DOT (Department of Transportation) Physical Exam: An Overview

Medically Reviewed by Jabeen Begum, MD on January 19, 2024

• Who Needs a DOT Physical?
• How to Get a DOT Medical Card
• What Does a DOT Physical Consist of?
• Where Can I Get a DOT Physical?

A Department of Transportation (DOT) physical is a physical exam that is required of people who drive commercial vehicles. The point of a DOT physical is to make sure that people who are driving commercial motor vehicles (CMVs), such as large trucks and buses, are physically, mentally, and emotionally fit. 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 eight people.
• Carry hazardous material in your vehicle that requires your vehicle to have a placard.
• Drive a vehicle on the interstate 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

If you pass your DOT physical, you’ll receive a Medical Examiner's Certificate (MEC), also known as your DOT medical card. This certification, along with your commercial driver’s license (CDL), allows you to drive a commercial vehicle for 2 years, provided you have no underlying physical or mental condition that requires testing more often.

Medical conditions that require you to have an annual DOT physical include:

• Diabetes
• 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:

• If you've ever had surgery
• Any medicines you're taking, including prescription and over-the-counter medicines
• Any health problems you've had
• If you use tobacco, alcohol, or illegal substances
• If you've ever failed a drug test
• If you've ever been dependent on an illegal substance
• Any symptoms you're currently having

You will have a hands-on physical that includes checking your:

• Height
• Weight
• Blood pressure
• Vision
• Hearing
• General appearance
• Skin
• Eyes
• Ears
• Mouth 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'll also get a urinalysis to check for protein, blood, sugar, and specific gravity. These tests can tell your doctor if you need additional tests to check for other medical problems. You may have other tests if your doctor thinks they're necessary.

You may 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

Where Can I Get a DOT Physical?

DOT physicals can only be performed by health care professionals who are certified by the FMCSA. You can search for a licensed medical examiner here. Licensed medical examiners may be:

• 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?

Ahead of your scheduled DOT physical, you can prepare by maintaining or improving your health. Try the following:

• Make sure your medications are up to date, and take them regularly as prescribed.
• If you wear eyeglasses or contact lenses, have your eyes checked and your prescription updated.
• Avoid heavy drinking.
• Don’t misuse substances.
• Avoid foods that adversely affect blood pressure, such as salty snacks.
• Avoid foods that adversely affect your blood glucose level, such as sugary sweets.
• Consider quitting smoking , if you smoke cigarettes or vape.
• Manage your weight. Exercise more often than not, and follow a healthy diet.

What Should I Bring to a DOT Physical?

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 of your doctors' names and addresses
• A list of all of 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 issues
• The results of recent heart tests, if you've had them
• A letter from your neurologist if you've 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)

What Conditions 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 are able to 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 didn't meet these standards but met all other standards of the 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’ll 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 keep it on at all times 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’ll 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 can't 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. Some companies will cover the cost for you, so check with your employer to see if they'll pay for your DOT physical.