Medically reviewed by Dr. Alan M. Tebby, D.C., FMCSA Certified Medical Examiner | Last updated: January 21, 2026
TL;DR: What You Need to Know
Most medical conditions do not automatically disqualify commercial drivers from DOT certification. FMCSA standards under 49 CFR 391.41 evaluate whether conditions are adequately controlled and do not interfere with safe vehicle operation. Drivers with diabetes, hypertension, sleep apnea, heart conditions, and many other health issues can obtain DOT medical cards with proper documentation and treatment compliance. Charlotte DOT Exam Center’s FMCSA-certified medical examiners have 84+ combined years of experience helping drivers with complex medical histories achieve certification. Call 704-544-3494 for same-day appointments. $70 flat rate.
DOT Medical Certification Periods by Condition
The following table shows typical certification periods for common medical conditions. Individual circumstances may vary based on treatment compliance and disease stability.
| Medical Condition | Certification | Key Requirements |
|---|---|---|
| Healthy (no conditions) | 24 months | Meet all FMCSA physical standards |
| Stage 1 Hypertension (140-159/90-99) | 12 months | Annual recertification required |
| Stage 2 Hypertension (160-179/100-109) | 12 months (one-time) | Must achieve <140/90 for renewal |
| Type 2 Diabetes (non-insulin) | 12-24 months | A1C documentation, no hypoglycemia |
| Insulin-Treated Diabetes | 12 months max | ITDM exemption, endocrinologist clearance |
| Sleep Apnea (treated) | 12 months | CPAP compliance: 4+ hrs/night, 70% of nights |
| Heart Attack/Bypass/Stents | 12 months | Cardiologist clearance, stress test |
| Seizure Disorder | Disqualified* | *Exemption possible after 8+ years seizure-free |
| Vision (corrected to 20/40) | 24 months | Glasses/contacts permitted |
| Monocular Vision | 12 months | Vision exemption required |
| Hearing Loss (with aids) | 24 months | Must pass whisper test or audiometry |
How Medical Conditions Affect DOT Certification
The Federal Motor Carrier Safety Administration (FMCSA) establishes medical fitness standards for commercial motor vehicle (CMV) drivers under 49 CFR Part 391. These regulations protect public safety while providing pathways for drivers with manageable health conditions to maintain their careers.
FMCSA Medical Examiner Evaluation Process
During a DOT physical examination, the certified medical examiner evaluates whether your medical condition:
- Is likely to cause sudden incapacitation while driving
- Interferes with your ability to safely control a commercial vehicle
- Requires medications that impair driving ability
- Is adequately controlled with current treatment
Three Certification Outcomes
After your DOT physical, the medical examiner will determine one of three outcomes:
1. Certified: You meet all FMCSA standards. Certificate valid for up to 24 months depending on health status.
2. Certified with Conditions: You meet standards but require more frequent monitoring. Certificate valid for 3-12 months with specific documentation requirements.
3. Not Certified: Your condition currently prevents safe operation of a CMV. The examiner will explain what steps may lead to future certification.
How to Get a DOT Physical with Medical Conditions: 5 Steps
Follow these steps to successfully obtain DOT medical certification with a pre-existing medical condition:
Step 1: Identify Your Medical Condition Requirements
Review FMCSA requirements for your specific medical condition. Conditions like diabetes, hypertension, sleep apnea, and heart disease have specific documentation requirements. Check the condition categories below to understand what applies to you.
Step 2: Gather Required Documentation
Collect all necessary documents before your appointment. For diabetes, bring recent A1C results within 90 days. For sleep apnea, bring CPAP compliance data showing 4+ hours/night on 70% of nights. For heart conditions, obtain cardiologist clearance and stress test results. See complete documentation checklist.
Step 3: Schedule or Walk In for Your DOT Physical
Call Charlotte DOT Exam Center at 704-544-3494 or walk in during business hours. For complex medical situations, calling ahead allows staff to confirm you have all required documentation. Walk-ins welcome Monday-Friday 8:30am-5:00pm, Saturday 8:30am-12:00pm. $70 flat rate regardless of medical complexity.
Step 4: Complete the DOT Physical Examination
The FMCSA-certified medical examiner reviews your documentation and medical history, then performs the physical examination including vision test (20/40 minimum), hearing test (whisper test), blood pressure measurement, and condition-specific assessments. Examination takes 30-45 minutes.
Step 5: Receive Your DOT Medical Certificate
If you meet FMCSA standards, you receive your DOT medical certificate same-day. Certificate validity ranges from 3-24 months depending on your medical condition. Results are electronically submitted to the FMCSA National Registry within one hour. If not certified, the examiner explains next steps for future certification.
