A DOT physical is a mandatory medical exam for CDL drivers and some non-CDL drivers that are regulated by the DOT.
The DOT physical is intended to make sure that a driver's physical and mental health will not impair their driving ability.
After passing a DOT physical, drivers will be issued a medical examiner’s certificate, also called a medical card. The medical card is required to operate a vehicle that requires a commercial driver’s license (CDL) or to drive a vehicle over 10,000 pounds across state lines. CDL drivers will also need to provide a copy of their medical card to their state’s driver’s license agency.
The DOT physical exam usually lasts around 45 minutes. We cover exactly what to expect during the physical examination here.
When you pass, you are issued a medical card that is valid for 24 months or less. When a medical card is valid for less than 24 months, it is usually because a medical issue requires more frequent check-ins.
A DOT medical card, or medical examiner’s certificate, provides proof that an individual has successfully completed a DOT physical and meets the medical requirements to hold a CDL.
The Federal Motor Carrier Safety Administration (FMCSA), a division of DOT, provides this sample of a medical certificate.
The DOT medical card also provides an expiration date by which the driver will need to take another physical.
If a non-CDL driver operates a vehicle over 10,000 pounds across state lines, they will need to carry a copy of their valid medical card, but they are not required to submit it to the DOT or to their state driver’s licensing agency.
CDL drivers must submit the medical card to their state driver’s licensing agency when they apply for or renew their CDL. State applications vary, so be sure to check with your state agency for detailed application instructions. FMCSA has a state-by-state guide with instructions on submitting medical cards to each state’s driver’s license agency.
A medical card is typically good for 24 months but certain medical conditions may require more frequent renewals.
These decisions are made by the medical examiner, but common conditions that result in shorter medical card lengths include:
Any driver required to have a valid medical card can receive traffic citations and fines if you continue to drive with an expired card.
If you hold a CDL, then the consequences of letting your medical card expire vary by state. In most states, your license will either be downgraded or suspended if you let your medical card expire. FMCSA maintains a list of state requirements that includes the state penalties for not renewing.
Any driver that operates a commercial vehicle is required to carry a medical card by law. The FMCSA defines a commercial vehicle as:
If you operate a vehicle that meets any of these criteria, then you must go through a DOT medical exam and maintain a valid medical card.
Even if you are not required to hold a CDL, you must undergo a DOT physical and maintain a valid medical card if you operate a commercial vehicle.
The only difference for non-CDL drivers who operate a commercial vehicle is that they do not have to submit the medical card to their state driver’s licensing agency.
Yes, potential CDL candidates will need to pass a DOT physical before they are allowed to take the CDL permit exam.
The DOT physical is meant to be a comprehensive look at your overall health. You should expect several tests and a general medical examination during your visit. This will include:
To pass the vision test, you need to have a minimum of 20/40 visual acuity in both eyes. You are allowed to wear contact lenses or eyeglasses to meet this standard. Your peripheral vision will also be checked. The minimum peripheral vision to pass is at least 70 inches in both eyes.
Since 2018, drivers with monocular vision (impaired vision in one eye) may be able to receive a medical card despite not meeting the vision standards in both eyes. A separate evaluation by an optometrist, ophthalmologist, or your medical examiner if they are qualified, will be conducted. While you no longer need to apply for an exemption to receive your medical card, having monocular vision will result in a maximum 12-month medical card rather than the standard 24 months.
The hearing test will check whether you can hear a whisper from five feet away. The examiner will stand behind you at least five feet away and whisper a short word or set of numbers and letters. You will need to repeat this back to the examiner.
An examiner may instead use a device to measure your hearing, which will check that you can hear below 40 decibels in your good ear. Hearing aids can be worn during the hearing test for either test method.
Your examiner will take readings of both your blood pressure and your pulse rate. Passing blood pressure is anything below 140/90. The pulse rate is used to check for an irregular heartbeat.
You will need to provide a urine sample, which may or may not be tested for drugs. The DOT does not require a drug test during the physical, though you will need to undergo random drug screening if you hold a CDL or are hired into a federal driving position. Many employers will also require you to complete a pre-employment drug screen during the DOT medical exam. Keep in mind that marijuana use is a disqualifying condition, whether it shows on a drug screen or you disclose it verbally to the examiner.
The urine test is also used to identify other health conditions, such as diabetes. Since 2018, insulin-regulated diabetes will not prevent you from receiving a medical card. However, you will be required to show treatment status from your doctor and will be issued a medical card for no more than 12 months instead of the usual 24 months.
This test will not be performed at the exam but might be a requirement before you can pass. The following symptoms usually lead to a required sleep apnea test:
If you are found to have sleep apnea, treatment options vary. You may be advised to lose weight and use a mouth guard to improve your breathing while asleep. Moderate to severe sleep apnea may require a CPAP machine, which delivers steady air pressure through a mask and nosepiece.
The examiner will perform an overall check of your health and body appearance. Specific checks include:
Any signs of medical issues which could impair your driving may require you to undergo additional tests or treatment before you can be issued a medical card.
