What Is a DOT Physical Exam?
The DOT physical exam is an exam required by the Department of Transportation (DOT) to verify the health of commercial motor vehicle (CMV) drivers and determine if drivers are physically, mentally, and emotionally fit to operate a CMV. The DOT physical exam was mandated by the Federal Motor Carrier Safety Administration (FMCSA) to ensure the safety of drivers and people who share the road.
Specifically, the FMCSA states that the “Department of Transportation (DOT) physical examination must be conducted by a licensed ‘medical examiner’ listed on the Federal Motor Carrier Safety Administration (FMCSA) National Registry.”
Why Is a DOT Physical Exam Required?
The DOT physical exam is required every two years to ensure the health and capability of CMV drivers. Mandating DOT physical exams is a public safety issue since driving a 5-ton or more large truck can be dangerous if the driver is not healthy and of sound mind. Any health condition that can affect the driver is a public safety issue simply because of the size of the truck.
What Does the DOT Physical Exam Consist Of?
The DOT physical exam consists of documentation of the driver’s health, a series of tests, and a physical assessment performed by a doctor.
The health history of the driver includes questions about past and present medical problems involving:
Head or brain injuries or illnesses including concussions, seizures, or epilepsy
Eye problems excluding glasses or contacts
Ear and/or hearing problems
Heart attack, heart disease, bypass, or other heart problems, including pacemakers, stents, implantable devices, or other heart procedures
High blood pressure and high cholesterol
Chronic lung diseases, such as COPD or asthma
Kidney problems including kidney stones, pain with urination, or dialysis
Diabetes
Mental health concerns, such as anxiety, depression, nervousness, or other illnesses related to mental health
Fainting or passing out, dizziness, headaches, numbness, tingling, or memory loss
Cancer, unexplained weight loss, blood clots, or bleeding problems
Stroke, mini-stroke, paralysis, or weakness in extremities
Missing or limited use of arms, hands, fingers, legs, feet, or toes
Back or neck problems
Sleep disorders, such as narcolepsy or obstructive sleep apnea
Tobacco and alcohol use
Illegal drug use within 2 years
Failing a drug test or being addicted to drugs
Current medications
Surgeries
Stomach, liver, or digestive problems
Drivers are expected to fill out the health history form to the best of their knowledge and not include false or missing information.
DOT Physical Requirements
DOT physical requirements include vital signs, hearing, and vision tests, and a medical examination of the body systems. Based on these exams, the doctor can determine if the driver meets standards to pass the examination. The body systems assessed during the exam include skin, eyes, ears, mouth, throat, heart, lungs, abdomen, genito-urinary system including hernias, back and spine, extremities and joints, and the neurological system including reflexes and gait.
Vital signs include monitoring pulse rate, blood pressure while sitting, height, and weight. The hearing test includes a whisper test in which the doctor records the distance from the driver at which a forced whisper voice can be heard. Another hearing test is used with an audiometric machine using hertz from 500 Hz to 2000 Hz. Standard hearing test passing scores include a perceived whisper voice no less than 5 feet or an average hearing loss of less than 40dB with or without hearing aids.
The vision test is particularly important for the DOT physical exam. Standard passing scores include at least 20/40 acuity in each eye with or without correction and at least 70o field of vision in peripheral field. A color test will also be issued to verify that the driver can recognize and distinguish among traffic control signals and devices showing red, green, and amber colors.
During the physical exam, the presence of a certain condition may not necessarily disqualify the driver. If the condition is controlled adequately, is not likely to worsen, or is readily amenable to treatment then most likely the driver will pass.
How Do I Prepare For a DOT Physical Exam?
Before your DOT physical, you need to gather your medical information. To make sure the exam runs smoothly, it is best to be prepared before the exam. You should bring the following with you to the exam:
Eyeglasses or contacts
Hearing aids
Most recent lab results and your HgA1C level if you are diabetic along with blood sugar logs
Letter from a cardiologist if you have heart problems that outline the medical history, current medications, and indication to work
List of prescription medications including dosage regimens
Names of doctors who wrote your prescriptions
Your doctor’s office address and phone number
DOT Physical Exam Blood Test
DOT physical exam blood tests are similar to a regular physical exam. Blood tests typically include complete blood counts, chemistry panels and lipid panels. These blood tests give a good inclination of a person’s overall health and wellbeing. If abnormal values result from these blood tests, more specific tests may be ordered.
What Is the Highest Blood Pressure For a DOT Physical Exam?
