Medically reviewed by Dr. Lemuel P. Byrd, Jr., D.C., FMCSA Certified Medical Examiner | Last updated: January 21, 2026
TL;DR: DOT Physical with Aortic Aneurysm
Aortic aneurysms require careful evaluation for DOT medical certification due to the risk of rupture or dissection. Small, stable aneurysms under regular monitoring may be certifiable with specialist clearance. Larger aneurysms or those approaching surgical thresholds are generally disqualifying until repaired. After successful surgical repair (open or endovascular), drivers can typically be certified with appropriate waiting period and documentation. Certification depends on aneurysm size, location, growth rate, and vascular surgeon clearance. At Charlotte DOT Exam Center, we evaluate drivers with vascular conditions. Call 704-544-3494. $70 flat rate.
Understanding Aortic Aneurysms and DOT Certification
An aortic aneurysm is a weakened, bulging area in the wall of the aorta, the main artery carrying blood from the heart. According to the CDC, aortic aneurysms can occur in the chest (thoracic) or abdomen (abdominal) and pose serious risks if they rupture or dissect.
For commercial drivers, the FMCSA’s concern is the risk of sudden incapacitation from aneurysm rupture or dissection. The FMCSA Cardiovascular Advisory Panel provides guidance on evaluating drivers with known aneurysms.
Types of Aortic Aneurysms
- Abdominal Aortic Aneurysm (AAA): Most common type, occurs in the abdomen below the diaphragm
- Thoracic Aortic Aneurysm (TAA): Occurs in the chest portion of the aorta
- Thoracoabdominal Aneurysm: Involves both chest and abdominal portions
Aneurysm Size and DOT Certification
Aneurysm size is the primary factor determining rupture risk and certification eligibility:
| AAA Size | Risk Level | DOT Certification |
|---|---|---|
| Less than 4.0 cm | Low risk | May certify with monitoring |
| 4.0-5.4 cm | Moderate risk | Case-by-case, specialist clearance needed |
| 5.5 cm or larger | High risk (surgical threshold) | Generally disqualifying until repaired |
Note: Thoracic aneurysm thresholds may differ. Consult with your vascular surgeon or cardiologist for specific guidance.
Growth Rate Matters
A stable aneurysm that hasn’t grown over multiple imaging studies is more favorable for certification than one showing rapid growth. Growth of more than 0.5 cm per year is concerning and may affect certification even for smaller aneurysms.
Certification Criteria for Aortic Aneurysms
For potential certification with an unrepaired aneurysm:
- Size below surgical threshold: Generally less than 5.0-5.5 cm for AAA
- Stable or slow growth: Documented over at least 6-12 months of monitoring
- No symptoms: No abdominal or back pain, no evidence of expansion
- Regular surveillance: Committed to ongoing imaging surveillance
- Vascular specialist clearance: Written clearance for commercial driving
- Blood pressure controlled: Hypertension increases rupture risk
When Aneurysms Are Disqualifying
Certification is generally not possible when:
- Aneurysm has reached surgical threshold (typically ≥5.5 cm for AAA)
- Rapid growth documented (>0.5 cm/year)
- Symptomatic aneurysm (pain, tenderness)
- Saccular or irregular shape (higher rupture risk)
- Patient is awaiting scheduled repair
DOT Certification After Aortic Aneurysm Repair
Drivers who have had successful aneurysm repair can typically be certified after appropriate recovery:
Open Surgical Repair
- Waiting period: Typically 3-6 months
- Requirements: Surgical recovery complete, imaging showing stable repair, vascular surgeon clearance
- Certification period: Usually 12 months initially
Endovascular Repair (EVAR/TEVAR)
- Waiting period: Typically 3 months (shorter recovery than open surgery)
- Requirements: Imaging showing successful repair, no endoleak, specialist clearance
- Surveillance: Ongoing imaging to monitor endograft
- Certification period: Usually 12 months
Required Documentation
- Vascular surgeon or cardiologist clearance: Must include aneurysm size, location, and clearance for commercial driving
- Recent imaging: CT angiogram or ultrasound within past 6-12 months showing current size
- Size history: Previous measurements showing stability or growth rate
- Operative report: If repaired, documentation of surgical procedure and outcome
- Post-repair imaging: If repaired, showing successful repair
- Blood pressure records: Demonstrating good control
Frequently Asked Questions
Q: Can I drive commercially with an aortic aneurysm?
Possibly, if the aneurysm is small (generally <5.0 cm), stable, and asymptomatic. You’ll need vascular specialist clearance and commitment to ongoing surveillance.
Q: What size aneurysm disqualifies you from DOT certification?
Aneurysms at or above surgical threshold (typically 5.5 cm for AAA) are generally disqualifying until repaired. Aneurysms between 4.0-5.4 cm require specialist evaluation.
Q: Can I drive after aneurysm repair surgery?
Yes, after appropriate recovery (typically 3-6 months), with imaging showing successful repair and specialist clearance.
Q: How often do I need imaging with an aneurysm?
Typically every 6-12 months depending on size. Your vascular specialist will recommend the surveillance interval. Ongoing monitoring is required for continued certification.
Q: Will I get a 1-year or 2-year certificate with an aneurysm?
Most drivers with known aneurysms receive 12-month certificates to allow for regular monitoring and recertification.
Key Takeaways
- Size matters: Small, stable aneurysms may be certifiable; large ones are disqualifying
- Surgical threshold: Generally 5.5 cm for AAA — disqualifying until repaired
- Stability important: Non-growing aneurysms more favorable
- After repair: Can certify after 3-6 month recovery with documentation
- Specialist clearance required: Vascular surgeon or cardiologist
- Ongoing surveillance: Regular imaging required for continued certification
- 12-month certificates typical: Annual recertification
Charlotte DOT Exam Center Location
Address
Charlotte DOT Exam Center
8415 Pineville-Matthews Road, Suite 102
Charlotte, NC 28226
Phone: 704-544-3494
Hours
Monday-Friday: 8:30am – 5:00pm
Saturday: 8:30am – 12:00pm
Walk-ins Welcome
Schedule Your DOT Physical Today
Expert evaluation for drivers with aortic aneurysms.
$70 Flat Rate • Walk-Ins Welcome • Same-Day Certification
