Medically reviewed by Dr. Alan M. Tebby, D.C., FMCSA Certified Medical Examiner | Last updated: January 27, 2026
Autoimmune disorders don’t automatically disqualify you from DOT certification. The key factors are disease control, functional ability, and medication compatibility. Many autoimmune medications—including biologics and immunosuppressants—are compatible with commercial driving. Your examiner evaluates whether your condition is stable and whether you can safely perform commercial driving duties.
At Charlotte DOT Exam Center, our FMCSA-certified examiners have extensive experience evaluating this condition.
📞 Call 704-544-3494 | 💰 $70 flat rate | 🚶 Walk-ins welcome
Autoimmune disorders encompass a wide range of conditions where the immune system attacks the body’s own tissues. These include lupus, inflammatory bowel disease (Crohn’s, ulcerative colitis), psoriasis, and many others. Each condition has unique considerations for commercial driving.
The FMCSA evaluates autoimmune disorders based on disease activity, functional impact, and treatment compatibility with driving. Well-controlled autoimmune disease with stable treatment is typically certifiable. Active flares or severe disease may temporarily prevent certification.
At Charlotte DOT Exam Center, we evaluate autoimmune disorders individually based on your specific condition and current status. Our examiners can help you understand what documentation supports your certification.
Autoimmune disorders occur when the immune system mistakenly attacks healthy body tissues. There are over 80 recognized autoimmune diseases affecting various organs and systems. For DOT purposes, evaluation focuses on how the condition affects your ability to drive safely.
Autoimmune diseases collectively affect approximately 24 million Americans. Many people with autoimmune conditions maintain active careers, including commercial driving, with proper disease management.
The FMCSA physical qualification standards are found in NIH Autoimmune Disease Information. According to the FMCSA Physical Qualifications, autoimmune disorders affects many Americans, including commercial drivers.
The FMCSA evaluates autoimmune disorders based on functional capacity—your ability to safely operate a commercial motor vehicle. Key factors the medical examiner considers include:
For additional information, see the American Autoimmune Related Diseases Association and Lupus Foundation of America.
Commercial drivers with autoimmune disorders often have similar questions. Here are the most common questions we answer at Charlotte DOT Exam Center:
Yes, many drivers with autoimmune disorders maintain CDL certification. The key is stable disease control and ability to safely perform commercial driving functions. Each autoimmune condition is evaluated individually.
Most autoimmune medications are DOT-compatible, including biologics (Humira, Remicade, etc.), immunosuppressants, and anti-inflammatory medications. Corticosteroids like prednisone are also acceptable.
Lupus (SLE) can be certified if well-controlled. Considerations include organ involvement (especially kidney, heart, CNS), flare frequency, and medication side effects. Stable lupus on appropriate treatment is typically certifiable.
Yes, IBD is commonly certified if well-controlled. Considerations include flare frequency, urgency symptoms, and medication side effects. Drivers need reliable access to restrooms, which should be planned for routes.
Active flares may temporarily prevent certification depending on severity and symptoms. After flare resolution and return to baseline, certification can typically proceed.
For well-controlled, mild autoimmune disease, primary care documentation may suffice. For moderate-to-severe disease or complex medication regimens, specialist documentation (rheumatologist, gastroenterologist, etc.) is helpful.
Active or recently diagnosed autoimmune disease may receive 1-year certification for monitoring. Stable, long-term controlled disease may receive standard 2-year certification.
Conditions like MS have specific evaluation criteria due to potential effects on motor function, vision, and cognition. These require neurologist documentation and careful assessment of current functional status.
Understanding which medications are compatible with commercial driving helps you prepare for your DOT physical and communicate effectively with your medical examiner.
| Medication Category | Common Examples | CDL Compatible? |
|---|---|---|
| NSAIDs | Ibuprofen, naproxen, celecoxib | ✅ Yes |
| Corticosteroids | Prednisone, budesonide | ✅ Yes |
| Conventional DMARDs | Methotrexate, sulfasalazine, hydroxychloroquine | ✅ Yes |
| Biologics | Humira, Remicade, Enbrel, Stelara, Entyvio | ✅ Yes |
| JAK Inhibitors | Xeljanz, Rinvoq | ✅ Yes |
| Aminosalicylates | Mesalamine, sulfasalazine (for IBD) | ✅ Yes |
| Immunomodulators | Azathioprine, 6-mercaptopurine | ✅ Yes |
| Antimalarials | Hydroxychloroquine (Plaquenil) | ✅ Yes |
✅ = Compatible | ⚠️ = Requires evaluation | ❌ = Not compatible while driving
Your DOT medical certificate duration depends on your condition’s status, treatment effectiveness, and documentation provided:
| Severity Level | Characteristics | Typical Certificate | Documentation Required |
|---|---|---|---|
| Mild/Well-controlled | Minimal symptoms, stable on treatment | 2 years | Medication list + primary care records |
| Moderate (controlled) | Some symptoms but functional, stable treatment | 1-2 years | Specialist records recommended |
| Moderate (active) | Frequent symptoms or recent flare | 1 year or defer | Specialist documentation required |
| Severe/Poorly controlled | Significant symptoms affecting function | Defer until controlled | Specialist documentation + treatment plan |
| Situation | Typical Wait | Documentation Needed |
|---|---|---|
| After disease flare | Until symptoms return to baseline | Documentation of disease control |
| New diagnosis | After treatment initiated and stable | Treatment records + specialist input |
| New biologic started | After initial dosing (4-8 weeks) | Documentation of tolerance |
| After bowel surgery (IBD) | Full recovery (6-12 weeks) | Surgeon clearance |
Proper documentation streamlines your DOT physical and supports certification. Gather these items before your appointment:
Drivers with autoimmune disorders may have related conditions also evaluated during the DOT physical:
For complete information, see our DOT Physical Medical Conditions hub page.
Yes, if your disease is well-controlled and you can perform driving functions safely.
Yes, most autoimmune medications are compatible with commercial driving.
Can be certified if well-controlled, depending on organ involvement and flare frequency.
Yes, if well-controlled. Plan for restroom access on routes.
Active flares may temporarily prevent certification until resolved.
Helpful for moderate-to-severe disease or complex treatment regimens.
Charlotte DOT Exam Center provides expert DOT physical examinations for commercial drivers with autoimmune disorders. Our FMCSA-certified medical examiners—Dr. Alan M. Tebby, D.C. and Dr. Lemuel Byrd—have extensive experience with this condition.
8415 Pineville-Matthews Road, Suite 102
Charlotte, NC 28226
Questions? Call us at 704-544-3494 to discuss your autoimmune disorders and DOT certification requirements.