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.
Can a hernia disqualify you from driving in Texas
@Leo
You should not have any issues, as long as it does not interfere with your ability to operate a commercial motor vehicle safely and you can perform the duties of a CMV operator.
If you take a D.O.T Physical at one doctor office will your medical records show up at another medical examiner office?
@jarell
Your information goes into a central Federal database, but is not visible to anyone other than the Feds. But if you are ‘doc shopping’ the fed will be the ones you will be dealing with.
On Jan. 19th 2015, I had some tingling in my arm and hand, I went to the local urgent care and the
ER doctor diagnosed it as a TIA. They did a CT scan and a doppler scan on the arteries in my neck, and a chest x-ray. All of the tests came back negative. ALL my symptoms had subsided within about 20 mins., but since the Dr diagnosed, me with a TIA, she referred me to a neurologist in Lacrosse which when I went to that appt. the neurologist ordered more tests, which all came back negative for an embolic source for my TIA. The CT was neg.for carotid narrowing, the ECHO of the heart showed normal functioning. I also did the DOT occupational therapy driver prescreen evaluation,with the results being above average for my age group. But since I now have this diagnosis of TIA or stroke on my record I can’t even get a DOT DR. to even look at the test results. They won’t even give an appt.for the DOT physical. Is there any way I can get an unbiased DOT DR. to at least look at my situation? One more thing I never passed out or lost consciousness, and was given no medications or therapy for any of this. Thank You Dave
@Dave
This is going to be tough, until you can get the ER doctor to rethink his initial diagnosis. It can be done, but you will have to be patient and bring all of the available information to him for further examination. He has to have everything you have to re-think his preliminary diagnosis.
In the last year, my boyfriend has had 3 dot physicals (new job, coming back from an injury and now another new job). He passed the 1st two with no problem. The third examiner stated he had protein in his urine and wanted further info. We sent her what we had from lab results. He has been diagnosed by his primary with chronic kidney disease and has had it most of his life (he’s in his early 50’s). She has disqualified him from driving stating that he is in kidney FAILURE. She’s telling him that she has derived this from the lab results we gave her but according to the charts I’ve seen, he has not reached that final stage yet. He is stuck…2,000 miles from home with a new company that isn’t sure what they should do with him but are trying to stick by him. He’s a terrific driver. What are our options? Shouldn’t he at least be given something short-term until he can see his primary again?
@Suzanne
Take the records and lab findings to another CME along with the primary doctors opinion on a medical release form. This should be enough for a second opinion.
I just started a new job driving regionally my company sent me to there DOT Medical EX. I’m Taking a oxycodone 10mg 180 pills a month have for 6 years I broke bones in my neck and back I don’t take them while I’m driving only after work as needed. I Got the letter from my primary DR for him, he would only give me a medical card for 30 days til I changed my script to 45 pills a month did that got another letter from my primary DR. again for him he gave me a medical card good for 90 days so he can check that I am only getting 45 pills a month he has told my work about my prescription what I’m taking an the amount. I’m on paid Leave right now the DOT EX. has to talk to the companies corp. DR. an decide if I am gonna keep my job because the card is only good for 90 days. I work in Utah. Does the Medical EX. have the right to do what he is doing.
@Justin
If you did not sign a medical release form for the examiner to release your medical information to the company, you may have a pretty good legal case against the medical examiner. If you did sign a release, then he had the right to do what he did.
Thank you for your response. How about the other part of my question? Is the Doc allowed to dictate my prescriptions? Is he allowed to determine what pain regiment I am supposed to take? If my doctors have written a letter stating that I am fully capable of driving a semi while taking these medications, that I have taken for over 6 years, is it ethical/ legal for this doc to say NOPE, I say you can ONLY do this. Without ever seeing my medical history, an X-Ray or a CT Scan or anything to determine the type of pain I am in or what my pain management should be? Without even taking into consideration the side effects of taking me off this medication suddenly?
@Justin
The CME is not the person to make that determination. His job description is to determine “medical fitness for duty” period. He has over stepped his boundaries and job description.
Also you want to have your medical doctor complete a medical release form for you, not just a note saying you can drive, that isn’t his job to make the CME’s determination.
I am currently a school bus driver in california and recently diagnosed with adhd for which my doctor wants to prescribe vyvance. My doctor is willing to fill out the medical release form stating I am ok to drive the bus. Will this fly with the motor vehicle department in my state? And if so do i need to do present the release form to anyone other than the lab that draws my random drug tests? Thanks.
@Jay
You will have to check with the state of California’s DLD to make the final decision.
The medical doctor’s report will be very helpful to any examiner who will be questioning your medications and their uses.
If you have a current dot card gooduntil next year. My doctor has given me a script for trazodone to help me sleep because of a slight anxiety issue. Can I be taking this while holding a class A cdl. I have taken this before with no problem. Didn’t realize it could be an issue before ,thought I would check before starting again.
@Michael
Have your doctor fill out a medical release form for you.
If there are any issues with how it effects your ability to operate a commercial motor vehicle safely, then it’s going to be an issue. So until you know that you and the world around you are safe while taking this medication, avoid driving.
What about absence epilepsy? which forms does my neurologist need for me to get my permit? until i get permission from her I’m legally not allowed to be behind the wheel. which one does she need and how long do you think it takes to get back?
@Nicole
You will need to get your questions answered by the FMCSA on this one. Time frames and proper paperwork are going to vary, but once you get it started, it should go pretty quickly.