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.
Why do the psychiatrists do not give the clearance letter to people with mental illness, doctor’s office manager say there has been new policy that they are not required to give clearance letter any more basically its up to the doctors to give you a clearance letter or not. My question is what should a mentally ill person do if he\she do not get the clearance letter from the doctor for his\her CDL license? please explain in plain english.
Thank you. . .
@Ahmad
All of the certified medical examiners, CMEs, are looking for a medical release form for any and all conditions that a driver may have. That request for medical explanation from the primary doctor is only to provide supporting information that the driver is ‘fit for duty’ mentally, physically, and emotionally. That release can come from any of your primary doctors. As far as why your doctor will not provide you with a release is beyond me. I have no explanation and there is no new rule or regulations that point in that direction.
My husband is not getting re-certified for CDL but a lower one, driving a truck for Frito Lay. He has hypertension and reads even higher at the doctors office, he has been on drugs to control the BP for the last 3 1/2 weeks but they are still telling him conflicting information at Nextcare where the DOT exam is being done. They keep saying he has to have THREE “good” readings in office?
@cherryglam
If he is on medication and has been so for over one year, then he must have multiple reading below 140/90. That’s a Fed regulation.
I just received a Temporarily Disqualified status on on physical exam due to being on light duty from a shoulder injury. I must renew my CDL soon. Will I lose my CDL when I renew. How can I get it back?
@Mark
Your state should not revoke your cdl due to a shoulder injury, yet you can not qualify as a fit for duty cdl driver.
Just let the state know what the situation is, and they will have some policy that takes your situation into consideration.
If I’ve been diagnosed with schizophrenia but it’s controlled with medication should I even bother to apply for a DOT card or am I wasting my time?
@Christian
With a properly controlled conditions such as you describe, you can go for the CDL.
There will be lots of questions regarding your condition and how it is being controlled. Make sure you take a completed medical release form from your prescribing doctor. That will answer most of the questions that a CME will have regarding your condition and what your physical, mental and emotional states are.
Ok thank you. My condition is mild and is controlled with medication so as long as I’m on them I’m fine.
My situation too.
I just had my DOT physical. They found sugar in my urine but my blood sugar was under 200. They restricted my license to 3 months (in NC). I know it is high but I thought as long as it was under 200 I could get a normal 1 year license. Does this sound correct to you?
@Robert
No matter what level your blood sugar is you cannot have sugar in your urine.
The CME is giving you 3 months to get your sugar under control, you could have been disqualified on the spot.
Get it under control, go back and have a clean urine sample and they will take you to a one year card.
Hi there
I have. been a class b driver for 14 years now just doing inner city driving for a sanitary district…I have been currently seeing a councilor for marriage counseling where she basically diagnosed me with PTSD…she is private practice and has not put this in my transcript…I would like to look into medicating but don’t want to open up a can of worms???? What do you think???
@Adam
Check with your doctor. If they feel that the meds will be of help, then check it out. You may need a bit of time off to see how the medication effects you and you will need a medical release form completed by the prescribing doctor for your DOT medical certification examination.
Do you think if I get officially diagnosed PTSD it will cause me problems with keeping my california Comercial drivers license? And when you say a bit of time how much is a bit?
@Adam
On average about 90 days on the meds before you know what effects they will have on you.
The diagnosis will need to have a medical release form with it and the use of the medications.
After cardiac bypass surgery, what information is needed to take with you for a new DOT medical exam. There seems to be some confusion about whether a stress test is needed now or later. One doctor is saying it is not needed until 5 years after the surgery but her associate is saying one is needed now. Both doctors are in the same office & both are certified to do DOT exams. What info is required at DOT exam?
@Judy
FMCSA is requesting a stress test every two years, once fully healed. There is a 3 month wait following the surgery.
I was on proxac for a few yrs for ocd but have been taken off of it by my dr. Since I’m no longer taking it will i have to disclose this info? Also will I need the forms filled out by my prescribing dr?
@Rob
If you have been taken off the medications and the condition is under control, then you want to tell the CME that that is the case. He may request a note from your primary prescribing doctor stating that you have been taken off the medication. So you could do that in advance of the DOT examination.