DOT Physical - The Complete Guide

What New Truck Drivers Need to Know About The DOT Physical:

• Drivers are required to pass a physical examination given by a DOT-approved medical examiner to obtain and maintain a medical examiner's certificate
• Drivers must have a valid DOT medical card to drive a commercial vehicle in the U.S.
• Drivers receive a medical certification which is normally valid for 24 months. Your medical exam will be transmitted and stored electronically in the Commercial Driver's License Information System (CDLIS). Those with health issues may have medical cards that expire sooner.
• Drivers who cannot meet the requirements for the Diabetes, Vision, Hearing, or Physical Impairment parts of the DOT physical may be eligible for a Driver Exemption Program.
• Drivers must submit a "self-certification" to their state driver's licensing agency (SDLA) to declare their intent to drive commercially in 1 of 4 possible categories. This information will be added to the driver's CDLIS record.
• Under the recently enacted FAST Act, military veterans can have their DOT physical done by a qualified physician through the Veterans Administration, rather than National Registry certified medical examiners.
• CMV driver examinations can only be completed by Certified Medical Examiners (MEs) listed on the FMCSA's National Registry.

See Also: Fixing America's Surface Transportation (FAST) Act, Section 5403

Topics covered in this guide will include:

• What Types Of Health Concerns Will The DOT Physical Test?
• What Does The DOT Physical Exam Include?
• What Parts of The Body do they check during the DOT Physical?
• What Are the Physical Qualifications for Driving a CMV?
• What Happens After I Take the DOT Physical?
• DOT Physical - Frequently Asked Questions
• Straight From the Trucker's Mouth: Trucking Truth Forum Stories

What Types Of Health Concerns Will The DOT Physical Test?

You will be asked about your personal medical and health history, including whether you've had issues concerning any of the following:

• Loss of hearing
• Digestive problems
• Psychiatric disorders
• Dizziness or fainting
• Alcohol or drug misuse
• Missing limbs
• Spinal cord injuries
• Impaired vision
• Kidney disease
• Stroke
• Chronic pain
• Paralysis
• Brain injuries or neurological disorders (i.e., Epilepsy, narcolepsy, or seizures)
• A history of heart attacks or heart disease
• Issues with breathing or other respiratory conditions

Drivers must certify that the information they give is accurate and true. It is important to be honest because false or missing information will likely cause a driver's Medical Certificate to be invalidated.

Drivers can look over the Official Medical Examination Report 649-F (6045) that your Medical Examiner will fill out and transmit to the DOT after your physical.

What Does the DOT Physical Exam Include?

The physical exam itself will consist of:

Vision Test:

The drivers' eyes will be tested using a standard Snellen eye chart. (To see what a typical vision test consists of, watch this video.)

Hearing Test:

They will test the ability to hear tones at specific distances and frequencies.

Blood Pressure/Pulse Rate:

Blood pressure and pulse rate will be taken. Abnormally high readings or hypertension (high blood pressure) may result in a shorter medical certification.

Urinalysis:

Your urine sample will be tested in a lab for blood, sugar, and protein, which might indicate hidden health problems. Check out this short video for more information about the urinalysis exam. Note: trucking companies will do drug & Alcohol Testing during the pre-employment process.

What Parts of The Body do they check during the DOT Physical?

General Appearance:

The CME will look for warning signs such as being markedly overweight, noticeable tremors (shakes), or other indicators of drinking or drug abuse problems.

Eyes:

They will check your eyes for size equality, the ability to adjust to light, and for proper movement and coordination. They will ask about a history of cataracts, glaucoma, and other issues which may require a follow-up with a specialist.

Ears:

Ears will be checked for visible signs of scarring or blockage and holes in the eardrums.

Mouth & Throat:

They will check for physical deformities that could interfere with breathing or swallowing.

Heart:

The heart will be checked for murmurs and worrying rhythms. They will also check for an enlarged heart, pacemakers, and implantable defibrillators.

Lungs & Chest:

Medical examiners will be looking for abnormal sounds and breathing rates. Anything out of the ordinary may require further tests, such as x-rays.

