A major component of getting your CDL and landing a driving job will be a physical examination. The FMCSA requires that every driver who holds, or wants to attain, a commercial drivers license must submit and pass a DOT physical examination at least every 2 years.
The DOT physical will check a drivers overall physical health and include eyes, ears, blood pressure, limb impairment, and a drug and alcohol screen.
Additionally, every individual company will administer their own physical as a part of the pre-employment process, which may also include a physical fitness test to make sure a driver can handle the job, or a hair-follicle drug screen.
Generally, the DOT physical is along the same lines as you would expect from your general practitioner. Hearing, vision, medical history, limb impairment, vascular system and blood pressure will all be included.
Wiki - What New Drivers Need To Know About The DOT Physical Exam:
In order to drive a commercial vehicle in the U.S. with a maximum gross vehicle weight rating of over 10,000 lbs in interstate commerce, drivers are required to pass a physical examination given by a DOT-approved medical examiner.
FMCSA National Registry of Certified Medical Examiners
The National Registry of Certified Medical Examiners requires medical examiners to participate in required training, pass a certification test, and register on the National Registry system to become a certified medical examiner.
Aside from the classes of illegal drugs, the FMCSA does not keep a master list of prohibited prescription drugs for drivers, but in general any medication that affects, or could potentially affect, a drivers ability to safely operate the vehicle will be disqualifying.
The FMCSA does specify that anti-seizure medication, as well as methadone use, are disqualifying medications.
Any driver who expects to be taking prescription medication, or has taken any recently, will normally need to get some kind of documentation from the prescribing doctor attesting that
FMCSA - What medications disqualify a CMV driver?
A driver cannot take a controlled substance or prescription medication without a prescription from a licensed practitioner, and it cannot adversely affect their ability to safely operate a CMV.
By far the two biggest reasons that drivers fail their physical are for high blood pressure, and sleep apnea. Drivers with high blood pressure (hypertension) can still be medically certified, but for shorter periods of time depending on the severity. Additionally, drivers with insulin-treated diabetes are disqualified unless they are approved for an exemption as seen below.
Sleep apnea isn't specifically addressed by the FMCSA in their regulations, but many, many companies will require a driver to undergo a sleep evaluation and use a CPAP machine if their Body Mass Index (BMI) is high enough.
Wiki - Blood Pressure & DOT Physical
Drivers with hypertension (high blood pressure) are NOT automatically disqualified from driving. Recent changes to the FMCSA blood pressure guidelines means that drivers with high BP can still be medically certified, but for a shorter time period depending on the severity of their hypertension
Wiki - Sleep Apnea, Truck Drivers, & BMI Calculator
The FMCSA regulations on the physical qualifications of drivers addresses obstructive sleep apnea in this way: "Has no established medical history or clinical diagnosis of a respiratory dysfunction likely to interfere with his/her ability to control and drive a commercial motor vehicle safely;"
FMCSA - Medical Examination Report
This is the examination report that FMCSA medical examiners use when performing DOT physicals. It covers the drivers health history and physical well-being.
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Yes, the FMCSA does have exemption programs available for drivers that cannot meet the DOT requirements for vision, hearing, diabetes, and physical impairment.
Drivers will need to apply to the FMCSA for exemptions before receiving their medical certification.
Wiki - DOT Physical - Driver Exemptions
In certain cases, CDL drivers cannot meet the DOT medical requirements regarding physical impairment, vision, hearing or diabetes, and cannot obtain a medical card. The FMCSA allows you to apply for exemptions that will keep you driving.
FMCSA - Official Driver Exemption Programs
Please note that all exemption programs are for drivers who intend to operate commercial motor vehicles (CMVs) in interstate commerce. FMCSA does not have statutory authority to grant waivers/exemptions to drivers from states' intrastate requirements.