What is the waiting period for a DOT physical after a single unprovoked seizure?

The FMCSA requires a minimum **5-year** waiting period for a single unprovoked seizure. The driver must be **seizure-free** and **off all anti-seizure medication** for the entire five years before certification can be considered. Certification is limited to one year and requires annual neurologist clearance.

Can I pass a DOT physical with a diagnosis of epilepsy?

A clinical diagnosis of **Epilepsy** (two or more unprovoked seizures) is an **automatic DOT disqualification**. Drivers may apply for a federal **FMCSA Exemption**, which is complex and typically requires the applicant to be seizure-free for **8 years** before application is considered.

How long must I wait after a stroke or TIA to pass a DOT physical?

The minimum waiting period for a **TIA** (mini-stroke) or a **non-cortical stroke** is **1 year (12 months)**. If the stroke occurred in a region of the brain that presents a high risk for seizures (cortical involvement), the waiting period is extended to **5 years**. All cases require mandatory neurologist clearance.

What documentation do I need from a neurologist for my DOT exam?

You must provide a clearance letter from your neurologist that explicitly states you are safe to operate a Commercial Motor Vehicle (CMV) and that the physician understands the demands of commercial driving. You also need reports of recent imaging (CT/MRI) and a complete list of all current medications.

DOT Physical Neurological Requirements: Waiting Periods for Seizures, Stroke, TIA, and Neurologist Clearance in Charlotte, NC

DOT Physical Neurological Requirements

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Quick Answer: Neurological conditions are the most complex for DOT certification. The minimum waiting period for a Single Unprovoked Seizure is 5 years (seizure-free and off medication). Epilepsy (two or more seizures) is disqualifying unless an FMCSA exemption is obtained (8 years seizure-free). A Stroke or TIA requires a minimum 1-year waiting period. All cases require mandatory neurologist clearance.

In This Guide:

Seizure and Epilepsy Waiting Periods
Stroke and TIA Certification Rules
Comprehensive Waiting Period Table
Neurologist Documentation Checklist

FMCSA Mandatory Waiting Periods for Seizures and Epilepsy

The rules governing seizures are the most strict in FMCSA regulations because of the high risk of sudden incapacitation. The classification of the event dictates the required waiting period.

Epilepsy (2 or More Unprovoked Seizures)

Automatic Disqualification Rule:A clinical diagnosis of Epilepsy (two or more unprovoked seizures) is an automatic DOT disqualification under 49 CFR 391.41(b)(8).

Certification is only possible through a rare, complex FMCSA Exemption application, which typically requires the driver to be seizure-free for 8 years (on or off medication), along with extensive medical documentation.

Single Unprovoked Seizure

This is defined as a one-time seizure with no identifiable cause. While not technically “epilepsy,” it carries a high recurrence risk.

Minimum Waiting Period: 5 Years.
Mandatory Requirement: The driver must be seizure-free and off all anti-seizure medication for the entire 5-year period.
Certification: Limited to 1 Year, and requires mandatory annual follow-up with a neurologist.

Stroke and TIA (Mini-Stroke) Certification Rules

The time you must wait after a stroke or TIA (Transient Ischemic Attack) depends heavily on the type of event and whether it occurred in a region of the brain that increases the risk of future seizures (cortical involvement).

Neurological Event	Minimum Waiting Period	Key Certification Requirements
Transient Ischemic Attack (TIA)	1 Year (12 months)	Must be asymptomatic, have a normal neurological exam, and provide neurologist clearance. High recurrence risk during the first year is the reason for the mandatory wait.
Stroke (Non-Cortical / Brainstem)	1 Year (12 months)	Applies to strokes in regions with low seizure risk (e.g., cerebellum). Must have no physical or cognitive residuals that interfere with CMV operation.
Stroke (Cortical / High Seizure Risk)	5 Years (60 months)	Applies to strokes involving the medial or anterior cerebral artery, or any event deemed by a specialist to have a high risk of subsequent seizures. Must be seizure-free and off medication.

Mandatory Neurologist Documentation Checklist

To avoid a Determination Pending status, every driver with a history of seizures, stroke, or TIA must bring the following documentation to the exam. Failure to provide these items will result in an automatic deferral.

A Clearance Letter from your Neurologist (must explicitly state that the doctor understands the functions of commercial driving and confirms you are medically safe to operate a CMV).
A detailed report of the neurological event (seizure, stroke, or TIA) and the exact date it occurred.
A report from a recent CT or MRI Scan (within the last 12 months) of the brain.
A complete, legible list of all current medications and dosages, including the date any anti-seizure medication was discontinued.

Q: Can I get certified if my neurologist clears me, but I haven’t completed the FMCSA waiting period?

A: No. The Medical Examiner is federally required to follow the FMCSA’s mandatory minimum waiting periods (1, 5, or 8 years). A clearance letter from a specialist alone is not sufficient if the statutory time has not elapsed.

Have Complex Neurological Documentation? Get Certified by an FMCSA Expert.

Don’t risk disqualification due to missing paperwork or confusion over waiting periods. Our FMCSA-Certified Medical Examiner is an expert in complex neurological clearance requirements.

Examiner: Dr. Lemuel P. Byrd, Jr., D.C.

Call Now: 704-544-3494

Hours: Monday-Friday 9am-5pm | Saturday 9am-12pm
Location: 8415 Pineville-Matthews Road, Suite 102, Charlotte, NC 28226
Cost: $70 | No Wait Policy | Walk-ins & Appointments Welcome