The DOT Physical for Truck Drivers: What It Is and How to Pass

All interstate and many intrastate truck drivers are required to pass medical exams earn and maintain their commercial drivers licenses (CDLs). But truck driving physicals involve much more than a simple checkup at a doctor's office. In fact, "physical" is a bit of a misnomer, as this DOT medical exam also includes vision, hearing, and mental health.

Read on to learn how to increase your chances of passing the DOT physical exam; what will be tested at your exam and the information you need to provide to your medical provider; why, how, and when to get your exam; and what to do if you don't pass.

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How Do I Pass the DOT Physical?

A U.S. Department of Transportation (DOT) physical exam is a checkup for all commercial motor vehicle (CMV) drivers mandated by the Federal Motor Carrier Safety Administration (FMCSA). To pass the DOT physical, you must demonstrate you can safely perform the demands of driving a CMV.

The simplest way to pass the physical is to maintain your physical and mental health. A few suggestions for doing this are:

Do your best to eat healthfully.

This is easier said than done while on the road, of course. Truck stops don't tend to have many healthy options on full display, and, if they are available, they can be more expensive than other choices. If you're able to stop at a grocery store for food, this may be your best option. If you're lucky enough to have a refrigerator in your truck, stock up on fruits and vegetables requiring refrigeration. If you don't have one, choose healthy meals when stopping for a bite, and grab healthier snacks that don't need refrigeration, like apples and granola.

Take vitamins.

As truck drivers don't always have easy access to healthy foods, vitamins can fill in nutritional gaps. Your doctor is the best resource for learning what supplements you need, but common vitamins people need are calcium, iron, magnesium, potassium, and vitamin D. Taking a multivitamin every day can generally help you get all of these in one pill. Be sure to speak with your doctor about medications you're on to ensure your vitamins won't interfere with them.

Stay hydrated.

Truck drivers often have a hard time staying hydrated, especially because of worries about too many bathroom breaks. However, driving while dehydrated poses similar dangers to driving while intoxicated, which puts you and those around you at risk. Plus, dehydration can harm your health, including causing issues that could result in you not passing your physical—even seizures in some cases. So, carry a reusable water bottle or two with you and fill them at every opportunity, and try to keep some extra disposable bottles in your car if there isn't enough time to stop.

Find opportunities to exercise.

Most importantly, take time to stretch when you get out of your truck—not only can this relieve the aches and pains of driving for long stretches, but it can help avoid blood clots. When you're on your breaks, find a place where you can go on a walk, jog, or bike ride. (Did you know there are foldable bikes, which may help save space?) Small hand weights also often fit easily in trucks, so you can do some minor strength training. Many truck stops have gyms in them, which you should try to take advantage of. And, there are many nationwide gyms you can be a member of—and perhaps your trucking company will even pay for this! As an added bonus, these often have showers available, so you won't have to pay to use the truck stop ones.

Practice good hygiene.

Even if you don't have the time or extra cash for a shower, use sinks to do thorough handwashing each time you stop—even if you don't use the restroom. Wash your face and brush your teeth frequently as well. Hand sanitizer can be used as a backup.

Go to the doctor and dentist.

Be sure to go to your checkups and try to find time to get medical care—even at an urgent care facility or one of the medical offices in many pharmacies—if you feel poorly. Your yearly doctor visits can help identify issues early so you can address them before your next required physical. And those dental appointments are just as important as doctor visits, as poor oral health has been connected to endocarditis and cardiovascular disease—both of which can negatively affect your ability to continue driving—as well as pneumonia and pregnancy issues.

Take your medications on schedule.

If you're on any medications, be sure to take them. If they require you to take them at a certain time of day, be sure to stick with that, even if you're driving. Set an alarm to remind yourself.

Get your vaccines.

Truck drivers may spend a lot of time alone, but this doesn't mean they're safe from illnesses. Your yearly flu shot can help keep you on the road, as can the shingles and pneumonia vaccines. Some vaccines need boosters every few years, so be sure you're up-to-date on those as well.

Pursue mental health support.

Everyone needs some help sometimes, and as trucking can be a lonely business, this absolutely can apply to truck drivers. While in-person mental health visits may not be possible given your schedule, there are many online opportunities now. Your best options may come from online resources like Talkspace or BetterHelp, as you can message your licensed therapist or counselor any time day or night, and they'll get back to you within business hours. You can also set up video appointments if your schedule allows.

