DOT Physicals & Medical Cards
Drivers of commercial motor vehicles must be medically qualified. A certified medical examiner checks that you can safely handle a big vehicle for long hours, and issues a medical examiner’s certificate (the “medical card”) that lasts up to two years.
- Truck drivers
- Bus drivers
- Work vehicles
Who needs one
Generally, anyone who drives a commercial motor vehicle in interstate commerce: vehicles or combinations rated over 10,000 pounds, vehicles carrying 9 or more passengers for pay (or 16 or more without pay), or placarded hazmat. Many states require it for in-state drivers too. See DOT Rules for Work Trucks.
Who can do the exam
Only a medical examiner listed on FMCSA’s National Registry of Certified Medical Examiners. Your family doctor can do it only if they’re on the registry. Check the registry before you book.
What’s checked
| Area | Standard (summary) |
|---|---|
| Vision | At least 20/40 in each eye and both eyes together (with or without glasses or contacts), at least 70 degrees of side vision in each eye, and able to tell red, green and amber |
| Hearing | Hear a forced whisper at 5 feet in the better ear (hearing aids allowed), or pass a hearing test |
| Blood pressure | Below 140/90 for a full two-year card; higher readings may mean a shorter card or treatment first |
| Urine test | Checks for signs of kidney problems and diabetes (not a drug test) |
| Health history | Heart conditions, lung disease, seizures, sleep disorders, mental health, medications and more |
| Physical exam | General health, movement and anything that could affect driving |
Common conditions
- Diabetes treated with insulin: allowed if your treating doctor completes the required assessment form and your condition is stable.
- Sleep apnea: examiners may ask about snoring, daytime sleepiness and neck size, and may require a sleep study. Drivers who use CPAP as prescribed can usually stay certified. See Driver Fatigue & Sleep Apnea.
- Heart conditions: often require a clearance letter from a cardiologist.
- Medications: some, including certain sleep aids and opioids, can be disqualifying or require a doctor’s statement that they’re safe for driving.
- Vision or limb impairments: FMCSA has alternative standards and exemption programs in some cases.
How long the card lasts
Up to 24 months. The examiner can certify you for less time, such as one year, to monitor a condition like high blood pressure. Don’t let it lapse; you can’t drive a CMV without a valid certificate, and your state may downgrade your CDL.
Preparing for the exam
- Bring a list of all medications and doses
- Bring glasses, contacts or hearing aids you use while driving
- Bring records and clearance letters for conditions like diabetes, heart disease or sleep apnea
- Bring CPAP compliance reports if you use one
- Answer the health history honestly; false answers can cost you your CDL
Keep a copy: Examiners now report results electronically, and many states receive them directly. Still, keep a copy of your certificate until you’ve confirmed your state’s record is updated.
Standards & references
- FMCSA National Registry of Certified Medical Examiners
- 49 CFR 391.41: Physical qualifications for drivers
- See also: Fitness for Duty
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