DOT Physical Exam: Procedure, Risks, Rules, FAQ

All professional bus and truck drivers know how demanding and regulated their job is. As a part of normal procedures during employment, drivers must undergo regular DOT physical exams.

The DOT (Department of Transportation) physical is a physical exam that is a requirement for all CMV drivers. The FMCSA (Federal Motor Carrier Safety Administration) regulates it, and the exam itself is concerned with the physical readiness of the driver to operate a heavy vehicle.

Here is everything you need to know about it.

What Is a DOT Physical

The DOT (Department of Transportation) physical is a physical exam regulated by the FMCSA that is required for all CMV drivers. 

It contains a set of mental and physical health regulations that each commercial vehicle driver must meet to start and keep a career in trucking.

Passing a DOT exam is mandatory to get a CDL (Commercial Driver License) by federal law. The exam determines the driver’s overall capability to safely operate a commercial motor vehicle.

The physical is a recurring exam, meaning all professional drivers must have an up-to-date DOT physical certification.

This ensures that the driver is:

  • Able to handle the physical demands of the job,
  • Capable of handling the job schedule,
  • Capable to handle the emotional stress that comes with the job,
  • Able to control any disease they might have that can impede the way they handle the vehicle.

While strict, the DOT physical is mandatory to ensure the safety of both drivers and other motorists.

US Department of Transportation Logo

What Does a DOT Physical Consist Of?

The DOT physical consists of a series of predetermined physical and mental checks that determine whether the driver is fit for duty.

The physical consists of the following:

  1. Filling out a form (for first-time physical check-up),
  2. Physical examination,
  3. Urinalysis,
  4. 5-panel DOT controlled substance screen,
  5. Neurological Exam.

The DOT Physical Form Details

When a driver gets their physical for the first time, they will have to fill out a medical health history form that contains information on the driver’s health history.

The DOT exan form contains the following questions about the driver’s health:

  • Do you take any medications?
  • If you take any medications, which ones are they?
  • Were you the subject of surgeries?
  • If you did, which surgeries were performed on you?
  • Do you consume tobacco, alcohol, and other substances?
  • Do you have any health symptoms and/or medical conditions?

The above questions are just an example. The questions on the actual physical may vary. 

First-timers will have an option to fill-out this form ahead of time, and they can bring it with them to the physical.

A sample from a DOT physical form. You can find the whole form on the FMCSA site
A sample from a DOT physical form. You can find the whole form on the FMCSA site

Physical Examination

During the physical examination, the driver undergoes the following exams:

  • Hearing exam,
  • Vision exam,
  • Blood pressure exam and pulse rate,
  • Heart and vascular system exam,
  • Abdominal exam.

DOT Physical: Hearing Exam

All CMV drivers must be able to perceive the so-called “forced whisper” at a distance of 5 ft or less. The driver can wear their hearing aid, if they use one, during this test. The “forced whisper” test is equal to an average hearing loss in the “better ear” of less than 40 dB.

DOT Physical: Hearing Exam
DOT Physical: Hearing Exam. Source: WikiHow

DOT Physical: Vision Exam

All CMV drivers are required to have at least 20/40 acuity in each of their eyes. During the test, the driver can wear their glasses if they use a pair. Also, a part of the vision exam is peripheral vision. The driver has to have at least 70” peripheral in the horizontal meridian. This exam is measured in each eye.

DOT Physical: Vision Exam
DOT Physical: Vision Exam. Source: WikiHow

DOT Physical: Blood Pressure Exam

The driver will undergo a blood pressure check to determine the levels of their blood pressure, i.e. whether it is higher or lower than normal. The test also includes irregular heartbeat exams, like murmurs.

DOT Physical: Blood Pressure Exam
DOT Physical: Blood Pressure Exam. Source: WikiHow

DOT Physical: Heart and Vascular System Exam

This part of the exam includes cardiovascular checks for blood and lung-related issues that may impair the driver’s ability to operate CMVs.

DOT Physical: Abdominal Exam

This part of the exam includes checks for liver irregularities, presence of abdominal fluid, and irregular bowel sounds.

DOT Physical: Abdominal Exam
DOT Physical: Abdominal Exam. Source: WikiHow

Urinalysis During DOT Physical

The urinalysis test gives information about the driver’s blood sugar levels, as well as other health indicators, like kidney conditions, toxin exposures, infections, and hematuria.

5-panel DOT Controlled Substance Screen

During the urinalysis test, the trucker will be checked against the 5-panel DOT controlled substance screen. 