Abdomen:

The abdomen will be checked for an enlarged liver & spleen, unusual masses, sounds, hernias, and other weaknesses.

Vascular System:

Your circulatory system will be checked for an abnormal or weak pulse and varicose veins.

Urinary System:

The medical examiner will check for hernias.

Extremities and Limbs:

Loss or damaged limbs or digits. Limp, deformities, weakness, or other deficiencies of use in arms, legs, hands, and feet. Grasping strength will also be tested if necessary.

Spine/Skeletal:

The DOT physical will screen for deformities, limitation of movement, and tenderness.

Neurological:

The brain and the nervous system will be tested to ensure proper balance, equilibrium, reflexes, and speech coordination.

What Are the Physical Qualifications for Driving a CMV?

Per FMCSA guidelines, a driver is physically qualified to drive a commercial motor vehicle if he/she:

• Has no loss of a foot, leg, hand, or arm, unless they have been granted a skill performance evaluation certificate.
• Has no impairment of a hand or finger that prevents grasping. Additionally, no arm, foot, or leg problems that would interfere with driving a truck.
• Has no established medical history or clinical diagnosis of diabetes mellitus currently requiring insulin for control.
• Has no current clinical diagnosis of myocardial infarction (heart attacks), angina pectoris (coronary heart disease), coronary insufficiency, thrombosis, or any other cardiovascular disease of a variety known to be accompanied by syncope, dyspnea, collapse, or congestive cardiac failure.
• Has no established medical history or clinical diagnosis of respiratory issues that might be likely to interfere with their ability to control and drive a CMV safely.
• Has no current clinical diagnosis of high blood pressure likely to interfere with the ability to operate a commercial motor vehicle safely.
• Has no established medical history or clinical diagnosis of Epilepsy or any other condition that is likely to cause loss of consciousness or ability to control a CMV.
• Has no established medical history or clinical diagnosis of rheumatic, arthritic, orthopedic, muscular, neuromuscular, or vascular disease, which interferes with their ability to safely control and operate a commercial motor vehicle.
• Has no mental, nervous, organic, or functional disease or psychiatric disorder likely to interfere with the driver's ability to drive a commercial motor vehicle safely.
• The driver must have distant visual acuity of at least 20/40 (Snellen) in each eye without corrective lenses or visual acuity separately corrected to 20/40 (Snellen) or better with corrective lenses. Distant binocular acuity must be at least 20/40 (Snellen) in both eyes with or without corrective lenses. The driver's field of vision must be at least 70° in the horizontal meridian in each eye. Finally, the driver must be able to recognize the colors of traffic signals and devices showing standard colors red, green, and amber.
• The driver first perceives a forced whispered voice in the better ear at not less than 5 feet—with or without the use of a hearing aid. If tested using an audiometric device (an electronic machine used to measure hearing loss), the driver should not have an average hearing loss in the better ear greater than 40 decibels at 500 Hz, 1,000 Hz, and 2,000 Hz with or without a hearing aid.
• The driver has no current clinical diagnosis of alcoholism.
• The driver does not use any Schedule I drugs. This includes amphetamines, narcotics, or any other habit-forming drugs.
• Prescription drugs taken regularly for chronic conditions require your doctor to be familiar with your medical history. Your doctor must confirm that the substance will not negatively affect your ability to operate a commercial motor vehicle safely.

While the FMCSA does not maintain a specific list of prohibited prescription drugs, it specifically prohibits methadone and anti-seizure medication. For more on what medications are prohibited, please see the FMSCA's explanation of which medications disqualify a CMV driver.

What Happens After I Take the DOT Physical?

If the medical examiner finds that the driver examined is physically qualified to drive a commercial motor vehicle (CMV), the medical examiner will furnish one copy of the results to the person who was examined and complete a Medical Examiner's Certificate. The medical examiner will also electronically transmit the medical report to the DOT, where they will enter it into the Commercial Driver's License Information System (CDLIS).

For more information, see submitting medical certifications for your state's SDLA.

If a driver fails to update their medical certification with the State Driver Licensing Agency before it expires, the SDLA will notify the driver that they are no longer medically certified to drive a CMV. During this time, the DMV will downgrade their CDL to a "non-CDL" status.

