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 was told gabapentin is an automatic disqualifier for obtaining a cdl class b DOT licensure from the doctor at my physical testing facility. if i have an explanation from my neurologist, does that allow me to qualify?
@April
As long as the CME understands why and for what purpose you are taking this medication, then it is up to him to make the final decision. A medical release form from your neurologist will be a big help, but not a sure fact to be DOT qualified.
Im a driver and i also have worked on trucks and trailers for over 30 yrs i broke my neck in 96 went back in 09 passed a driving school 4.0 average taught the instructors a few things they never knew when i first started driving i trained. Myself to urinate be4 i got in the truck if I had the urge to go again i could make it go away till i was done. I’ve been urinating at 4am for the last 35yrs like clockwork wake up out of a dead sleep and can go right back to sleep then i cant go until late-night everyone says they can urinate any time they want i cant turn it on i can turn the urge off …
I went for a urine sample told them i had to go real bad my appointment was at 9am they made me wait till 9:45 and handed me the cup my mind and body went into drive mode that ended it i drank water was there 5 more still couldn’t go closing time at 5pm still couldn’t go.
Said i failed to test they said i had to take a shy bladder test next day i went the dot dr the next day gave me a reg exam like you take to get your med card he said i failed to test and the only thing DOT will except was renal shut down for failing to give a sample if i had renal shut down id be almost dead and shy bladder test please tell me what is done in the test ? I Read in the DOT reg. The Dr is supposed to give me the test within 5 days they said i had to take it the next day no test just a reg exam the next day ….can you explain test and was i right about the 5 days
@Robert
Was this a test for your DOT medical card or for a drug screen? One can be redone at anytime, but no medical certificate until you perform the urine test. The other is a pass/fail based on your ability to urinate and the test is sent out to the lab.
I am a Independent transport driver of empty vehicles. (Etc) new Rvs, busses, sometimes cdl units that require a Class b cdl. I do not transport any kind of passengers. I recently had to have a Pacemaker for a electrical issue that I was not aware of. I have until July 21 2017 before it expires. My question is do I have to get a new CDL Physical and Medical Card. MY cardiologist said I could drive in two weeks. I have notified the company I deliver for and they have no issues with a letter from the Cardiologists.
I forgot to mention. There is no underlying condition. All blood woek is exceptional and no blockage whatsoever.
@Edward
If the pacemaker install is new, then yes you need a new medical certificate to keep your commercial drivers license valid. Get a medical release form from your cardiologist and take it with you. You should be good to go if all else is OK.
i got a 3 month medical card cuz the doctor said i need a sleep study and expires july 29th well i got that but they cant get me in until aug 17th what do i need to do can i go to another doctor or phyiscian and get a new one until i can get a sleep study? thanks
@Eric
Well if you need the sleep study, based on true necessity, then you should be able to talk to your CME and explain your situation.
Since there were no new rules regarding OSA, you may want to get a second opinion from another CME. Also check with your primary care physician and get an opinion from him too.
See these articles for more information on the sleep apnea screening issue.
I have chronic kidney disease. I have been a driver for 17 years. Passed all my medcards no problem, went in March and passed, received my year. Went in and tested again (medcard) for a new job a couple weeks ago and failed. High amounts of proteins in my urine. They gave me a 3 month medcard and said I need to come back in 3 months. If I get a release signed from my doc stating I’m just fine to drive,will I receive my year medcard back? How does that work? I am fine to drive, I am not on dialysis, just on meds, but have never had an issue. Completely clean driving record, again for 17 years. Its my livelihood. thanks.
Also, I’m in stage IV renal failure. Would I be able to drive still with a intra-state CDL license? I’ve read that previously in this forum. How do I obtain that in KS? thanks
@Bob
Since your condition is progressive and you would be best served by driving intra-state, you really need to check with your state drivers license department and see what the state variances are for your situation. A medical release form would be very helpful for any CME so he has the best and most up-to-date information to base his final decision on.
So if I get a release from my doc stating I’m good to go, will I still be able to pass my medcard? I don’t see any reason for me to be on disability because I can perform my duties just fine, never had an issue. Seems stupid for the government/taxpayers to pay for me to be on disability if I can still work…stupid actually, I want to work.
I just need to know if my doctor provides the necessary documents, I can still drive. I don’t think now researching it, intra-state is an option here where I am employed. So a release is the option. Thanks for your time and answers.
@Bob
If your doctor is certified to do DOT examinations and he wants to pass you off as OK to drive, then that decision making process is up to him.
As an interstate driver in stage 4 renal failure, not sure any CME is going to pass you off without a lot of further testing and supporting information from your primary doctor. It’s in the FMCSA guidelines that your issue resides, not in your doctors opinion. He is really good at what he does, but it’s the FMCSA guidelines that will question this.
I feel that the dr and medical should be the ones to determine not The FMCSA.
