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 trying to find information for someone that has their CDLs and is in a category A. He was told that he is overweight and will lose his CDLs if he cannot lose 70 lbs before he takes his medical exam to get the medical card. My question, Is there a way to get around this? He only has 18 months until he can retire and would like to keep the CDLs. I have been searching and I have not yet seen anything about there being a weight limit that would cause him to be restricted.
@Crystal
There is no weight limits on any driver. So someone is blowing smoke up the information tube.
There may be other conditions that may limit the length of the medical card, but weight is not one of them.
I have heard of some medical examiners requesting sleep studies to make sure there is not an issue, I have also read that the DOT is looking into possibly changing the rules for over weight drivers as well.
State of Maryland senate bill effective 10/01/2003 stating. If you are a Maryland NON- Commercial Driver operating a commercial motor vehicle in interstate commerce (within the State of Maryland) and the vehicle weighs 10,001 and up to 26,000 pounds,you are now required to have a valid Federal Motor Carrier (DOT) physical card in your possession. If licensed prior to October 1.2003, have a preexisting Medical Condition, and the onset was prior to 10/01/03, you would be EXEMPT from this requirement for a 20 year period,provided your preexisting condition dos not worsen. You are still required to maintain a DOT physical. This is also found on the Maryland MVA’s Web Site.
Would this Suggest that I’m Exempt due to my preexisting Medical condition I take a anti-seizure medication due a brain surgery in 2000 and have for the past15yrs
@Jerry
You need to check the wording on some of your statements. Interstate is not in the state only. Interstate means that you are traveling outside of your home state. Intra-state only is with in the states boundaries and that the cargo is from and staying inside the state boundaries. If the cargo being hauled is leaving the state, then you are driving interstate commerce.
As far as the medications you are taking, you may, after checking with the state Drivers License Department, be correct as far as the condition and the time frames. Check with your state DLD and confirm. If not just make sure you get your primary prescribing doctor to complete your medical release form for you and take it to the examination. That will answer most of the examiner’s questions.
Is it legal for my company to give the dot physical doctor a list of medication I am taking without my consent
@Chris
Unless you sign some type of medical release form from the company giving them permission to release any of your medical records, then the answer should be NO. And if they did so with out your permission, then they are way outside of HIPPA compliance and you may have a case against them for doing so. Make sure you have all your information together before making any accusations.
Additional info. on comment from march 4, 2015 at 5:56pm
Thanks for the Info. I printed my compete history from 2000 to date of everything with doc. names, address,phone #,, dates. I passed everything until he read anti-seizure med. on the back of the dot physical form and also pointed it out. One more thing at the time of the surgery in 2000. i turned in my B -CDL’s down graded to a C license – non CDL. The tow trucks are all under 26,0001lb. We Tow for the State Police ,Baltimore co. and Harford Co. the state police are the only one to ask for a dot medical card. I still have the letter from the Maryland Medical advisory board say to go to the local MVA a get your down graded license.
NOW THE RULES AND REG HAVE CHANGED, I’M HAVING PROBLEMS GETTING RE CERTIFIED FOR A DOT PHYSICAL. THE DOCTOR I HAVE SEEN IN THE PAST FOR THE PHYSICAL IS NOT A CERTIFIED DOT DOC. SO I HAD TO USE A DOC. THAT DOE’S NOT KNOW ME OR MY MEDICAL HISTORY. I HAVE GONE THROUGH THE MVA MEDICAL ADVISORY BOARD AFTER HAVING BRAIN SURGERY IN 2000 AND HAVE BEEN ON ANTI-SEIZURE MEDS. FOR THE PAST 15 YRS. NOW THIS IS A PROBLEM. I OWN A TOWING COMPANY AND DO NOT TOW ON THE INSTATES I TOW LOCAL, WITH IN A 25-30 MILE RATIOS AND BEEN IN BUSINESS FOR THE PAST 20YRS. ANY IDEAS THANK JESSE
@Jesse
Start with your local drivers license department.
You should not be trying to pass a class A interstate test. You are in a class which requires a medical certificate, but not a class A certificate.
Each state has specific rules and examination requirements that are different than the class A drivers.
You should not be having any problems, especially since you have been doing this for quite a while. Get a medical release form from your doc and explain to the DOT medical examiner what has been, and what is going on.
Thanks for the Info. I printed my compete history from 2000 to date of everything with doc. names, address,phone #,, dates. I passed everything until he read anti-seizure med. on the back of the dot physical form and also pointed it out. One more thing at the time of the surgery in 2000. i turned in my B -CDL’s down graded to a C license – non CDL. The tow trucks are all under 26,0001lb. We Tow for the State Police ,Baltimore co. and Harford Co. the state police are the only one to ask for a dot medical card. I still have the letter from the Maryland Medical advisory board say to go to the local MVA a get your down graded license.
Is a person disqualified from getting a medical card if he is on fentynal patches for chronic pain?
@John
Start with a medical release form from your doctor explaining the needs and usage of the patches. There are going to be questions, so you may as well start with your doctors explanation.
You are also going to test positive on any drug screen, so you will still need your doctor’s prescription and notes.
I HAD BRAIN SURGERY IN 2000, HAVE BEEN ON DILAN TEN ( ANTI-SEIZURE MEDICATION) FOR THE PAST 15YRS. I OWN AND DRIVE TOW TRUCKS (LOCALLY,NO INTERSTATE) MAINLY FOR THE POLICE DEPARTMENTS.I HAVE DONE ALL I WAS ASKED TO DO. I TURNED IN MY B -CDL’S AND JUST HAVE C LICENSE AFTER THE MEDICAL ADVISORY BOARD HAD COMPLETED ITS REVIEW AND I DID AS THEY ASK OF ME . AND NOW WITH THE NEW REG. MY DOC. IS NOT ON THE LIST AND I’M HAVING A PROBLEM GETTING MY MEDICAL CARD. I’VE BEEN IN BUSINESS SINCE 1995. WHAT SHOULD I DO THANKS
I just had a Heart attack.. can I still work? What are your regulations on this?
@Carter
FMCSA regulations – You will need to be completely healed and released by your doctor, with a medical release in hand, before you can retake your medical examination. Once you pass a new medical examination, then you are good to go.