A temporary medical card is issued when your medical examiner identifies a health condition that needs to be addressed before they can issue your regular medical card.
The most common length for a temporary medical card is three months. When these are issued, you typically need to do something to bring a medical condition under control. A new exam is required before the temporary medical card expires.
If you do not meet the requirements to pass your DOT physical, it may be possible to obtain an exemption. Exemptions are considered for hearing and conditions causing seizures. Before 2018, exemptions were also considered for vision impairment and diabetes. Rule changes have allowed greater discretion for medical examiners to approve medical cards for drivers with some vision impairments or well-controlled diabetes.
Applying for an exemption should only occur when you are not able to improve your health through other means. Processing for exemption applications can take up to 180 days. The exemption process begins with completing an application package, available through FMCSA.
You will fail a DOT physical if you have a condition that could cause impairment or make you unable to drive safely. While discretion is left to the medical examiner, conditions that can result in a failed physical include:
Conditions that could cause a fail, depending on your medical examiner’s discretion, include:
When you fail your DOT physical, the results are uploaded to the FMCSA database. Since you won’t receive a medical card, this can impact your CDL or employment.
If you fail your medical exam, the first thing is to understand why you failed. Ask for guidance on any treatment or personal changes that might improve your health to meet the DOT standards. You can also ask for options that may help you be considered for recertification
If you believe the reason you failed is truly unreasonable, then you can seek a second opinion. The second examiner will need to review your complete medical history before giving their opinion. If the second examiner decides you meet the requirements, then the passed result will be uploaded to FMCSA and take the place of the failed result.
Keep in mind that FMCSA may contact you or start an investigation if they receive a pass result shortly after you failed. They also receive notice of incomplete exams if you leave before an exam is completed. It is much better to focus on improving your health than to doctor shop or end an exam early when you think you might fail.
There is no required waiting period after a failed DOT physical before you can book a new exam.
How long you wait will depend on why you failed and what has been recommended to improve your health. If you undergo treatment or change medication, be sure to explain to your next medical examiner what has changed since the last physical.
To make your the process as straightforward as possible, take time to schedule it in advance and bring all needed paperwork with you. Scheduling 45-60 days before your current medical card expires will make sure you have time to deal with any additional tests or retrieve information your medical examiner needs.
Before your physical, fill out the driver’s portion of the Medical Examination Report Form. This will save you from needing to fill it out in the waiting room and will help you remember any doctor’s notes or medication details you will need to provide.
Bring the following items with you:
To prepare, you should adopt healthy eating habits, drink enough water, ensure you get enough sleep, and engage in physical activity appropriate for your ability.
DOT physicals are widely available nationwide. Popular locations for include:
DOT physicals can only be performed by FMCSA-certified medical examiners. You can search through the FMCSA registry to find a medical examiner near you.
Your DOT physical cannot be conducted virtually from your home. In some states, a medical examiner can examine you remotely with the in-person assistance of a nursing professional. This means that you may have a nurse walk through the exam with you in a clinic while the medical examiner is connected via a video call.
The price for a DOT physical varies by location and provider but they typically cost between $50 and $300.
If you are employed, check whether your employer covers the costs before making your appointment. For new drivers, many companies will offer DOT physicals during training.
Unfortunately, most insurance does not cover DOT physicals. This is because it is considered an employment test, not standard healthcare. You can check with your insurance provider to be sure of your coverage options.
If you are self-employed or your employer does not cover the cost of DOT physicals, the best way to find a cheap option is to call around. Ask for pricing before making a clinic appointment or starting the examination. As these are standardized exams, most clinics charge a set price and can tell you that price upfront.
Common questions about the DOT physical and medical card.
DOT driving refers to any commercial vehicle driving that is subject to DOT regulations. If you hold a commercial driver’s license, or if you operate a vehicle over 10,000 pounds across state lines, then you are subject to DOT regulations.
These terms mean the same thing. A DOT physical is necessary to apply for or renew a CDL, and so it is sometimes called a CDL physical.
Yes, if the injury or illness has impaired your ability to drive safely. Your motor carrier may require you to complete a new DOT physical even if you believe your ability has not been impaired.
You will pass with anything below 140/90. Readings above 140/90 can require further testing, treatment referral, or result in a failed exam.
This is the most common length for a temporary medical card issued when you have a health condition that needs to be monitored or addressed before you can be issued a regular medical card.
Only one. Temporary medical cards, including a 3-month DOT medical card, are intended to give time to resolve a health condition. If unimproved, your next exam may result in a failed physical.
Probably not. Synthetic urine such as UPass lacks uric acid found in human urine and is not reliable to pass urine tests.
This varies by state but can include traffic citations, fines for the driver and employer, license suspension, and immediate refusal to allow you to continue driving.
No. Consequences vary by state, but most likely your license will be downgraded or suspended if a new medical card is not provided.
Yes. Most clinics bill DOT physicals under the CPT code 99455.