DOT physical checklist, what to bring and what gets tested

A DOT physical is a federally mandated exam for commercial drivers. The standards come from the Federal Motor Carrier Safety Administration (FMCSA). This paper covers what to bring, what we test, what disqualifies a driver, and what to do if you fail one item.

Who needs a DOT physical

You need a DOT physical if you operate a commercial motor vehicle that:

• Weighs 10,001 pounds or more, or
• Transports 16 or more passengers, including the driver, or
• Transports 9 or more passengers for compensation, or
• Carries hazardous materials in quantities requiring placarding.

Drivers crossing state lines almost always fall under federal rules. Intrastate drivers may have additional state-specific rules.

How long the certificate lasts

A standard medical card is valid for up to 24 months. Drivers with conditions that need monitoring (controlled hypertension, controlled diabetes, sleep apnea on treatment) may be issued a shorter certificate (3 months, 6 months, or 12 months) and re-evaluated.

What to bring

To make the visit fast and reduce the chance of a redo, bring:

1. Photo ID.
2. Glasses or contacts. If you wear them while driving, bring them.
3. Hearing aids. Same rule.
4. A current medication list. Include over-the-counter products.
5. A list of treating providers for any chronic condition.
6. Documentation for chronic conditions:
   • Blood pressure: recent readings if you monitor at home.
   • Diabetes: most recent hemoglobin A1c, glucose logs, list of medications. Drivers on insulin need a specific federal exemption document (Form MCSA-5870) completed by the treating clinician.
   • Sleep apnea: compliance report from your CPAP machine showing usage averaging at least 4 hours per night on at least 70 percent of nights over the last 30 days.
   • Heart conditions: most recent cardiology note, including any stress test or echocardiogram results.
   • Vision: recent eye exam, especially if you have monocular vision or use corrective lenses.
   • Seizure history: a current letter from neurology is essential. Most seizure histories require an exemption.

Missing documentation is the most common reason a driver leaves with a 3-month card instead of a 24-month card or has to come back for a second visit.

What gets tested

The exam covers:

• Vision. Each eye and both together must be at least 20/40 with or without correction. A field of vision of at least 70 degrees in the horizontal meridian in each eye is required.
• Hearing. You must be able to perceive a forced whisper at 5 feet, with or without a hearing aid, or pass an audiometric test.
• Blood pressure. Below 140/90 is ideal and gets a 24-month card. 140 to 159 over 90 to 99 can still pass with a 12-month card. 160 to 179 over 100 to 109 is a 3-month card. 180 over 110 or higher disqualifies until treated and stable.
• Urinalysis. Tests for protein, blood, sugar, and specific gravity. It is not a drug screen, although your employer may require one separately.
• Heart and lungs. Listening exam, plus a check for ankle swelling or significant peripheral vascular issues.
• Abdominal exam. Looking for hernias, masses, scars suggesting prior surgery.
• Neurologic. Reflexes, sensation, balance, gait.
• Musculoskeletal. Range of motion, strength, anything that might affect operating a vehicle.

What disqualifies a driver

The full list is long. The most common automatic disqualifications include:

• Uncorrected vision worse than 20/40 in either eye.
• Uncontrolled blood pressure.
• A current diagnosis of epilepsy without a federal exemption.
• Use of certain controlled medications without proper documentation.
• A current alcohol use disorder.
• Current use of Schedule I drugs.

Many conditions that sound disqualifying are actually conditional. You can drive with diabetes, controlled blood pressure, sleep apnea on treatment, and a history of heart surgery. The key word is conditional, meaning documentation is required.

What to do if you fail one item

Failing a single item does not automatically end your driving career. Common paths forward:

• Blood pressure too high. Start or adjust treatment, recheck in a few weeks, return for a recertification.
• Vision below standard. Update your prescription or get evaluated by an ophthalmologist.
• Sleep apnea suspected. Get a sleep study. If positive, start CPAP, document compliance for 30 days, return.
• Diabetes not yet under control. Work with your primary care to get A1c into target range.

We work with drivers to get the right card the first time when possible and to get back on the road quickly when something needs to be addressed first.

The next step

Schedule your DOT physical at least a week before your current card expires so there is room to fix anything that turns up. Bring everything on the list above and you will likely leave with a 24-month card in hand.