High blood pressure can disqualify drivers from passing the DOT physical. A normal blood pressure is 120/80. A blood pressure of 180/120 or higher is considered a DOT disqualifying medical condition. When the condition resolves and the blood pressure goes down to 140/90, the driver may be certified at 6-month intervals. If the driver is able to lose weight, and come off all blood pressure medications, the medical examiner can grant a DOT physical medical card for up to 2 years.
What Is the Urine Test For a DOT Physical Exam?
A urine test, called a urinalysis, is completed during a DOT physical. A urinalysis is a urine sample test that detects protein, blood, or sugar in the urine. The presence of these particles may be an indication for further testing to rule out any underlying medical condition. Some medical conditions that would have the presence of protein, blood or sugar in the urine include kidney disease, UTIs, or even diabetes.
A urinalysis is done for several reasons, including to check your overall health, or diagnose certain medical conditions, such as if you are experiencing abdominal pain, back pain, or frequent urination. A urinalysis may help diagnose the causes of such symptoms, and if a urinary tract infection is suspected, it can be a valuable diagnostic tool. In certain situations, a urine sample may be used as a drug test. If the urinalysis indicates a urinary tract infection, consulting with a healthcare professional becomes crucial for a proper diagnosis and, if necessary, obtaining a UTI prescription for effective treatment.
What Can Disqualify You From a DOT Physical Exam?
Under FMCSA regulation, a medical examiner may not certify a driver who has a DOT disqualifying medical condition or uses medications or substances that compromises the ability to drive safely. Some conditions can disqualify you from a DOT physical, but may be at the discretion of the doctor. The condition must be serious enough to prevent the driver from resuming driving duties. Implementing the right treatment can reverse or control the underlying issue.
A disqualification may be temporary depending on the severity of the condition. Drivers may apply for exceptions for diseases including hypertension, respiratory dysfunction, diabetes, vision impairment, epilepsy, and mental disorders. If you have one of these conditions but you and your provider believe you are well enough to drive, you can apply for the FMCSA’s Driver exemption program. Once submitted, it can take 180 days to be reviewed and decided upon.
The following are considered automatic DOT disqualifying conditions:
Heart problems until resolved by a cardiologist, including chest pain due to heart disease (angina pectoris), reduced blood flow through one or more coronary arteries (coronary insufficiency), or risk of forming blood clots (thrombosis).
Epilepsy
Meniere’s disease
Uncontrolled blood pressure
Vision loss greater than 20/40 in each eye, with or without contacts or glasses
Failing both hearing tests (whisper and audiometry)
Use of marijuana
Diabetes- depending on 3 months of electronic glucose records
Receiving oxygen therapy
What Happens If You Fail a DOT Physical Exam?
If you fail a DOT physical, you can reapply or submit an exemption to the FMCSA for review. Reviews can take up to 180 days to get a response. If you are temporarily disqualified, typically you can request a reexamination in a few months.
DOT Physical Exam Near Me
DOT physical exams are performed at certain specialty clinics that only perform DOT physicals, urgent care clinics, and other certified medical examiner offices. If the exam goes well, the examiner will issue a DOT medical card that is good for 2 years.
Although PlushCare cannot give DOT exams, we can help you get all of your documentation you need to help you prepare for your DOT exam. PlushCare can help provide the necessary materials, such as blood labs and other medical information, to give to the DOT physical medical examiner.
Read More About Physical Exams
Sources
Federal Motor Carrier Safety Administration. DOT Medical Exam and Commercial Motor Vehicle Certification. Accessed on March 4, 2021 from https://www.fmcsa.dot.gov/medical/driver-medical-requirements/dot-medical-exam-and-commercial-motor-vehicle-certification
Federal Motor Carrier Safety Administration. Driver Medical Fitness for Duty. Accessed on March 21, 2021 at
https://www.fmcsa.dot.gov/medical/driver-medical-requirements/driver-medical-fitness-duty
U.S. Department of Transportation. DOT Guidance on Compliance with Drug and Alcohol Testing Regulations. Accessed on March 4, 2021 from https://www.transportation.gov/sites/dot.gov/files/2020-03/DOT_Guidance_on_Compliance_with_Drug_and_Alcohol_Testing_Regulations.pdf
The American Association of Nurse Practitioners. Prepare for the Federal Motor Carrier Safety Administration (FMCSA) Certification Examination. Accessed on March 4, 2021 from https://www.aanp.org/news-feed/prepare-for-the-federal-motor-carrier-safety-administration-fmcsa-certification-examination
