Top 5 Reasons Truck Drivers Fail the DOT Physical in Charlotte
The DOT Physical is mandatory, but passing is not automatic. Many drivers in the Charlotte area fail—or get a short, 3-month certification—not because they’re sick, but because they are unprepared.
As a local FMCSA Certified Medical Examiner, Dr. Byrd is here to help you pass the first time. Here are the Top 5 most common reasons drivers fail the DOT physical and exactly what you need to do before your appointment.
1. Uncontrolled High Blood Pressure
This is the single most common cause of temporary disqualification. If your blood pressure (BP) is too high, you pose a risk of a sudden cardiovascular event.
- Failure Threshold: Any reading of 180/110 mmHg or higher results in immediate, temporary disqualification.
- What to Do: Take prescribed medication and bring a complete, current list.
➤ Deep Dive: See our in-depth guide: DOT Physical Blood Pressure Standards
➤ Related Condition: Learn about Heart Condition Requirements.
2. Untreated or Non-Compliant Sleep Apnea
OSA leads to excessive daytime sleepiness. Failure to provide a current, compliant usage report is an automatic failure or temporary disqualification.
- Compliance Standard: You must show evidence of using your CPAP machine for at least 4 hours per night, 70% of the time over a 30-day minimum period.
- What to Do: Print your CPAP compliance report and bring it with you.
➤ Deep Dive: See our in-depth guide: FMCSA Sleep Apnea Requirements
3. Vision and Hearing Failures
You must have adequate sensory perception to safely operate a CMV. These are non-discretionary standards.
- Vision Standard: You must have at least 20/40 acuity in each eye (with or without corrective lenses).
- Hearing Standard: You must be able to hear a forced whisper from five feet away in at least one ear (with or without a hearing aid).
➤ Deep Dive: See our in-depth guide: DOT Vision & Hearing Standards
4. Unmanaged Insulin-Treated Diabetes (ITDM)
While the rules have changed, failing to provide the correct paperwork is still a major roadblock.
- Failure Condition: Showing up without the FMCSA MCSA-5870 form completed by your treating physician within the last 45 days will stop your certification process immediately.
- What to Do: Schedule an appointment with your treating physician before your DOT physical.
➤ Deep Dive: See our in-depth guide: DOT Physical Diabetes Standards
5. Disqualifying Neurological or Psychiatric Conditions
Any condition that could cause sudden incapacitation, loss of consciousness, or severely impair judgment is disqualifying until properly managed and cleared by a specialist.
- Neurological Risk: Active seizures or epilepsy are disqualifying. You may require a Neurologist Clearance Letter.
- Psychiatric Risk: Uncontrolled Bipolar disorder or severe depression requires a Psychiatrist Clearance Letter.
➤ Deep Dive (Neurological): See our guide on Neurological Condition Requirements.
➤ Deep Dive (Mental Health): See our guide on Mental Health Requirements.
Preparation is the key to getting your two-year card. View all required documentation for every condition on our comprehensive list:
✓ View the Ultimate DOT Physical Requirements Checklist
Ready to Get Your DOT Medical Card in Charlotte?
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I am the administrator for the Charlotte DOT Exam facility, located in Charlotte NC. I oversee the facility services providing DOT exams in accordance with the standards of the FMCSA. We also provide DOT drug testing with MRO support when required. Drug testing can also be done for non-DOT exams such as pre-employment. In order to minimize wait times, I always encourage our clients to contact us first and make an appointment.
I would also suggest that each individual wanting to test for the CDL health card read the article “Preparing For Your DOT Exam” as it lists several things to bring to the test, such as CPAP usage reports and medicine lists.
