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. Its primary purpose is to confirm that an individual is physically and mentally fit to safely operate a large vehicle on public roadways. The process identifies medical conditions that could suddenly impair a driver’s ability to maintain control, protecting both the driver and the public. Drivers must typically pass this physical every two years to maintain their commercial certification.
Required Paperwork and Health History Review
The DOT physical begins with a comprehensive review of the driver’s medical background. Drivers must complete the health history section of the FMCSA Medical Examination Report Form (MCSA-5875), detailing past and current health conditions. This ensures the medical examiner is aware of any pre-existing risks.
This review requires full disclosure of chronic conditions, such as heart disease, diabetes, or sleep apnea, and any history of seizures, brain injuries, or psychiatric disorders. Drivers must also provide a complete list of all current medications, including dosage and prescribing physician information, as certain drugs can impair reaction time or cognitive function. For specific conditions, like insulin-treated diabetes or a history of cardiovascular events, the examiner may require clearance letters or recent lab results from a treating specialist before certification is granted.
Sensory Function and Vital Signs Assessment
The assessment measures specific sensory functions and vital signs, which have strict quantifiable standards set by the FMCSA. Clear vision is assessed, requiring a distant visual acuity of at least 20/40 in each eye individually, and 20/40 when both eyes are tested together, with or without corrective lenses. A driver must also demonstrate a field of vision of at least 70 degrees in the horizontal meridian in each eye, and the ability to distinguish standard traffic signal colors (red, green, and amber).
Hearing is evaluated using either a forced whisper test or an audiometric device. To pass the whisper test, the driver must perceive a forced whisper at five feet in the better ear, with or without a hearing aid. If an audiometer is used, the driver cannot have an average hearing loss greater than 40 decibels at 500 Hz, 1000 Hz, and 2,000 Hz in the better ear. These criteria ensure the driver can hear warning signals, horns, and sirens necessary for safe operation.
The medical examiner measures the driver’s blood pressure and pulse rate to evaluate cardiovascular health. A reading below 140/90 mmHg allows for the maximum two-year medical certificate. Readings between 140/90 and 159/99 mmHg (Stage 1 hypertension) typically result in a one-year certification, provided the driver is monitored annually.
Higher readings, such as Stage 2 hypertension (160–179/100–109 mmHg), lead to a one-time, three-month certification to allow the driver to lower the pressure. A blood pressure at or exceeding 180/110 mmHg is immediately disqualifying until the pressure is reduced and stabilized below 140/90 mmHg. Uncontrolled hypertension increases the risk of stroke or heart attack, which could cause an instantaneous loss of control while driving.
Hands-On Physical Examination and Urinalysis
The hands-on physical exam comprehensively checks the driver’s physical systems to ensure no condition exists that could suddenly impair driving ability. The examiner observes the driver’s general appearance, noting signs of fatigue, weakness, or tremors. A neurological assessment checks reflexes, coordination, and balance to confirm motor function is intact.
The musculoskeletal evaluation focuses on range of motion in the neck, spine, and limbs. This ensures the driver can execute the physical demands of operating a CMV, such as turning the steering wheel or climbing into the cab. The examiner listens to the heart and lungs, checking for murmurs, abnormal rhythms, or impaired respiratory function. The abdominal area is checked for organ enlargement or hernias, and the vascular system is assessed for issues like varicose veins or abnormal pulses.
A standard urinalysis is a mandatory part of the DOT physical. This is a health screening test, not a drug test, and is used to check for the presence of protein, sugar (glucose), and blood.
Detecting high glucose levels can indicate undiagnosed or uncontrolled diabetes, which may lead to blurred vision or sudden incapacitation from hypoglycemia. The presence of protein or blood in the urine indicates potential underlying kidney disease or other urinary tract issues. These markers help the medical examiner identify conditions that may require further testing or treatment before a full medical certificate is issued.