I have a question I’ve had 2 dot physicals and passed both of them I had a liver kidney transplant 4 years ago no problems at all first physical had to have clearance from doctors and they passed me for one year then when time was up I had my second one do e they said they don’t need another letter from doctor and passes me that one still has 1 year on it but got new job they sent me to a place blood pressure was 143/98 never had blood pressure problems at all I have a cdl a she said I need to get her a letter saying I’m able to work another clearance letter and blood work and did not even give me 3 months can they do that it’s for a new job
The other two I had was done at 2 different dr offices and the second was passed for 2 years and I still have a year on it but the job was wanting me to go ahead and get a new one
@Robert
All depends on what the company policies are.
So if you want to pass this examiner’s physical, then you will need to jump through her hoops. Not real sure why they would hold you from work when you are already working, but a medical release form from your doctor with a copy of your last blood workup should be satisfactory. You will only be good for one year at the time due to the liver transplant, but the blood workup is for confirmation that all is well with you.
could congestive heart failure keep from driving with a CDL? I don’t have one yet, but want to get one. I’m healthy and condition is under control.
@Daniel
With a medical release form from your cardiologist with an expected prognosis in hand at the time of the examination and you should be pretty good to go. Your condition is not an instant disqualifier, but has to be supported with additional documentation from your cardiologist.
Im on dialysis can i get my class b licence i want to drive busses?
@Neil
First check with your local drivers license department to make the state requirements known. You will most likely need a waiver to do any driving of this sort and the state is the one that will issue it to you.
Is there a different DOT medical card or exam if a person is to drive a company vehicle such as a pick-up truck and not a CDL required vehicle?
@Jeff
Same examination to determine medical fitness for duty, but different boxes checked on the medical certificate.
Hello I recently had a dot physical where I was required to undergo a sleep study, turns out I have very mild case of sleep apnea. Well I used the crap and got my medical card back. 4 months later I switch jobs and the CME denied me my medical card and said I have to do the cpap compliance again, why? Also the pulmonary Dr stated I no longer need the therapy…… What can I do???
@Freeman
Compliance is one thing and redoing a sleep study is different.
Just get a recent readout from your unit demonstrating a 70% compliance on a daily basis and you should be good to go.
Some ME’s are now wanting 80% compliance on a sleep study…..call ahead!! i just went in with a 73% and failed even though the DOT only requires 70%. This in the state of GA where they are allowing the ME’s to make a decision on what your results should be. Talk about a crap shoot!
I had torn my rotator cuff and had surgery to repair three major tears.After a year of therapy,one of the repairs let loose again so they had to go back in and repair it again.I was finally released with permanent restrictions (No overhead lifting and no lifting over 20# on my right side).My employer sent me to update my medical card in case they needed a back up driver and the examining Dr. told me that I couldn’t get a DOT card with any physical restrictions unless my Ortho released the limitations.Was wondering if there was any kind of waiver or restricted type CDL that could help.Any info would be greatly appreciated…
@Craig
You want to have your orthopedist explain to the CME, on a medical release form, why you have the present restrictions and if you can bring in a job description from work, that will also be a big help. Since it appears that you do not drive on a full time basis, the CME needs to understand what your situation is and what your capabilities really are.
I’m taking metformin,Lisnopril,Atorvastatin,and Invokana.was taking Levemir and have been off for 2months just wanted to know who or how do I go about getting a medical waiver.Thank You.
@Raymond
It’s not that you would need a waiver, but make sure you take a medical release form from your doctor along with your latest A1c results when you go for the medical certificate examination.
Howdy,
I just got disqualified/placed on hold from the examiner because I have a mild case of cerebral palsy on my left side. He said i should get a clearance from my physician or a orthopedist, I believe. I can drive fine. I just would like to know the steps to pass and get my card. He also said something about going through a practice run of things truckers do to see if I can handle it, which I was confused about. He said that i should be able to get it. He wasn’t that friendly or helpful. I do appreciate it all the help and advice. Thanks again
@Bryan
You will need a medical release form from your doctor and your neurologist. Not sure how extensive your condition is or whether you would need a skills performance evaluation. Your CME should be able to make that determination after he sees your medical release forms. FMCSA is looking over all the CME’s shoulders and their main issue is going to be safety. So get the information that is needed and go back with the forms in hand and ask more questions regarding the need for the SPE.
Hi. I have the same condition as Bryan.
Please, tell us more. It’s so complicated to figure out steps to do.
Before I attend CDL driving school or do any steps to driving career I must be sure that I will get medical approvement.
When I asked my neurologist about it he said that he does not give me any restrictions and instructor, who is going to test me must decide on the account of how I do on Driving Test.
Should I take some paper with that statement from my neurologist? Are there some form for it? Is my doc in charge to give me this statement or I must go to some special doctor?
What is CME?
Thank you
@Anton
Yes, you should make sure you can be medically qualified before you attend CDL school.
CME is “certified medical examiner” – the person who you need to see for a DOT physical exam to see if you qualify for a DOT medical card.
