If you’re a commercial driver, chances are you’ve heard the words “DOT physical” more than a few times. Whether you’re hauling freight across state lines or operating a school bus in your hometown, the Department of Transportation (DOT) medical exam is something you simply can’t avoid.
As a certified FMCSA Medical Examiner, I’ve worked with hundreds of commercial drivers right here in Georgia. And I know one thing for sure, there’s a lot of confusion (and sometimes stress) around this exam. So today, I want to break it all down: what the DOT physical includes, what it doesn’t, how to prepare, and how to stay healthy and compliant.
What Is a DOT Physical?
The DOT physical is a required medical exam for anyone operating a commercial motor vehicle (CMV). It ensures that you’re physically and mentally fit to drive safely, for your sake and everyone else’s on the road.
The Federal Motor Carrier Safety Administration (FMCSA) sets the guidelines for the exam, and only certified medical examiners like myself are allowed to conduct it. You’ll need a valid Medical Examiner’s Certificate (MEC) , often called a “DOT card”, to get or keep your commercial driver’s license (CDL).
Most DOT physicals are valid for up to 2 years, but in some cases, they’re issued for shorter periods depending on your health status.
What Does the Exam Include?
Let me walk you through what to expect when you come in for your DOT physical. The whole thing usually takes about 30 minutes, and it’s pretty straightforward.
1. Medical History Review
We’ll start with a questionnaire about your medical background: conditions like diabetes, high blood pressure, heart disease, surgeries, medications, and any history of substance use. Be honest. I’m not here to disqualify you. I’m here to understand your health and make sure you’re safe to drive.
2. Vital Signs & Physical Exam
Next, I’ll check your:
- Blood pressure and heart rate
- Height and weight (to calculate BMI)
- Vision (you’ll need at least 20/40 vision in each eye, with or without glasses or contacts)
- Hearing (you need to hear a forced whisper at 5 feet)
- General health, including lungs, heart, abdomen, neurological function, and mobility
3. Urinalysis
This isn’t a drug test. It’s a basic check for things like blood, sugar, or protein in your urine, which can be signs of diabetes, kidney issues, or other health concerns.
If your employer or the DOT specifically requests a drug screen, that would be a separate test.
Common Health Concerns for Drivers
A lot of drivers worry they’ll automatically “fail” the DOT exam because they have a chronic health condition. But the truth is, many drivers pass even with conditions like high blood pressure, diabetes, or sleep apnea, as long as those issues are under control.
Let’s look at a few examples:
- High blood pressure: If your reading is under 140/90, you’ll likely get a two-year card. Higher readings may result in a shorter card, or require follow-up documentation.
- Diabetes: If you use insulin, you’ll need to bring an Insulin-Treated Diabetes Mellitus Assessment Form (MCSA-5870) completed by your treating physician. Controlled diabetes, whether with insulin or oral medication, is no longer a barrier to certification.
- Sleep apnea: If you’ve been diagnosed, I’ll need to know you’re using a CPAP machine regularly and that your condition is being managed.
Bottom line? The exam isn’t about perfection—it’s about safety and stability.
Tips to Prepare for Your DOT Physical
You don’t have to panic before your appointment. But a little preparation goes a long way:
- Bring your valid driver’s license and glasses or hearing aids, if you use them.
- Take your medications as prescribed. Skipping blood pressure meds the day of your exam could raise your reading.
- Bring documentation for any medical conditions—like recent A1C results, a CPAP compliance report, or clearance letters from specialists.
- Avoid salty, fatty foods and energy drinks the day before, these can spike your blood pressure.
- Stay hydrated, but don’t overdo it just to “flush your system.” That doesn’t help and could skew your urinalysis.
What Happens If You Don’t Pass?
First, don’t panic. If something pops up like high blood pressure or an elevated sugar level, we’ll usually give you a chance to follow up with your doctor and return with proper documentation or treatment.
In most cases, you won’t be disqualified permanently. The goal is to work with you, not against you.
Keeping Your DOT Card Up to Date
Once you pass your physical, you’ll receive a copy of your Medical Examiner’s Certificate, and your results will be submitted to the National Registry of Certified Medical Examiners as required by law.
It’s your responsibility to keep track of when your certificate expires, mark it on your calendar and schedule your next exam at least a month in advance. If your card lapses, your CDL can be suspended or downgraded.
A Doctor’s Word to America’s Drivers
I’ve got deep respect for commercial drivers. You keep our economy moving, our shelves stocked, and our communities connected. You work long hours, often under pressure, and with few breaks. That’s not easy, and it takes a toll on your body.
That’s why this exam exists, not just to check a box, but to protect your health and the lives of those you share the road with. My job isn’t to “catch” you doing something wrong, it’s to support you in staying healthy enough to do the job you love, safely and legally.
So when your next DOT physical comes around, don’t stress. Come in, be honest, and know that my job is to help you pass and keep moving forward.