DOT Physical Medical Conditions A-Z: Complete Guide by Category
Select your condition category below to learn specific FMCSA requirements, certification pathways, required documentation, and how Charlotte DOT Exam Center can help you achieve certification.
Cardiovascular Conditions
Heart and blood vessel conditions are among the most common issues affecting commercial driver certification. FMCSA evaluates cardiovascular risk based on diagnosis severity, treatment stability, and functional capacity.
- High Blood Pressure (Hypertension)
- Borderline Blood Pressure
- Heart Disease Overview
- Heart Conditions, Pacemakers & Stents
- Congestive Heart Failure
- Pacemakers & Defibrillators (ICDs)
- Heart Attack Recovery
- Coronary Bypass Surgery (CABG)
- Cardiac Stents
- Arrhythmia & Atrial Fibrillation
- Blood Thinners & Anticoagulants
- Heart Valve Replacement
- Aortic Aneurysm
- Peripheral Artery Disease (PAD)
Neurological Conditions
Neurological conditions require careful evaluation because they may cause sudden incapacitation. Many drivers with stable, treated neurological conditions can achieve certification with proper documentation.
- Neurological Disorders Overview
- Seizures & Epilepsy
- Stroke Recovery
- Multiple Sclerosis (MS)
- Parkinson’s Disease
- Peripheral Neuropathy
- Vertigo & Vestibular Disorders
- Traumatic Brain Injury (TBI)
- Migraines & Chronic Headaches
- Narcolepsy
Metabolic & Endocrine Conditions
Diabetes is the most common metabolic condition affecting commercial drivers. FMCSA has specific protocols for both insulin-treated and non-insulin diabetes, as well as other endocrine disorders.
- Diabetes Overview
- Diabetes A1C Requirements
- Insulin-Treated Diabetes (ITDM)
- Hypoglycemia
- Thyroid Conditions
- Obesity & BMI Requirements
- Kidney Disease & Dialysis
- Liver Conditions
Respiratory & Sleep Conditions
Sleep apnea affects an estimated 28% of commercial drivers. FMCSA requires treatment compliance documentation. Other respiratory conditions are evaluated based on their impact on driver alertness and physical capability.
- Sleep Apnea Overview
- Sleep Apnea CDL Requirements
- Sleep Apnea FMCSA Regulations
- Sleep Apnea New Rules
- Respiratory & Lung Conditions
- COPD
- Asthma
- Pulmonary Fibrosis
Mental Health Conditions
FMCSA evaluates mental health conditions based on stability, treatment compliance, and whether medications cause impairing side effects. Many drivers with well-managed mental health conditions qualify for certification.
- Mental Health Standards Overview
- Mental Health Requirements
- ADHD
- Anxiety Disorders
- Depression
- PTSD
- Bipolar Disorder
- Schizophrenia & Psychosis
- Substance Abuse Recovery
Vision Conditions
FMCSA requires minimum 20/40 acuity in each eye and 70-degree peripheral vision. Drivers who cannot meet standards with correction may qualify for vision exemptions.
- Vision Requirements Overview
- Vision Exemption & Waiver
- Monocular Vision
- Color Blindness
- Cataracts & Glaucoma
Hearing Conditions
Drivers must perceive a forced whisper at 5 feet or pass audiometric testing. Hearing aids are permitted. Federal hearing exemptions are available for qualified drivers.
- Hearing Requirements Overview
- Hearing Test & Whisper Standards
- Deaf Drivers CDL Guide
- Hearing Aids
- Hearing Exemption Program
Musculoskeletal & Physical Conditions
Physical limitations are evaluated based on whether they prevent safe vehicle operation. The Skill Performance Evaluation (SPE) certificate program allows drivers with limb impairments to demonstrate driving competency.
- Hernia
- Back Problems & Spinal Conditions
- Arthritis
- Amputation & Limb Deficiency
- Chronic Pain Management
- Rheumatoid Arthritis
- SPE Certificate Guide
- Carpal Tunnel Syndrome
Other Medical Conditions
Additional conditions that may affect DOT certification, including cancer history, organ transplants, and post-surgical clearance requirements.
FMCSA Exemption Programs
Federal exemption programs allow qualified drivers with certain disqualifying conditions to obtain DOT medical certification. These programs require specific documentation and ongoing compliance monitoring.
Available Exemption Programs
Vision Exemption Program: For drivers who cannot meet the vision standard in one or both eyes. Requires 3 years of driving experience with the vision deficiency and ophthalmologist evaluation.
Hearing Exemption Program: For drivers who cannot meet the hearing standard. Requires audiologist evaluation and demonstration of safe driving ability.