You should take a medical release form from your neurologist to your DOT physical exam, so the CME has good information to help with the qualification decision.
The CME makes the qualification determination, not the neurologist, so good information is important.
I have cerebral palsy I passed it the first time with a chiropractor I got my class a
When I went to u.s. Xpress I was given a one year physical but they did not hire me because I was on Adderall a few days before from an old prescription
The doctor there knew I had cerebral palsy he gave me a one year instead of a two-year like the chiropractor but did not get hired because of the Addral or at least that’s what they said
Hi i’m 26yrs old i recently applied for a truck driving job and was bused to a cdl school and was given a dot physical, the CME asked if i had any scars i said yes and told him it was from doctors putting in a tube to drain fluid from my brain the only issue i had that required them to put in the tube was my right hand shook i havent had any issue or seizures which i know goes with that type surgery since 94 when the surgery was done. I passed everything else on exam but was never given the medical card the doctor held on to it until i talked to the school to see what companys i could work for but i was told no company would hire me. My question is will this stop me from obtaining my cdl.
@David
No! Maybe the CME is looking for more information before he moves forward in your case. He would need a medical release form from your primary doctor explaining that you have never had seizures and that the surgery was to remove excess fluids. The more information that you can provide to the CME the better. He may feel that the risk factors are too high without further information.
Last December 2014 I was involved in (MVA) where a fuel tanker pulled out of a re-fueling depot and ran into the side of my tandem Mack. I was cleared of the at-fault which was obvious. My problem is I tore 3 of the 4 rotator cuff tendons off the bone in my dominate arm and ruptured my bi-ceps tendon as well all of which I have been in therapy for since Not recovered yet or released from treating surgeon. I also tore three ligaments and the cartilage in two places of my dominant hand and wrist too of which I just currently had my first of three surgeries to correct the issues stated. I’m on pain management 10mg of oxicontin 2x a day and 900 mg of neurontin 3x a day to resolve the pain issues until all my surgeries are completed. My dilemma, my medical card is up next month and I’m sure I will fail because of the above. I live in Pa. and was told I will have to downgrade to a box EI on Pa.’s self-certification form DL-11CD (2-13) until I can pass a medical exam from this accident I was told I have to fail and then downgrade. Is this correct info or is there more or less I have to do? Thanks you guys do us drivers a great service!! John
@John
You are not in a position to even take the DOT examination because you have not been released and you’re set up for more surgery. So go down and check with the local drivers license department and see what they have to say. You should be able to downgrade for a short time, given your circumstances, and then re-enstate your CDL once you can pass the DOT physical examination again.
I had an AAA done on 09/29/2015 and just recently went through orientation for a carrier and passed the physical. The physician assistant that did the physical tore up my dot card and said I needed a letter stating from my surgeon that I pose no threat to myself or others around me if I drive a commercial vehicle … I also have to wait three months after the surgery before I can qualify.. Is this correct information ????
@Chris
According to the FMCSA guidelines, yes this is correct.
2012 – a friend of mine who’s been a long time Tractor Trailer Class A in good standing driver, was tricked into visiting a mental health institute by his sociopathic brother – stating its “go there and get checked out or leave my house for good”, so not wanting to cause trouble he went unaware that his brother had called ahead stating my friend was saying he’s “hearing voices and waving a gun around” and when my friend got there the doc said here this will ease any anxiety you might have during this interview and gave him two pills to take – so not wanting to ruffle feathers he gullibly took the pills- it was haldol that immediately rendered him a zombie and he was then held for a month unknowingly. He’s not schizo, never was, and isnt on meds and I wish I was in state when this happened to have helped him. My questions is does he HAVE to put this incident on the forms for his DOT med card renewal while he’s trying to get it reversed?
@Kim
It would be best to be honest. If he was ultimately released without further incidence, then a note/medical release form from the treating physician should be all that is needed.
4 seizures in a short amount of time 6 years ago, been controlled on medications since then. Trying to get a medical examiners certificate for an ambulance gig, but marked as not qualified. Any tips?
@Forest
You’ll need information from your neurologist along with a medical release from him. Drivers on seizure medication are going to have a tough time due to the medications and the seizures. It’s mostly a safety issue. But the information should be helpful for the examining CME to make the best decision across the board given your situation.
Hello, i was recently diagnosed with Lupus. And was wondering if this would pose a flag at passing my medical test?
@Josh
It is a progressive condition, so make sure you take a medical release form from your doctor explaining what level your condition is in. That way the CME has the available information to make the best decision. In and of itself Lupus isn’t an instant disqualification.
Can I not be hired as a CDL driver if I take 20 MG Narco per day as prescribed by my doctor?
@David
Due to the effects and possible side effects of this drug, you will need to have been on the medication for a good period of time and you will need a medical release form from your prescribing doctor. With a proper explanation from the doctor, you may pass the DOT medical examination. But it will require supporting paper work from your doctors.