DOT physical exams and DOT medical cards: Common questions and issues

DOT Physical Exams | DOT Compliance | CNS

DOT physicals explained

Before a driver can get on the road, the Federal Motor Carrier Safety Administration (FMCSA) requires all drivers of commercial motor vehicles (CMVs) to pass a DOT physical exam.

A DOT physical, or CDL physical, is a test performed by a Certified Medical Examiner (CME) reviewing your general health, mental and emotional well-being and is a required by federal law for anyone driving a CMV.

DOT physicals are required to obtain a DOT medical card, which must be renewed at least every two years, showing that the driver has consistently been medically qualified to drive.

Passing a DOT physical exam ensures that CMV drivers are fully equipped to handle the physical demands of operating a commercial vehicle, such as the long driving hours, stress and exhausting schedules that go along with the job.

After passing you will receive a DOT medical card, which must be placed in the Driver Qualification File (DQF) and kept there for at least three years.

For CDL drivers, the federal medical card is temporary proof in the DQ file until a Motor Vehicle Record (MVR) is received, reflecting the newest exam. The MVR must be on file within 15 days of the exam, along with a note that you checked the NRCME database for the exam and both must be kept on file for three years.

For questions regarding driver files,
contact a DOT Compliance Specialist about Driver File Management.

What do examiners test during a DOT physical exam?

Before any testing is done, a CME must be chosen using the National Registry of CMEs online database. All examiners listed have been verified as fully qualified and having the required medical credentials  and complete knowledge of FMCSA regulations and the transportation industry.

Drivers must fill out a form—on-site or before-hand—detailing their current health, health history and a list of current medications.

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Below are DOT physical exam requirements that are tested:

  1. Urinalysis
  2. Blood pressure/pulse rate
  3. Vision
  4. Hearing
  5. Physical exam (check body for abnormalities in over a dozen areas)

A DOT medical card is considered relevant and valid for up to 24 months, however, if the CME has concerns about the driver’s health, a medical card certificate could be issued for 3 months, 6 months, or however long they see fit to come back for their next required physical exam.

Automatic disqualifications if found during a DOT physical exam

According to federal regulation 49 CFR 391.41, there are specific medical disqualifications that will prevent the examiner from passing your DOT physical exam. These include:

  • Hearing loss
  • Vision loss (if not correctable 20/40 vision in both left or right eye)
  • Epilepsy
  • Insulin use to treat diabetes
  • If any habit-forming drugs are being taken, including narcotics and amphetamines

However, a driver can obtain an exemption for some of the automatic disqualifications.

For example, the FMCSA vision exemption program is for monocular vision and can be issued for a maximum of two years, to be renewed. To obtain this exemption, an ophthalmologist or optometrist must provide an annual medical and eye exam.

It is important to note that marijuana is still a schedule 1 drug federally. All safety-sensitive positions should not consume marijuana products or unregulated CBD oil products.

Non-CDL drivers of a CMV are not required to have a DOT drug test and many companies and drivers assume it is okay to consume marijuana in states where it is legal. However, the federal DOT health history form can cause an automatic disqualification when it comes to marijuana history.

There are two questions asking if the driver has used an illicit substance within that last two years, or if they have ever failed a drug test or been dependent on an illegal substance. Marking “yes” warrants either a federal drug test or an automatic disqualification. This can affect non-CDL drivers for construction, landscaping, local delivery, moving companies and more.

Some red flags leading to temporary disqualification include, but are not limited to:

  • Cardiovascular issues
    •  i.e. – Drivers having higher than acceptable likelihood of acute incapacitation from a cardiac event.
  • Psychological disorder
    •  i.e. – Drivers are experiencing a psychological or personality disorder (even in early stages) that can affect memory, reasoning, attention, or judgement.

What should I bring to my DOT physical exam?

In order for your DOT physical exam to go as smoothly as possible, arrive early and be prepared with any personal documents and information you might need, such as:

  • Medical Examination Report (also available on-site)
  • Driver’s license
  • DOT medical card (if applicable)
  • Medication list
  • Corrective lenses or hearing aids
  • Medical records, including recent lab results for Diabetes maintenance within the last year, cardiovascular testing results for heart conditions of any kind, and recent CPAP machine printout, if applicable

Where to get a DOT physical exam?

CNS offers DOT physical exams at our location in Lititz, PA with our Certified Medical Examiner (CME), and we also have mobile DOT physicals available in certain states.

Learn more about mobile DOT physicals
(Group volume discounts and mobile options available)

If you are a part of our Drug and Alcohol Consortium, we can assist in finding a location to obtain a DOT physical or drug test nationwide.

What to do after receiving a new DOT medical card

After receiving a DOT medical card—depending on state rules—the driver needs to take the certified document to the DMV within 15 to 30 days to update the medical expiration date or if the driver is applying for a CDL.

If we performed your DOT physical, our licensing team will attach the new medical card to your CDL license through PennDOT.

If any information on the medical card certificate in ineligible, inaccurate, or missing, the driver will receive a letter requiring the medical card to be corrected and faxed or emailed back to the DMV.

Employers must pull a Motor Vehicle Record (MVR) within 15 days of completing the certified driver physical exam. The DOT requires the medical card information at the DMV to be added to the MVR and is why an MVR must be pulled after each updated medical card.

The updated MVR is required to be placed in the driver qualification file and can be audited by the DOT. A non-CDL driver does not need an updated MVR after a new medical card is received. Instead, a copy of the medical card certificate needs to be on file for three years.

For questions about audits, contact a DOT Compliance Specialist about our DOT Audit services.


DOT Compliance Services

Simplify the entire physical, drug consortium and DQF process

Our complete Proactive Safety Management (PSM) program has been organized to get you through an FMCSA audit by managing your driver qualification files, drug consortium, Electronic Logging Devices (ELD), vehicle maintenance and more.

Whether you are a large trucking company that is onboarding drivers quickly or a construction outfit with multiple trucks in your fleet, you need to stay aware of FMCSA regulations.

For more information, contact us at 888.260.9448 or info@cnsprotects.com.

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