL OFF A TRAILER AND HIT MY HEAD AND BACK ON THE GROUND. MY QUESTION IS CAN I BE CERTIFICATED TO DRIVE AFTER HAVING A SEVERE TBI? I STILL FEEL THE AFFECTS AND THE DR I SEE IS A SPORTS MEDICINE DOC, AND I HAVE NEVER HAD ANY NEUROLOGICAL EXAMS OR HAVE I EVER SEEN A NEUROLOGISTS. BUT I AM AT MMI ACCORDING TO THE CONCUSSION DR.
@Tim
You will need a medical release form completed by your primary doctor.
You may also need to have a neurological evaluation to determine the extent of the TBI residuals.
Medical release first and then try the DOT examiner. He may request the neuro evaluation.
Is it possible to have your class A and be on dialysis?
@Elvira
Maybe as an intra-state only driver, but not as an interstate driver.
So check with your state Drivers License Department to make that final determination.
what is the ejection fraction number required by DOT to obtain a CDL license in NC after bypass surgery?
@Banditt
Greater than 40 % LVEF.
Is there a liaison that helps with concerns about DOT certification? My husband was offered a job pending his physical and passed the physical with flying colors. However, the CME has temporarily disqualified him based on pain medications. He is legally prescribed these opioid medications by a reputable doctor specializing in pain management who also treats spinal injuries (reason for my husband’s treatment).
The CME refuses to grant the certification unless my husband stops taking his meds but the process for coming off of six years of pain management is longer than one weekend and my husband needs to start work on Monday. We attempted to explain this and asked if we could provide documentation from his prescribing doctor but the CME wouldn’t entertain the idea. He’s made a broad-based decision with no merit and no evaluation of medical history. This seems unfair at minimum and borderline discriminatory in reality. Do we have any recourse? I’ve been scouring the internet for information and advice.
Right now our outlook is bleak. It seems the only option my husband has is to stop his medication immediately in order to get his certification from this guy. Doing so is extremely risky and can result in life-threatening detox. The company is only having my husband drive a pickup truck for them but they are insistent on DOT certification. The CME also completely disregardedrour request for temporary certification (90 days) to allow my husband to come off his medication safely.
@Confused
The primary question: Did your husband take a medical release form, completed by the prescribing doctor, with him to the DOT examination? That, in and of itself, may help you out immensely. The CME has to have supporting information from the primary prescribing doctor, so see if that will answer the main CME’s questions.
No, because we didn’t know anything about any of this. When the original CME temporarily disqualified him, we asked about a medical release because we immediately started looking up information and discovered that he could rule in my husband’s favor with a release.
The CME refused to accept any communication from the prescribing doctor and said that the only way he would qualify my husband was if he immediately stopped taking his medication (which would be very dangerous). Another CME happily certified my husband without even batting an eye at his medications. Will this certification stand if the first CME temporarily DQ’d him?
@Confused
This is not the CME position to do such a thing.
So if you went to another medical examiner, one that understands his position, and he clears your hubby, then you should be good to go.
If your hubby has a CDL, then this is the medical certificate your hubby submits to your state DMV for self-certification record with his CDL.
Don’t be so manipulated good grief. You always have a choice. Stay on the pills. Drop their offer go somewhere else.it ain’t legit.
Hi Just had an angioplasty and a stent. Cardiologist sent cardiac clearance to dot dr. Already have a class A cdl. We’ll be getting a Passenger and School bus endorsement.
How long will my medical card be good for 6 months or 1 yr in state of florida.
Thanks for the help
@Stephen
Once you are fully healed you will receive a one year card from this point on.
You will also need supporting testing regarding your heart each time you go for your re-examination with the DOT examiner. Some of the testing need only be done every two years, so check with your examiner to see what all you will need starting now. Good Luck.
I am currently a driving instructor, and I have a student who knows he is suffering from kidney failure, it is to the point of causing him tears.
He wants to complete the instruction and obtain his CDL for local work at home. I know it is a risk, but he is a good driver. I have researched FMCSR for this and it is rather vague. . .
My question is; “If he regulated his treatments, once it comes to that, can he still hold a valid CDL and work?”
Thank you for your time!
Zac
@Dude
Tough one. He may be able to get an intra-state only CDL.
He would not pass the DOT federal examination.
So check with your state Drivers License Department and go from there. Good Luck.
I have been licensed as a Commercial Driver for numerous years, I have Type 2 Diabetes and have controlled in the past with diet and oral medications. About 1 1/2 years ago I started on Insulin injections. I work and reside in Georgia now and only drive in the state. I took a new Medical Exam in July of this year and passed all ok and was issued a certificate good for 1 year. I got a job operating a Yard Dog truck here locally in August, they called me in yesterday and told me that to their understanding I am not qualified to operate a Commercial vehicle if I am taking Insulin and are going to lay me off……….Help I need some good answers
@Tim
Check your present medical card and determine if the examiner has you as an intra-state only driver.
Most of the state DMV’s will let you drive intra-state with a state diabetes waiver.
Check with your state DMV and determine if you can drive intra-state as an insulin dependent driver and what the process is to acquire the state waiver. Good Luck!