Everything You Need to Know About DOT Physical Exams: A Guide by Twenty-One Medical

DOT Physical Exams

A Department of Transportation (DOT) physical is a required examination for individuals driving commercial motor vehicles (CMVs), such as large trucks and buses. This exam ensures that drivers are physically, mentally, and emotionally fit to operate these vehicles safely. The Federal Motor Carrier Safety Administration (FMCSA) mandates this testing to enhance public safety.

Who Needs a DOT Physical?

You 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 eight people.
  • Carry hazardous materials that require a placard on your vehicle.
  • Operate a vehicle in interstate commerce with a gross combination weight rating, gross vehicle weight rating, or gross combination weight of 10,000 pounds (5 tons) or more.

How to Get a DOT Medical Card

Passing your DOT physical will earn you a Medical Examiner’s Certificate (MEC), commonly known as a DOT medical card. This certification, combined with your commercial driver’s license (CDL), allows you to drive a commercial vehicle for two years, assuming no underlying health conditions necessitate more frequent testing. Conditions requiring annual DOT physicals include:

  • Diabetes
  • High blood pressure (hypertension)
  • Heart disease

For severe conditions, such as very high blood pressure, physicals may be required every three months during treatment.

What Does a DOT Physical Consist of?

The healthcare provider will ask detailed questions about your medical history, including:

  • Past surgeries
  • Current medications (both prescription and over-the-counter)
  • Health issues you’ve experienced
  • Use of tobacco, alcohol, or illegal substances
  • History of drug test failures or dependence on illegal substances
  • Any current symptoms

The hands-on physical examination will assess:

  • Height and weight
  • Blood pressure
  • Vision and hearing
  • General appearance
  • Skin, eyes, ears, mouth, and throat
  • Heart, lungs, chest, abdomen, back, and spine
  • Genital and urinary system (including hernia check)
  • Extremities and joints
  • Nervous system and reflexes
  • Gait (how you walk)
  • Circulatory system (arteries, veins, lymphatic system)

A urinalysis will be conducted to check for protein, blood, sugar, and specific gravity, indicating if further tests are needed. You may also require additional tests if symptoms suggest conditions like obstructive sleep apnea, which can present with heavy snoring, gasping for breath during sleep, dry mouth or sore throat in the morning, morning headaches, or daytime sleepiness.

Where Can I Get a DOT Physical?

DOT physicals must be performed by healthcare professionals certified by the FMCSA. Certified examiners include:

  • Doctors of medicine (MD)
  • Doctors of osteopathy (DO)
  • Doctors of chiropractic (DC)
  • Physician assistants (PA)
  • Advanced practice registered nurses (APRN)
  • Nurse practitioners (NP)

How Do You Prepare for a DOT Physical?

Prepare for your DOT physical by maintaining or improving your health. Consider these tips:

  • Keep your medications updated and take them as prescribed.
  • Ensure your eyeglass or contact lens prescription is current.
  • Avoid heavy drinking and substance misuse.
  • Steer clear of foods that negatively impact blood pressure (e.g., salty snacks) and blood glucose levels (e.g., sugary sweets).
  • Quit smoking or vaping if applicable.
  • Manage your weight through regular exercise and a healthy diet.

What Should I Bring to a DOT Physical?

Bring the following to your DOT physical:

  • A list of your doctors’ names and addresses
  • A list of your medications and dosages
  • Glasses, contacts, or hearing aids, if used
  • Blood sugar readings and recent HbA1C results if diabetic
  • CPAP machine records showing 90-day compliance if you have sleep apnea
  • A cardiologist’s letter indicating you’re safe to drive if you have heart issues
  • Results of recent heart tests, if applicable
  • A neurologist’s letter if you’ve had a stroke, brain tumor, seizure disorder, or brain bleeding
  • A doctor’s letter if taking medications causing sleepiness or controlled substances
  • A doctor’s letter if you’ve lost permanent use of an arm or leg, detailing work restrictions
  • Recent blood level and clearance test results if on warfarin (Coumadin)

What Conditions Disqualify You From Getting a DOT Card?

Certain conditions may disqualify you from passing a DOT physical due to their impact on safe driving, including:

  • Uncontrolled or unstable heart conditions
  • Epilepsy or seizure disorders
  • Meniere’s disease (causing dizziness)
  • Uncontrolled diabetes or high blood pressure
  • Uncorrected vision or hearing loss
  • Use of marijuana (even if prescribed) or illegal substances
  • Need for oxygen therapy
  • Specific respiratory conditions
  • Kidney disease indicated by protein in urine

Some disqualifications are at the medical examiner’s discretion, but exemptions or waivers from the FMCSA may be available for certain conditions. Addressing and controlling disqualifying conditions can allow for reapplication for certification.

What Are the New DOT Physical Requirements?

Vision Requirements:

  • Must have 20/40 vision in each eye (with or without correction) and a field of vision of 70 degrees or more in each eye.
  • Ability to distinguish between red, green, and amber.

Hearing Requirements:

  • Must hear a “forced whisper” at 5 feet with or without a hearing aid.
  • If hearing aid is needed, it must be worn while driving.
  • Failure to pass requires referral for an audiometry test, and failure with aids results in disqualification.

Blood Pressure Requirements:

  • Must be 140/90 or below to pass.
  • Hypertension treatment requires more frequent certification:
    • 140/90 to 159/99: certified for 1 year.
    • 160/100 to 179/109: temporary 3-month certification; must reduce BP below 140/90 for 1-year certification.
    • Above 180/110: disqualified until BP is below 140/90, then certified for 6 months.

Conclusion

For professional DOT physical exams in Pineville, NC, visit Twenty-One Medical. We provide comprehensive DOT exam services to ensure you meet FMCSA requirements and can safely operate commercial vehicles. Schedule your DOT physical with us today to stay compliant and on the road.