DOT Physicals
A Department of Transportation (DOT) physical is a medical examination that is required of people who drive certain commercial vehicles. DOT physicals make sure that people who drive commercial motor vehicles (CMVs), such as large trucks and buses, are physically, mentally, and emotionally fit to do so. The Federal Motor Carrier Safety Administration (FMCSA) requires this testing for the safety of the public.
Who Needs a DOT Physical?
You will need a DOT physical if you:
- Drive a vehicle designed to carry more than 15 people.
- Are paid to drive a vehicle designed to carry more than 8 people.
- Carry hazardous material in your vehicle that requires your vehicle to have a placard.
- Drive a vehicle on the interstate highways with a gross combined weight rating, gross vehicle weight rating, or gross combined weight of 10,000 pounds (5 tons) or more.
The DOT Medical Card
After passing a DOT physical, a Medical Examiner's Certificate (MEC), also known as your DOT medical card, will be issued to you. The MEC, along with your commercial driver’s license (CDL), allows you to drive a commercial vehicle for 2 years, if you have no underlying physical or mental condition that requires testing more often.
Some medical conditions that require you to have an annual DOT physical include:
- Diabetes Mellitus
- High blood pressure (hypertension)
- Heart disease
If you have a medical condition such as very high blood pressure, you may be required to have physicals every 3 months while you undergo medical treatment to correct or manage the issue.
What Does a DOT Physical Consist of?
The health care provider who performs your DOT physical will ask you detailed questions about your medical history including:
- Surgeries
- Medicines that you are taking, including prescription and over-the-counter medicines.
- Health problems that you have had.
- Use of tobacco, alcohol, or illegal substances.
- If you have ever failed a drug test.
- Use of or dependence on an illegal substances.
- Any symptoms that you are currently having.
You will have a hands-on physical that includes checking your:
- Height
- Weight
- Blood pressure
- Vision
- Hearing
- General appearance
- Skin
- Eyes
- Ears, nose, and throat
- Heart
- Lungs and chest
- Abdomen
- Back and spine
- Genital and urinary system, including checking for hernias.
- Extremities and joints
- Nervous system, including your reflexes.
- Gait, which is how you walk.
- Circulatory system, which includes your arteries, veins, and lymphatic system.
You will also get a urinalysis (urine dipstick test) to check for protein, blood, sugar, and specific gravity. These tests determine if you need additional tests to check for other medical problems such as diabetes and kidney disease. You may have other tests if your doctor thinks they are necessary.
You may also need a sleep apnea test if you have symptoms of obstructive sleep apnea, which is a disorder where you periodically stop breathing while sleeping. Symptoms of sleep apnea can include:
- Heavy snoring
- Gasping for breath during sleep
- Dry mouth or sore throat in the morning
- Morning headaches
- Daytime sleepiness
Things to Bring to a DOT Physical Examination?
You can fill out the driver's portion of the exam at home if you want to save time on the day of the physical. You will also need to bring:
- A list of all your doctors' names and addresses
- A list of all your medicines, including the dosage
- Your glasses, contacts, or hearing aids if you use them.
- A record of your blood sugar readings and your most recent HbA1C if you have diabetes.
- A record from your continuous positive airway pressure CPAP machine showing proper use for at least 90 days if you have sleep apnea.
- A letter from your cardiologist indicating you're safe to drive a DOT vehicle if you have heart problems.
- The results of recent heart tests if you have them.
- A letter from your neurologist if you had a stroke, brain tumor, seizure disorder, or bleeding in the brain.
- A letter and medical records from your doctor if you're taking any medicines that can cause sleepiness or are controlled substances.
- A letter from your doctor if you've lost permanent use of an arm or leg, including any work restrictions.
- A letter from your doctor and a recent blood level and clearance test if you're taking the blood thinner warfarin (Coumadin).
Conditions that Disqualify You from Getting a DOT Card
Conditions that may disqualify you from passing a DOT physical are those that interfere with your ability to drive safely. If something affects your hearing or vision, it could cause you to have an accident. You also may not be safe to drive if you have a condition that could cause you to lose consciousness or become dizzy. Such conditions can include:
- Uncontrolled or unstable heart conditions
- Epilepsy or seizure disorders
- Meniere's disease, an inner ear disorder that causes dizziness.
- Uncontrolled diabetes
- Uncontrolled high blood pressure
- Vision loss that can't be corrected
- Hearing loss that can't be corrected
- Use of marijuana, even if prescribed.
- Use of illegal substances
- Use of oxygen therapy
- Some respiratory conditions
- Protein in the urine, which may indicate kidney disease.
Some of these conditions will be left up to the medical examiner's judgment as to whether to qualify you or not. You may be able to get an exemption or waiver from the FMCSA for certain conditions. Sometimes, you may be disqualified until you bring a medical condition under control. If you can resolve a disqualifying condition, you can reapply for certification.
What Are the New DOT Physical Requirements?
DOT vision requirements
- To pass the vision test, you need to have 20/40 vision in each eye, with or without correction (glasses/contact lenses), and a field of vision of 70 degrees or more in each eye. You should also be able to differentiate between red, green, and amber (colors of traffic signals).
- Before 2022, if you did not meet these standards but met all other standards of DOT Physical, you could apply for an exemption. Now, the FMCSA has a new alternative vision standard. The rule now requires any person who doesn't satisfy, with the worse eye, either the distant visual acuity standard with corrective lenses or the field of vision standard, or both, must be medically examined and certified by a Medical Examiner as physically qualified to operate a commercial motor vehicle. Your ophthalmologist or optometrist must fill out a new form, the Vision Evaluation Report, Form MCSA–5871, and provide it to your DOT physical medical examiner.
DOT hearing requirements
- To pass your hearing test, you must be able to hear a "forced whisper" using your better ear when you're 5 feet from the examiner, with or without a hearing aid. If you fail this hearing test, you will be referred for an audiometry test.
- In most cases, you can get a hearing correction device and then pass your DOT physical. If you need a hearing aid, you must always keep it on while driving.
- If you are completely deaf and cannot pass the whisper test even with hearing aids, you will fail the hearing test.
DOT blood pressure requirements
- If your blood pressure is 140/90 or below, you will pass the DOT physical blood pressure requirements.
- If you've been diagnosed with hypertension and are being treated, you'll need more frequent certification:
- If your blood pressure is between 140/90 and 159/99, you'll be certified again after 1 year.
- If your blood pressure is between 160/100 and 179/109, you'll get a temporary 3-month certification, and you'll have to reduce your blood pressure to below 140/90 to get a 1-year certification.
- If your blood pressure is higher than 180/110, you cannot pass. When you reduce your blood pressure to below 140/90, you can be certified for 6 months.
Cost of DOT Physical
A DOT physical generally costs $85-$150. Check with your employer to see if they will pay for your DOT physical examination.
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