DOT Physical Medical Conditions: Complete Guide for Commercial Drivers

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.