If a driver cannot meet the requirements for the Vision, Diabetes, or Physical Impairment part of the DOT physical, they may be eligible for a driver exemption. Please see the Trucking Truth Wiki on DOT Physical Exemptions for more details.

DOT Physical - Frequently Asked Questions

Where Can I take the DOT Physical?

Drivers can't get a DOT physical just anywhere. Only Certified Medical Examiners (CMEs) are allowed to administer DOT physicals. To help in this process, the FMCSA has created a registry of certified medical examiners, which drivers can use for their required DOT physicals. Finding a CME near you is simple when using the FMCSA's National Registry of Certified Medical Examiners home page. Type in your city and state or zip code, and you will see a list of approved examiners in your area.

How Much is a DOT Physical?

The cost of a DOT physical will vary depending on a driver's location and whether it is covered by insurance. For example, a DOT physical in the Chicago area can cost approximately $100. However, the same DOT physical in North Dakota costs $80. New drivers should shop around to find the provider with the best pricing. One tip is to try a national pharmacy, such as CVS, which will often let you know the total cost of your DOT physical ahead of time.

How Long is a DOT Physical Good?

DOT physicals are valid for a maximum of two years. However, suppose a driver has some health conditions and qualifies for exemptions. In that case, they will issue the driver a short-term medical card that expires sooner than the maximum of every two years. The expiration date of the medical card will be noted on the card itself.

How Many People Fail the DOT Physical?

While hard numbers are unavailable, failing a DOT physical is a somewhat common occurrence due to the disqualifying factors listed above, such as high blood pressure or respiratory issues. However, drivers can get a second opinion from a different doctor. When doing so, the driver will have to be honest and upfront about their medical history and why they were denied a medical card in the first place.

Unfortunately, if a driver gets rejected a second time, they are out of options. This makes it so drivers can't shop around for medical examiners that will pass them.

A driver can increase their chance of passing the DOT physical by preparing for all aspects of the exam. For example, if a driver typically wears glasses or a hearing aid, they should bring these items so they can be tested properly and have a better chance of passing. For more tips on passing a DOT physical—without cheating—check out this video:

Straight From the Trucker's Mouth: Trucking Truth Forum Stories

User RandyinNC from Greensboro, NC, on the hearing test portion of the physical:

One thing I noticed and found a bit concerning was that during the "forced whisper" part of the test, the physician stood about 20 feet away. I could swear that I read somewhere that this portion of the test was to be done "no less than 5 feet" from the person. Also, it was actually kind of funny. When she did the whisper test (20 feet away), she covered her mouth with a notepad. So, I'm looking at her like, "What did you say?" Ah... had to be there to appreciate it. :)

User icecold24k from Tullahoma, TN, on options for where to get your DOT physical done:

…. You could also check with some of the local Walk-In Clinics or Urgent Care walk-in clinics. There is one by my house that does them as low as $79. I live in Tennessee. Also, your personal doctor may be certified to do them. It doesn't hurt to ask.

User Rick S. from Fort Lauderdale, FL, on checking what your situation requires:

If you are going to a "company-sponsored school", that doesn't REQUIRE YOU TO HAVE A PERMIT when you show up - you are wasting your time & $$, as they are going to have you get a new permit and require you to take THEIR PHYSICAL anyways.

User Steve L. from FL on paying for a DOT physical yourself:

I was so po'd. I paid for my own physical & card prior to school thinking I needed it to get my permit. Then I got to school (Independent) & it was included so I got a new one. Then when we faxed that to the company I'm going with (not Swift) it turns out 'cause the idiot doc lined through the expiration date and corrected it (and initialed it) the company said I needed a new physical 'cause it appeared the card could've been tampered with. They weren't saying it was, but they didn't want to be accused of accepting a med card that might have been tampered with.

So, I got three physicals in less than 45 days. The one I paid for was a waste of money.

Sources to include:

National Registry of Certified Medical Examiners

State-by-State Instructions for Submitting Medical Certificates

Official Medical Examination Report 649-F (6045)

What If I Don't Provide Documentation to the State Licensing Bureau?