Avoid drugs, alcohol, and cigarettes.

Of course, drugs and alcohol can impede your ability to drive safely—and if you have a positive drug test at your physical or during a random test or show signs of alcoholism, you risk losing your license. While some drugs, such as cocaine, may be tempting because they can temporarily increase alertness, those drugs often lead to heart problems and other issues. Smoking can also lead to heart disease, lung diseases, diabetes, and eye problems, among other issues, which can all harm your ability to keep your license and stay healthy. While the occasional drink—when you're fully off-duty and have time for the alcohol to leave your system—isn't harmful to most people, excessive alcohol consumption can lower your immune system, impact your memory, and cause heart disease, stroke, and mental health problems.

We aren't saying it'll be easy to maintain tip-top shape. But taking basic precautions and performing even the smallest positive choices could help you pass your physicals and keep you from missing work due to illness. If you don't pass your physical, there are several actions to take, which will be discussed later in this article.

COVID and Your DOT Physical

The COVID-19 crisis has affected everyone greatly, and this includes essential workers like truck drivers. The trucking industry is busier than ever, as people are shopping online more.

The long-term effects of COVID that are being observed could not just hurt your body, but potentially your ability to maintain your CDL. Some of the more "minor" long-term effects have included memory and concentration issues, rapid heart rates, and difficulty breathing. However, more severe effects have been observed. Organ damage has been seen in the heart, lungs, and brain—including seizures and temporary paralysis. Challenges with blood clots and blood vessels have also arisen in some patients, which may be of particular worry for truck drivers, as sitting for long periods already increases the risk of blood clots. Mental health issues have also affected many patients, including depression, anxiety, and even post-traumatic stress. Any of these challenges could result in you being unable to drive temporarily or, if issues continue over the long haul, permanently.

It's essential to take while the crisis is ongoing. These safety measures include:

The FMCSA has issued the ability to grant waivers for some regulations regarding the truck driving industry, including allowing drivers to delay obtaining their medical certificates if they come due during the crisis. This ruling currently expires on December 31, 2020, though they have the option to extend it. Not every driver will have this waived; this is done on a case-by-case basis.

What is Tested During a DOT Physical?

Several parts of your physical and mental health will be looked into during the DOT physical exam, including:

  • Appearance: The medical practitioner is looking for signs of alcoholism, obesity, and other medical conditions.
  • Vision: Your physician will check for glaucoma, cataracts, macular degeneration, and other related ailments. You must have at least 20/40 acuity in both eyes with or without correction. You're also required to have a minimum of 70 degrees peripheral vision in the horizontal meridian (left and right) in both eyes.
  • Hearing: Drivers will be given a "whisper test," in which the examiner whispers words five feet from the recipient. Your ears will also be checked for conditions like scarring of the tympanic membrane and ruptured eardrums.
  • Blood Pressure: The examiner will take your blood pressure and pulse. You'll also be checked for carotid and varicose veins.
  • Lungs and Chest: You'll be tested for impaired respiratory functions, abnormal breathing, cyanosis, and the like. The examiner will also check your mouth and throat for problems swallowing and breathing.
  • Heart: You'll be checked for heart murmurs, a pacemaker, and related issues.
  • Neurological: The examiner will check for neurological conditions such as ataxia, impaired equilibrium, or trouble with coordination or speech.
  • Abdomen and Viscera: The examiner will look for an enlarged liver and muscle weaknesses.
  • Spine: Your spine and other musculoskeletal parts will be tested to determine range of motion and tenderness.
  • Extremities: The examiner will check for limb impairments.

You'll also take a hernia test and be asked to provide a urine sample to check for underlying medical conditions like diabetes. Additionally, they'll also be testing for drugs during this time.

What Do I Bring to a DOT Physical?

All drivers are required to bring a complete list of the medications they're taking, including dosage procedures and doctors' names and addresses. Be sure to have a copy of your medical records with you if the examiner isn't your regular physician.

