The Department of Transportation (DOT) physical examination is a mandatory medical evaluation for all commercial motor vehicle (CMV) drivers. Conducted by a Certified Medical Examiner (CME) listed on the FMCSA National Registry, the exam ensures the driver is medically fit to operate a CMV safely, meeting standards set by the Federal Motor Carrier Safety Administration (FMCSA) to prevent sudden incapacitation or impaired judgment.
Reviewing Medical History and Medications
The examination process begins with a review of the driver’s medical history, which includes completing the Medical Examination Report (MER) form, MCSA-5875. Drivers must disclose past and current medical conditions, including cardiovascular disease, diabetes, neurological disorders, and a history of sleep apnea. This self-reported history serves as the foundation for the physical assessment, alerting the examiner to potential risk factors.
The CME reviews all prescription and over-the-counter medications, including dosage and frequency. If the driver manages a chronic condition like hypertension or diabetes, they must provide a note from their treating physician. This documentation confirms the condition is stable, the treatment plan is effective, and the medication does not impair safe vehicle operation. Failure to disclose medications or provide necessary documentation can lead to a temporary disqualification until the medical information is verified.
General Physical Examination Assessments
The hands-on portion of the physical involves an assessment of the driver’s overall health, beginning with the collection of vital signs. The medical examiner measures the driver’s height, weight, and pulse rate, but the most closely scrutinized vital sign is blood pressure. Uncontrolled hypertension is a significant concern due to the risk of sudden cardiovascular events while driving.
For a full two-year certification, a driver must present with a blood pressure reading of less than 140/90 mmHg. If the reading falls in the Stage 1 range of 140-159 systolic and/or 90-99 diastolic, the driver may only be certified for one year. A reading in the Stage 2 range of 160-179 systolic and/or 100-109 diastolic results in a one-time, three-month certification to allow the driver to initiate treatment and lower the reading to an acceptable level.
The physical includes assessments of the neurological system for coordination, reflexes, and balance, which are necessary for control of a heavy vehicle. The musculoskeletal system is checked to ensure the driver has the necessary range of motion and stability to perform functions required for safely operating a CMV, such as turning the steering wheel and managing foot pedals. The examiner also checks for signs of disease or disorders in the skin, abdomen, and vascular system that could pose a safety risk.
Required Vision and Hearing Tests
Adequate vision and hearing are directly related to safe driving performance. For distant visual acuity, a driver must have at least 20/40 vision in each eye separately, with or without corrective lenses. The driver must possess a horizontal field of vision of at least 70 degrees in each eye, and demonstrate the ability to correctly distinguish between the colors red, green, and amber, which is necessary for reading traffic signals.
The hearing standard can be met in one of two ways: passing a forced whisper test or an audiometric test. The forced whisper test requires the driver to be able to hear a whisper in the better ear from a distance of at least five feet, with or without a hearing aid. Alternatively, an audiometric test standard is met if the driver’s average hearing loss in the better ear is no more than 40 decibels at 500 Hz, 1000 Hz, and 2000 Hz.
A mandatory urinalysis is conducted as part of the DOT physical, although it is a health screening and not a drug test. The urine sample is analyzed for levels of protein and sugar, which can indicate underlying medical conditions like kidney disease or undiagnosed diabetes. The presence of high glucose, for example, signals the need for further evaluation.
The Certification Outcome and Validity
Upon completion of the physical examination, the CME determines the driver’s qualification status and issues the Medical Examiner’s Certificate (MEC), Form MCSA-5876. If the driver meets all the FMCSA standards, they are granted a full certification valid for up to 24 months. This certificate is the official proof of medical fitness required to maintain a commercial driver’s license.
If the driver has a medical condition that requires ongoing monitoring, such as controlled hypertension or diabetes, the examiner may issue a conditional certification for a shorter duration, often 3, 6, or 12 months. This shorter validity period ensures the driver returns for a follow-up examination to confirm the condition remains stable and well-managed. In cases where a condition poses an immediate safety risk, such as uncontrolled Stage 3 hypertension, the driver is medically disqualified until the condition is brought under control.