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 just got the opinion letter signed by my doctor in regards to BP pills which makes my BP completely normal, and another opinion letter about diabetes. I take pills right now for my diabetes and it makes my glucose completely normal. This is my 1st time getting a DOT physical card will I be limited to 1 year or should I qualify for a 2 year?
@Bryan
Your medical card will be limited to one year as long as you are taking medications. The DOT and FMCSA want to keep a close monitor on anyone taking medication such as yours.
My ejection fraction is at 40%. Will I have a problem with my physcial????
@allen
Make sure you have a medical release form completed by your doctor, with a copy of you last test results. You should be good to go from there.
I had stoke 5 years ago, I gave up my class A cdl when it was up for renewal 2 years ago and have my regular DL.
I am still in the business and still cable of driving a semi, but I only have use of one arm. would I be able to get my CDL back if a doctor passed me physically able?
bob
@ bob
With your present limitations you would need a medical release form from your doctor and the DOT examiner is going to want a SPE (skills performance examination). Otherwise you would not be granted a class A medical card or license.
I started treatment for adhd/ depression earlier this year. I take vyvanse in the a.m. along with wellbutrin and adderall in the afternoons. Currently I am a relief driver cdl a tractor trailer and 24ft box trucks, but I started out OTR truckload.My original doc thought it was unsafe for me NOT to be on treatment driving etc. I have become a much better driver since starting treatment, however now I am in need of a new medical cert. and want a new job. My original physician is not covered under my insurance so how do I go about being cleared as an eligible driver on medication? intrastate or interstate? thank you
@ebony
Just make sure, before you go for your next DOT exam, that you have your prescribing doctor complete your medical release form for you. That will answer most of the questions that the CME will have about your medications and your present condition.
I was told today by the fmsca by email that it is not there rule that you must take a year off after a stroke.but that is what is in their guide line book for drs. to use .I had a letter from my nurologst but dot dr would not even look at it.this should not be the case . how would you fight this?.
@Mark
Then go to another facility and ask them about your situation. The first doctor has you flagged in some way and apparently is not going to change his mind. So go somewhere else and ask them.
I damn near passed my physical and they asked me why I was on Coumadin. I had a stroke in November and as of last week I failed my physical cause of comadin. I got a doctors appointment in 1 week and hope I get better results . Mike
@Mike
You are not being held for the use of a properly prescribed medication. You are being held due to the fact that you had a stroke. That waiting period, depending on what type of stroke you had, can vary from 1 to 5 years before returning to work as a driver of a commercial motor vehicle.
I also had a mild stroke in nov2014 after being out on disability for hip replacement surgery in sept 2014. Now at the end of my 6 month disability. Went for dot phys and nurilogist cleared me for work but dot doc says guidelines tell him 1 year wait. So what do I do for 7 months now ? Unemployment with a $2400 cobra!!! O try for disability n Medicare ? I live in n. J. Thanks Charlie
@Charlie
Depending on where the stroke was, it could be an even longer wait period.
You may be able to do intra-state only. At least you could work. Check with your state Drivers License Department to make the final determination.
In Ohio What would be the waiting period and criteria to return to interstate commercial driving for a 34 year old male diagnosed with A-Fib with RVR, neurocardiogenic syncope, status post cardiac pacemaker procedure ?
@Mom
Once fully healed and with the primary doctors completion of a medical release form, he should be able to return to work. Once he completely medically fit to safely operate a commercial motor vehicle. This may require a stress test before he tries to return to work.
Someone told me Neurocardiogenic syncope is an automatic disqualified in Ohio even with pacemaker- do you know if this is true?
@Mom
Don’t know about your home state. But, according to the FMCSA, you would get a one year medical certificate. Just make sure your medical release form is completed by your primary before you go for your DOT examination.
I just had heart surgery to stop Afib. I was told by my surgen I was fit to return to work. I had to go get a return phyical at some place our company uses and they said I had to wait a month. It was NOT open heart or in my vein type surgery. I cant find a thing about having to wait a month to return to work.
@Pete
Not sure what type of surgery you had, so I am limited in the response. If you had a pace maker installed, then there is a one month waiting period. Other wise more information is needed.
Hello, I’m a 38yo male with a pacemaker and a mitral valve replacement as a result of childhood rheumatic fever. I’m currently taking Bystolic and Coumadin. I asked my cardioligist if this would affect me being able to obtain my class A and drive interstate, but he wasn’t sure. Would any of this prevent me from truck driving?
@Shannon
Until you are very stable on the medications that you are taking right now, you will have trouble passing the DOT medical examination.
Once stable on the meds and your doctor is willing to state that he feels very comfortable with your medications and your condition, then have him complete your medical release form for you to take to the DOT examiner. That will answer most of the questions that the CME will have. Good Luck
I have a pacemaker/difribulator implant. Can I get a dot medical card?
@Mark
The defibrillator will be a dis-qualifier for interstate driving of a class A driver.
You may be alright with an intra-state only license. Just check with your state DLD and see what they have to say.
@Mark
The defibrillator will be a dis-qualifier for interstate driving of a class A driver.
You may be alright with an intra-state only license. Just check with your state DLD and see what they have to say.