Drivers with certain medical conditions will need to bring additional documentation or items:

  • Any auditory or visual aids like eyeglasses, contact lenses, or hearing aids, if you use these to drive
  • Most recent laboratory results, if you have a condition that requires blood draws
  • Letter from your specialist if you have heart problems, experienced neurological conditions such as a stroke or brain tumor, or are taking controlled substances, medications causing sleepiness, or the blood thinner Coumadin
  • If you have sleep apnea and use a CPAP machine, bring a copy of the most recent reading and 90 days' worth of data
  • If you have amputated or missing limbs, you may need to bring an overview of the injury (including any work restrictions) from a doctor

You'll also be asked to submit a health questionnaire, which you can often fill out online before your appointment. If you have insulin-treated diabetes, you must have your doctor fill out the Insulin-treated Diabetes Mellitus Assessment, MCSA-5870 form no more than 45 days before the DOT physical.

Why are DOT Physicals Required?

DOT physicals are necessary for the public's safety and yours. Large vehicles like trucks and buses are more dangerous and difficult to maneuver than standard passenger cars. So, drivers need to prove they're mentally and physically fit enough to handle the physical and mental stressors associated with driving commercial vehicles.

When Do I Need to Get a DOT Physical?

A DOT medical card lasts for two years. Medical conditions like diabetes, hypertension or high blood pressure, and heart disease may require an annual DOT physical. If you have extremely high blood pressure, you may need to get a DOT physical more frequently—possibly every three months.

Where Can I Get My DOT Physical?

A DOT physical must be administered by a healthcare professional listed on the National Registry of Certified Medical Examiners (NRCME). You can search for verified examiners using a National Registry number, examiner or business name, or location.

Who Pays for My DOT Physical?

It depends. Insurance companies may treat an exam as preventative care, which is usually covered, but they may not. Some companies may pay for the DOT physical and require you to use the company doctor, while others expect the employee to pay for their own examination.

What Are the DOT Medical Card Requirements?

A DOT Medical Card is commonly referred to as a Medical Examiner's Certificate and is the document you receive upon passing the examination. You must submit a copy of this certificate to your State Driver Licensing Agency as part of your driving record. If you're found to be driving without certification, then you may incur fines, penalties, suspensions, or be fired from your job.

What Happens If I Don't Pass My DOT Physical?

If you don't pass your DOT physical exam due to a disqualifying medical condition, you can apply for recertification or request an exemption through the FMCSA.

Can Medical Issues Automatically Disqualify Me from Driving a Truck?

Most disqualifying medical conditions can be managed with the right treatment and professional care so you can obtain your DOT medical card.

However, conditions related to significant hearing or vision loss, a compromised nervous system, physical limitations, or a loss of consciousness often automatically disqualify you because they hurt your driving ability. These include:

  • Certain heart conditions such as heart disease causing pain or discomfort, heart attack, coronary insufficiency, and thrombosis
  • Certain respiratory conditions such as poorly managed lung disease
  • Deafness
  • Epilepsy and other seizure disorders
  • Marijuana use, even if prescribed by a doctor
  • Meniere's disease and other inner ear disorders that cause vertigo and balance issues
  • Narcolepsy
  • Stage 1 hypertension
  • Vision loss that can't be corrected

Some medical conditions allow the examiner to use their discretion when granting certification. These include:

  • Diabetes
  • High blood pressure
  • Proteinuria or excessive protein in urine, which may be an indicator of kidney disease

The FMCSA can waive certain cases of vision or hearing loss and seizure disorders if drivers meet the exemption criteria and submit the required documentation, which typically includes medical exams, driving records, and employment history.

What Steps Can I Take to Pass the DOT Medical Exam if I Fail?

Consult with your physician if you're unable to obtain a DOT medical card due to a disqualifying condition. You may be able to receive a certificate if you can demonstrate your condition is manageable and under proper care. The doctor could also recommend taking a new medication to see if it helps, though you may need to stay off the road while the determination is made.

If you've failed your physical, follow the steps at the top of this page to try to improve your health before your next appointment.

Do I Lose My Job if I Don't Pass the DOT Physical?

Failing your DOT physical doesn't necessarily mean the end of your trucking career. You won't be disqualified from driving unless you fail the test and can't get an exemption. If you lose your job over a failed physical, you can collect unemployment benefits from the state the company resides in.