Seizure Exemption Program: For drivers with a history of epilepsy who have been seizure-free for 8+ years off anti-seizure medication, or 10+ years on stable medication.
Insulin-Treated Diabetes Mellitus (ITDM): For insulin-dependent drivers. Requires endocrinologist evaluation, stable glucose control, and ongoing monitoring every 12 months.
Skill Performance Evaluation (SPE): For drivers with limb impairments. Requires road test with state examiner demonstrating ability to safely operate CMV.
What to Bring to Your DOT Physical for Medical Conditions
Proper documentation speeds your examination and improves certification outcomes. Bring the following items based on your medical conditions:
All Drivers Should Bring
- Valid photo ID (driver’s license or passport)
- Current glasses or contact lenses if worn
- Complete list of current medications with dosages
- Names and contact information for treating physicians
Condition-Specific Documentation
Diabetes: Recent A1C results (within 90 days), blood glucose logs, endocrinologist clearance letter for insulin users, completed ITDM form if applicable.
Sleep Apnea: CPAP compliance download showing 4+ hours/night on 70%+ of nights, sleep study results, treating physician clearance.
Heart Conditions: Cardiologist clearance letter, stress test results (within 12 months), echocardiogram if applicable, current medication list.
Hypertension: Blood pressure log showing recent readings, primary care physician clearance if readings are borderline.
Vision/Hearing: Recent eye exam results, audiogram if hearing aids are worn, vision exemption documentation if applicable.
Mental Health: Treating psychiatrist/psychologist clearance letter, documentation of medication stability, assessment that condition does not impair driving.
Why Drivers with Medical Conditions Choose Charlotte DOT Exam Center
Since 1991, Charlotte DOT Exam Center has helped thousands of commercial drivers with complex medical histories achieve and maintain DOT certification. Our FMCSA-certified medical examiners understand the regulations and work with drivers to find certification pathways.
84+ Years Combined Medical Examiner Experience
Dr. Alan M. Tebby, D.C.
FMCSA Certified Medical Examiner
NPI: 1407931991
40+ years clinical experience
Board Eligible Chiropractic Orthopedist
Dr. Lemuel P. Byrd, Jr., D.C., C.C.S.T.
FMCSA Certified Medical Examiner
NPI: 1205835543
44+ years clinical experience
Certified in Spinal Trauma
What Sets Us Apart for Complex Medical Evaluations
- $70 flat rate — same price regardless of medical complexity
- Same-day certification for drivers who meet standards
- Walk-ins welcome Monday-Friday 8:30am-5:00pm, Saturday 8:30am-12:00pm
- FMCSA National Registry electronic submission within 1 hour
- Guidance on documentation requirements before your visit
- Clear explanation of next steps if certification is delayed
- 4.8/5 rating from 426+ reviews
Charlotte DOT Exam Center Location
Address
Charlotte DOT Exam Center
8415 Pineville-Matthews Road, Suite 102
Charlotte, NC 28226
Phone: 704-544-3494
Email: appt@tebbyclinic.com
Hours
Monday-Friday: 8:30am – 5:00pm
Saturday: 8:30am – 12:00pm
Walk-ins Welcome
Serving Charlotte metro since 1991
Areas We Serve
Charlotte DOT Exam Center serves commercial drivers throughout the Charlotte metropolitan area including Charlotte, Pineville, Matthews, Mint Hill, Ballantyne, South Charlotte, Huntersville, Concord, Gastonia, Indian Trail, Monroe, Mooresville (NC), and Rock Hill, Fort Mill, Tega Cay (SC).
Frequently Asked Questions: DOT Physicals and Medical Conditions
Q: Can I pass a DOT physical with high blood pressure?
Yes. Blood pressure under 140/90 qualifies for a 2-year certificate. Stage 1 hypertension (140-159/90-99) receives a 1-year certificate. Stage 2 (160-179/100-109) may receive a one-time 1-year certificate. Blood pressure at or above 180/110 requires treatment before certification. Our medical examiners can advise on steps to improve your readings before examination.
Q: What happens if I fail the DOT physical due to a medical condition?
You receive a detailed explanation of which condition caused the determination and what steps may lead to certification. Many drivers return after obtaining specialist clearance, adjusting medications, or demonstrating treatment compliance. Charlotte DOT Exam Center works with drivers to identify the fastest pathway to certification.
Q: Can I get a CDL with diabetes?
Yes. Non-insulin-dependent diabetes typically qualifies for 12-24 month certification with documented A1C control and no history of severe hypoglycemia. Insulin-treated diabetes requires the ITDM exemption process, including endocrinologist evaluation and ongoing monitoring. Our examiners are experienced with diabetes certification.
