A DOT physical is a thorough medical exam that helps make sure you can safely drive commercial motor vehicles (CMVs). The U.S. government establishes certain health standards that all CMV drivers must meet. If you meet these standards, you receive a medical examiner’s certificate that’s typically valid for two years.

What is a DOT physical?

A U.S. Department of Transportation (DOT) physical is a medical exam that verifies you meet certain standards to drive a commercial motor vehicle (CMV). Examples of CMVs include semi-trucks, buses and vehicles carrying hazardous materials. Driving these vehicles is a big responsibility. Employers must make sure you’re able to take on this task safely.

For example, you must be able to hear sounds around you, see road signs and stay awake. Various health conditions or medications may affect your ability to do these things. Or some conditions may put you at risk for medical emergencies that, if they happen on the road, place you and others in danger.

On a national level, the Department of Transportation decides who needs a DOT physical. In general, they require it for anyone who drives a CMV across state lines. Individual states also have rules and regulations for who needs a DOT physical. You may need one if you drive a CMV within state boundaries.

You’ll typically need a DOT physical every two years to stay qualified to drive a CMV. You may need exams more frequently based on your medical history. If you meet the Department of Transportation’s medical standards, you’ll receive your medical examiner’s certificate. People commonly call this your medical card.

Who performs DOT physicals?

Certified medical examiners perform DOT physicals. These are healthcare providers who complete additional training in determining whether someone can safely drive a CMV. They understand the physical and mental demands this type of task requires.

Medical examiners must pass a certification test and do refresher training every five years to maintain their status. They must also take a certification test every 10 years. You can feel confident in their ability to evaluate your health in the context of driving a CMV.

You can find a medical examiner near you by searching the National Registry of Certified Medical Examiners. This online tool allows you to search by city and state or by zip code. Once you select a medical examiner, you can call to schedule your DOT physical appointment.

How should I prepare for a DOT physical exam?

It’s a good idea to contact your medical examiner’s office before your appointment and ask what you should prepare or bring with you. In general, you should:

  • Compile your medical history. Your medical history includes all of your past and current symptoms, diagnoses, surgeries, procedures and medications. You may be able to access your medical history through your electronic health record. You can also call your primary care provider and/or specialists to request information. Having this information on hand will help you complete the driver health history section of your medical examination report form.
  • Access the medical examination report form. You can download this from the U.S. Department of Transportation website. The first two pages of this report include sections you must complete, including a driver health history section. For example, there’s a checklist that asks if you’ve ever had certain diagnoses or symptoms. There are also spaces for you to add further information. You can start filling out this form at home before you go in for your appointment.
  • Complete additional forms as needed. Your usual healthcare provider might need to fill out additional forms for you to take to your DOT exam. These include the vision evaluation report, the insulin-treated diabetes mellitus assessment form and the CMV driver medication form. You can download all these forms from the Department of Transportation website. If you’re not sure which forms might apply to you, call your local medical examiner’s office to learn more.

Here are some items you’ll need for a few specific, common medical conditions:

  • If you have diabetes, you’ll need your most recent A1C results.
  • If you have sleep apnea, you’ll need a three-month CPAP compliance report.
  • If you take warfarin (Coumadin®), you’ll need a recent INR.

Knowing in advance what you need to bring can help prevent delays in certification.

Vision evaluation form

You must meet certain vision standards to drive a CMV. If your vision doesn’t meet those standards, you’ll need to submit a vision evaluation form at least once a year.

This is a form that your ophthalmologist or optometrist fills out. They provide details about your vision and eye health and comment on your ability to safely drive a CMV. Your ophthalmologist or optometrist should complete the form no more than 45 days before your DOT physical exam.

Insulin-treated diabetes mellitus assessment form

You need to submit this form if you take insulin to manage diabetes. The healthcare provider that helps you manage diabetes fills out the form. They’ll provide information on many aspects of your health, including:

  • When you started using insulin.
  • Your self-monitoring process.
  • Any recent history of severe hypoglycemic episodes.
  • Your hemoglobin A1C measurements.
  • Diabetes-related complications you’ve experienced.
  • Diabetes-related eye diseases.

Your provider will sign and date the form and give it to you to take to your DOT physical exam. This should happen no more than 45 days before your DOT exam date.

CMV driver medication form

This form explains the medications you’re taking. Medical examiners request you submit this form when they need to verify your medications won’t affect your driving ability. Therefore, you may not know you need the form until after your exam. For example, the examiner might tell you they can’t make a final decision about your certification until they get more information from your healthcare provider.

The medication form includes spaces for your provider to share details like the specific medications you’re taking, the dosages and what they’re treating. Your provider should fill out the form and give it back to you to take to a follow-up DOT exam appointment.

What does a DOT physical consist of?

A DOT physical is a thorough medical exam that evaluates many aspects of your health. Your medical examiner will explain each step of the process. They’ll begin by discussing your health history. This is the information you provide on the first two pages of your medical examination report form. Your examiner may ask you about some of your responses to get further information.

Then, your examiner will:

  • Check your pulse rate.
  • Take your blood pressure.
  • Measure your height and weight.
  • Ask you to pee into a cup for a urinalysis.
  • Check your eyes and vision.
  • Check your ears and hearing.
  • Use a stethoscope to listen to the sounds of your heart, lungs, arteries and belly.
  • Observe your gait, or your pattern of walking.
  • Check your reflexes.

All these steps allow your examiner to get a sense of your overall health. They’ll look for any signs of a health condition that may affect your ability to drive a CMV. Try to relax during this process. You might feel worried or anxious about the outcome. But keep in mind that the purpose of this exam is to keep you and others safe.

What can I expect after a DOT physical exam?

Your examiner will tell you the results of the exam and explain what you need to do next.

In some cases, you’ll need to visit a healthcare provider for further testing, treatment or paperwork. This may happen if your examiner finds an issue that needs attention. You may still qualify for your medical certificate, but only after you take care of the medical issue or documentation. In other cases, a health condition may disqualify you from receiving a medical certificate. Your examiner will explain the reasons and answer all your questions.

What type of results do you get from a DOT physical?

Your medical examiner will tell you the results and provide them on your medical examination report form. The table below lists the possible results.

Don’t hesitate to ask your medical examiner to explain more about your results and any next steps.

When should I call my doctor?

Call your primary care provider or specialists if you:

  • Want to learn more about your medical history in preparation for your DOT physical.
  • Have concerns about meeting the DOT physical requirements.
  • Need to request forms or paperwork to take to your DOT physical.
  • American Diabetes Association. Medical Certification (https://www2.diabetes.org/tools-support/know-your-rights/discrimination/drivers-licenses/commercial-drivers-license/medical-certification). Accessed 2/13/2024.
  • National Archives. Code of Federal Regulations. 391.43 Medical Examination; certificate of physical examination (https://www.ecfr.gov/current/title-49/subtitle-B/chapter-III/subchapter-B/part-391/subpart-E/section-391.43). Up to date as of 11/2/2023. Accessed 2/13/2024.
  • National Archives. Code of Federal Regulations. Part 383—Commercial Driver’s License Standards; Requirements and Penalties (https://www.ecfr.gov/current/title-49/subtitle-B/chapter-III/subchapter-B/part-383#383.1). Up to date as of 11/2/2023. Accessed 2/13/2024.
  • United States Department of Transportation. Federal Motor Carrier Safety Administration (FMCSA). Multiple pages reviewed (https://nationalregistry.fmcsa.dot.gov/resource-center). Accessed 2/13/2024.
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