The FMCSA requires a basic physical be performed by a certified medical examiner to help insure both driver health and public safety on our roads. The exam consists of a health history, brief physical, urinalysis, vision, and hearing checks, and can usually be completed in about 30 minutes. There are minimum health thresholds that must be met in order to qualify. Once passed, a driver is registered with the FMCSA database.

Yes, in most cases, your medical examiners certificate will be issued immediately upon passing your physical.

Diabetes does NOT disqualify you from operating a commercial vehicle, but you will need to bring your latest lab work to the examination, which should include fasting blood sugar and HbA1C. This needs to be from within the last 4 months. If you are new to using insulin to control your diabetes, you need to have used it for 3 months before you can pass the DOT physical. 

If you have diabetes you will be required to have your DOT physical annually (or more frequently) to ensure you continue to be fit enough to operate large commercial vehicles. You’ll also be required to have annual eye tests because diabetes can lead to some vision impairment.  

Blood sugar will be tested as part of the exam urinalysis.

Yes, as long as your blood pressure is not dangerously high, you can still qualify. Poorly controlled hypertension may limit the length of your certification or require follow up with your primary physician.

Yes, your hearing will be tested while wearing it/them so bring them to the exam and make sure they are working

There are FMCSA recommended testing and waiting periods for a variety of heart and cardiovascular conditions, but basically, if your primary physician documents your ability to return to driving, you can still be issued a medical card once you’ve recovered.

In short, no.

As of March 22, 2022 drivers with monocular vision are now subjected to a road test under certain circumstances and must obtain a Vision Evaluation Report, Form MCSA-5871, from a licensed ophthalmologist or optometrist covering visual acuity, field of vision and recognition of colors. This report is valid for 45 days and must be taken to your DOT physical for consideration by the medical examiner. You may also be required to provide previous vision records. Those qualified under the alternative vision standard must be reassessed every 12 months.

Form MCSA–5871

https://www.fmcsa.dot.gov/sites/fmcsa.dot.gov/files/2023-08/Vision%20Evaluation%20Report%20Form%20MCSA-5871_508.pdf

Yes, but to pass your OSA needs to be under control. To maintain compliance: Drivers must use a CPAP machine at least four hours per night, 70 percent of the time.

For your yearly DOT physical, you’ll need to show the CPAP report for the entire time period since the last medical card expired and the date of the physical.

Drivers beginning CPAP treatment may be certified if they have been successfully treated for a minimum of one week.

If you cannot meet these requirements, you will be given a 30-day certification to allow you to continue working while collecting 30 days of continuous data. If this is done, it will be extended to 60 days, and if that requirement is also reached, it will be extended to 90 days, and finally, you’ll get your one-year medical certificate. In short, it’s well worth staying on top of your records as you will likely have to pay for each of these follow up exams!

Your medical examiner is now advised to only recommend you for a sleep study if you have a BMI of 40 or over, whether or not you have any other medical conditions,

Or a BMI of 33 or more and at least 3 or 4 of the following conditions:  

Are a male or post-menopausal female   

Are aged 42 or over  

Hypertension (whether treated or not)   

Type 2 diabetes (whether treated or not)   

Personal history of stroke, coronary artery disease, or heart arrhythmias   

Micrognathia or retrognathia   

Loud snoring   

Witnessed sleep apnea episodes   

Small airway (reduced space at the back of the throat)   

Neck size over 17 inches for males, or 15.5 inches for females   

Hyperthyroidism  

If you meet the criteria that means your medical examiner must recommend you submit to a sleep study, and you will be given a 90-day certification to give you time to complete your sleep study and pass the physical, or receive treatment. Treatment for sleep apnea is to carry a CPAP machine with you when working. 

You cannot fail the physical exclusively for being overweight, however, the exam does check for signs and symptoms of health complications that are caused or exacerbated by being overweight. There is no BMI value alone that will cause you to fail the physical exam. However, there are certain BMIs that will flag you as being high risk for certain conditions, which may cause your medical examiner to do further tests into things like blood sugar.  Your medical examiner is required to recommend you for a sleep study to detect sleep apnea if you have a BMI over 40, or over 33 with other conditions present.

You can pass your physical with above-normal blood pressure, but if your blood pressure is too high, you will not pass. There is also no problem if you routinely take prescribed medication for high blood pressure. Taking such medication is common and allows blood pressure to return to safe levels offering an improved long-term outlook. 

If your blood pressure is normal (medicated or not), you will pass with no conditions.  

If your blood pressure is high, between 140-159 systolic and/or 90-99 mm Hg diastolic, it is described as “Stage 1” high blood pressure. If your blood pressure is in this range, you will pass but you will be required to take the DOT physical annually.  

If your blood pressure is between 160-179 systolic and/or 100-109 diastolic it is considered “Stage 2” high blood pressure, and you will only be granted a 3-month certificate in which you will be asked to take action to reduce your blood pressure down to 140/90 or better.  

If your blood pressure is higher than 180 systolic and 110 diastolic, you are considered “Stage 3” high blood pressure, are high risk, and you will not pass the DOT physical. At Stage 3, no certification will be granted.