Q: How does sleep apnea affect DOT certification?
Diagnosed sleep apnea requires treatment compliance documentation. FMCSA standards require CPAP use of at least 4 hours per night on 70% of nights. Bring your CPAP compliance download to your appointment. Treated, compliant drivers typically receive 1-year certification.
Q: What medications disqualify you from a DOT physical?
Schedule I drugs (marijuana, heroin, etc.) are absolutely disqualifying. Methadone is disqualifying regardless of reason. Many other medications are evaluated based on side effects and impairment potential. Bring your complete medication list and the examiner will evaluate each one. Most prescription medications do not disqualify drivers.
Q: Can I get a DOT medical card with ADHD?
Yes. ADHD does not automatically disqualify drivers. The medical examiner evaluates whether your condition and medications impair safe driving. Stimulant medications (Adderall, Ritalin, Vyvanse) require documentation of stable dosing. Bring clearance from your prescribing physician.
Q: What if I have anxiety or depression?
Anxiety and depression do not automatically disqualify drivers if well-controlled with treatment. Bring documentation from your treating provider confirming stable condition, medication compliance, and clearance for commercial driving. Benzodiazepines (Xanax, Valium, Ativan, Klonopin) may require additional evaluation.
Q: How long does the DOT physical take for drivers with medical conditions?
Most examinations complete in 30-45 minutes. Drivers with complex medical histories may need additional time for documentation review. Bring all required documentation to avoid delays. Same-day certification is available for drivers who meet standards.
Q: What vision do I need to pass a DOT physical?
FMCSA requires minimum 20/40 acuity in each eye (with or without correction) and 70-degree peripheral vision in each eye. Drivers who cannot meet these standards may apply for a vision exemption. Color recognition for traffic signals is also required.
Q: Can I drive commercially after a heart attack?
Yes, with cardiologist clearance. Waiting periods apply: typically 2 months minimum after uncomplicated heart attack, longer for complications. You will need stress test results, echocardiogram if applicable, and written clearance from your cardiologist. Certification is typically limited to 1 year.
Q: What happens if my blood pressure is too high at the exam?
If your blood pressure exceeds 140/90, the examiner may allow you to rest and retest. For readings between 140-159/90-99, you may receive a 1-year certificate. Higher readings may result in a temporary certificate to allow time for treatment, or you may be asked to return after starting medication.
Q: Do I need a doctor’s note for my medical conditions?
Specialist clearance letters are required for certain conditions including heart disease, insulin-treated diabetes, and seizure history. For other conditions, bring documentation of your diagnosis, treatment, and current stability. Our staff can advise you on specific documentation requirements when you call.
Q: Can I get certified with a pacemaker or defibrillator?
Pacemakers are generally certifiable with cardiologist clearance. Implantable cardioverter-defibrillators (ICDs) are more complex. Drivers with ICDs may be certifiable depending on the underlying condition and device history. Cardiologist documentation and waiting periods apply.
Q: What if I take blood thinners?
Blood thinners (Warfarin, Eliquis, Xarelto, Plavix) do not automatically disqualify drivers. The underlying condition requiring anticoagulation is evaluated. Bring documentation of stable INR levels if taking Warfarin, and cardiologist clearance if applicable.
Q: How do I schedule an appointment for a DOT physical with medical conditions?
Call 704-544-3494 or walk in during business hours. For complex medical situations, calling ahead allows our staff to advise on required documentation. Bring all medical records, specialist letters, and medication lists to your appointment for the fastest possible certification.
Key Takeaways: DOT Physical Medical Conditions
- Most medical conditions do not automatically disqualify you — FMCSA evaluates whether your condition is adequately controlled
- Documentation is critical — Bring A1C results, CPAP compliance data, specialist clearance letters, and medication lists
- Certification periods vary — Healthy drivers get 24 months; most treated conditions receive 12-month certificates
- Exemption programs exist — Vision, hearing, seizure, ITDM, and SPE exemptions provide pathways for qualifying drivers
- Blood pressure thresholds are firm — Under 140/90 for 2 years, 140-159/90-99 for 1 year, 180/110+ requires treatment first
- Same-day certification available — Drivers who meet standards leave with their DOT medical card the same day
- $70 flat rate at Charlotte DOT Exam Center — No additional charges for complex medical evaluations
Schedule Your DOT Physical Today
Don’t let a medical condition keep you off the road. Charlotte DOT Exam Center’s experienced medical examiners help drivers with diabetes, hypertension, sleep apnea, heart conditions, and other health issues achieve DOT certification every day.
$70 Flat Rate • Walk-Ins Welcome • Same-Day Certification
