The Department of Transportation (DOT) physical examination is a standardized medical assessment required by the Federal Motor Carrier Safety Administration (FMCSA) for commercial motor vehicle (CMV) drivers. This exam ensures a driver is medically and physically qualified to safely operate a commercial vehicle. The primary goal is to minimize accident risk by confirming the driver does not have health conditions that could suddenly impair their judgment, reaction time, or physical ability while driving.
Medical History Review and Vitals Check
The process begins with a detailed review of the driver’s medical history, which helps the medical examiner understand any pre-existing conditions. Drivers must disclose current and past diagnoses, including neurological disorders, cardiac issues, sleep apnea, and major surgeries. A thorough medication review is also conducted to identify any prescriptions that could cause drowsiness, impaired coordination, or other side effects that might compromise driving performance.
Following the history review, the medical examiner measures the driver’s baseline vital signs. Height and weight are recorded, and the pulse rate is taken to check for an irregular heartbeat or signs of cardiovascular strain. Blood pressure (BP) is measured, with the standard requirement being below 140/90 mmHg for a full two-year certification.
A mandatory urinalysis is required as part of the DOT physical, primarily for health screening rather than the mandated drug test. The urine sample is analyzed to screen for underlying medical conditions that could affect driving safety, such as high glucose levels indicating undiagnosed diabetes. The presence of protein or blood can also signal potential kidney issues or urinary tract infections.
Detailed Physical System Examination
The most extensive part of the examination involves an assessment of numerous body systems to confirm functional capacity for driving. The medical examiner first checks the driver’s vision, requiring a minimum visual acuity of 20/40 in each eye, with or without corrective lenses. The ability to recognize the colors red, amber, and green is also tested, along with peripheral vision.
Hearing is evaluated to ensure the driver can perceive a forced whisper at a distance of at least five feet, with or without a hearing aid. If this standard is not met, an audiometric test may be used, requiring an average hearing loss not exceeding 40 decibels. The cardiovascular system is assessed by listening to heart sounds for murmurs or extra beats. The examiner also checks the vascular system for signs of peripheral vascular disease or abnormal pulses.
The musculoskeletal system is examined to ensure the driver has sufficient strength and range of motion to operate a commercial vehicle’s controls, such as steering and foot pedals. The neurological system is checked through tests of reflexes, coordination, and balance to identify impaired motor function or signs of neurological disorders. The respiratory system is assessed by listening to lung sounds to detect conditions that might impair breathing capacity. The general physical exam also includes checks of the mouth, throat, abdomen, and spine.
Determining Fitness for Duty
Based on the review of medical history, vital signs, and the physical examination, the certified medical examiner determines the driver’s fitness for duty. If the driver meets all Federal Motor Carrier Safety Administration (FMCSA) requirements, they are issued a Medical Examiner’s Certificate (DOT medical card). This certificate is typically valid for a maximum of 24 months.
The certification period can be shorter if the driver has a condition requiring closer monitoring, such as controlled high blood pressure or certain cardiac conditions. For example, drivers with Stage 1 hypertension may receive a one-year certification, while those with Stage 2 hypertension may receive only a three-month certification to allow time for control. Disqualification occurs if the condition is considered too hazardous for safe operation, such as uncontrolled high blood pressure or severe vision loss.