Work out exactly when a medical examiner's certificate expires, see how long a certificate is likely to be issued for, and take a prepared checklist to the examination. Built from the driver qualification standards in 49 CFR Part 391 Subpart E.
The federal standards an examiner works to
At least 20/40 acuity in each eye and both together, with or without correction, a field of vision of at least 70 degrees in the horizontal meridian in each eye, and the ability to recognise the colours of traffic signals.
Perceive a forced whisper at not less than 5 feet, or an average hearing loss of no more than 40 decibels at 500, 1,000 and 2,000 Hz, with a hearing aid if one is worn.
FMCSA guidance certifies at up to 2 years below 140/90, 1 year at stage 1, a one-time 3-month certificate then 1 year at stage 2, and disqualifies at 180/110 until treated, then 6-month recertification.
The maximum is 24 months. The examiner may certify for a shorter period whenever more frequent monitoring is needed, and records the reason on the certificate.
What to take to the examination
Photo ID and your driver licence or CDL. If you wear glasses, contact lenses or a hearing aid, bring them.
Names, dosages and prescribing clinicians for everything you take, including over-the-counter medicines.
ITDM form for insulin-treated diabetes, CPAP compliance data for sleep apnea, cardiac or neurological clearance letters, and any current federal exemption.
DOT physical questions
What is a DOT physical?
A DOT physical is the medical examination required by 49 CFR 391.41 before a driver may operate a commercial motor vehicle in interstate commerce. It must be carried out by a medical examiner listed on the FMCSA National Registry, who checks vision, hearing, blood pressure, general health and medical history, then issues a medical examiner's certificate if the driver is qualified.
How long is a DOT physical good for?
The maximum certification period is 24 months. A medical examiner can certify a driver for a shorter period, commonly 12 months, 6 months or 3 months, when a condition such as raised blood pressure, insulin-treated diabetes or treated sleep apnea needs monitoring. The certificate shows the exact expiry date.
Does a DOT physical include a drug test?
No. The urinalysis in a DOT physical screens for protein, blood and sugar as general health indicators, not for drugs. DOT drug testing under 49 CFR Part 40 and Part 382 is a separate, separately authorised test. Many employers book both on the same visit, which is why the two are often confused.
What disqualifies you from a DOT physical?
Common blocks include blood pressure of 180/110 or above until it is brought down, uncorrected vision below the 20/40 and field-of-vision standards, hearing below the forced-whisper or audiometric standard, current use of a Schedule I substance, and epilepsy or other conditions likely to cause loss of consciousness. Several of these have federal exemption or waiver programmes.
What happens if my medical card expires?
The driver is no longer medically qualified and must not operate a commercial motor vehicle. For CDL holders the state licensing agency is notified and the CDL can be downgraded to a non-commercial licence, which is why the certificate should be renewed before the expiry date rather than after it.
How much does a DOT physical cost?
Price is set by each clinic or examiner and varies by location and whether extra testing is needed, so ask the provider directly when booking. Many employers pay for the examination as part of hiring.
Official sources
- FMCSA National Registry: find a certified medical examiner
- 49 CFR 391.41: physical qualifications for drivers
- 49 CFR 391.43: medical examination and certificate
- FMCSA medical programs and forms
Rules and agency systems can change. Check the linked source before making a filing or compliance decision.
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