This check tests for five drugs in the driver’s urine, including:

  • Marijuana,
  • Cocaine,
  • Opiates such as opium and codeine derivatives,
  • Methamphetamines and amphetamines,
  • PCP (Phencyclidine).

Neurological Exam During DOT Physical

The neurological exam is just as important as the physical parts of the exam. It will check the driver’s reflexes and coordination.

This test has the purpose of discovering any neurological problems that can impair the driver’s ability to operate the CMV. 

People with seizure disorders like epilepsy will automatically fail the DOT exam. In rare cases, they can request an exemption with the FMCSA. Read the FAQs for more information on this exemption.

Neurological Exam During DOT Physical
Neurological Exam During DOT Physical. Source: WikiHow

What to Bring to a DOT Physical?

Drivers who are to undergo a DOT exam should bring the following items with them, should they apply:

  • Prescription eyeglasses or contacts,
  • Hearing aids,
  • A list of all medications, their doses, and doctors who did the exam and gave the prescription,
  • Results of diabetes lab testing and blood sugar levels logs,
  • Heart specialist results for drivers with heart conditions,
  • Doctor’s letter of clearance if the driver takes any medications that cause drowsiness.

What Happens if You Fail a DOT Physical

Due to the nature of the DOT physical to filter out ineligible drivers from getting a CMV permit, not everyone passes the exam on the first try. 

There are many reasons why a driver failed the exam, including:

  • Epilepsy,
  • Substance abuse,
  • Amputations,
  • Cardiovascular disease,
  • Respiratory disease,
  • Diabetes,
  • High blood pressure,
  • Poor eyesight,
  • Poor hearing,
  • A mental disease.

However, failing the DOT physical does not mean the end of one’s trucking career. In most cases, the fails are within minor margins that can be corrected. High blood pressure can be regulated with medication, eyesight can be corrected with eyewear and laser corrections.

How to Pass a DOT Physical

Passing a DOT physical is a matter of being within acceptable margins for each of the individual tests.

The best way to pass the physical is by taking care of one’s health. Eat right, exercise whenever possible, take frequent breaks, and follow the doctor’s advice – all of these are the right way to pass the exam.

Most diseases are controllable. With the correct treatment, most of the conditions that are a cause for potentially failing the exam can be brought within acceptable margins.

It’s important to note that if you have any medical conditions, bring them up during the exam. Bring all relevant documentation to the exam as well, including doctor’s notes on specific health conditions. Be upfront with your examiner during the physical – so they have no reason to fail you.

FAQs About DOT Physical

Below are some frequently asked questions about DOT physical exams:

How Often Does a CDL Driver Need a DOT Physical Exam?

For most commercial motor vehicle drivers, the medical certificate lasts two years. However, if the driver has irregular blood pressure (low or high), or they are with a health condition that may impair their ability to operate the CMV, they will receive a one-year certificate. 

In rare cases, like when a driver has very high blood pressure or other similar condition, they will receive a three-month certificate. However, if the driver has an improvement in their condition after the three-month period, they may be eligible to get a one or two-year certificate.

Do I Need a DOT Physical?

All persons who fall into one of the following categories need a DOT examination by federal law:

  • Operators of motor vehicles that carry 15 or more people;
  • Transporters of HAZMAT that require the vehicle to be placarded;
  • Persons who are paid to operate a motor vehicle designed to carry more than eight people;
  • Persons who operate motor vehicles with a GCWR, GVW, GVWR, or GCW of over 10,000 pounds (see image for reference)

Passing a DOT physical is one of the requirements to become a truck driver.


Where to Go to Get a DOT Physical?

Only FMCSA National Registry listed licensed medical examiners can perform the DOT physical exam.

There is no one-size-fits-all specialization, so medical examiners can range from medical doctors, chiropractors, and physician assistants, to osteopathic doctors and advanced practice registered nurses.

How Much Does a DOT Physical Cost?

The cost of a DOT physical start from around $80. 

Is a DOT Physical Covered by Insurance?

Insurance does not cover DOT physical exams. However, the employer can decide to pay for the exam at their discretion.

Are Employers Required to Pay for DOT Physical?

No, employers are not required to pay for your DOT examination. However, they can require you to take a new exam if it is within their policy. 

If this is the case, the employer usually covers the cost of the exam.

Do You Have to Take Your Clothes Off for a DOT Physical?

While DOT exams are different due to many factors, most truck drivers say that they are not asked to take off their clothes during the physical.

Having said that, many drivers report that during the urinalysis test, they are accompanied by a witness during the urination process.

It is recommended to wear roomy clothes to make the exam go easier for both you and the person examining you.

Can You Refuse Parts of a DOT Physical?

No, you must pass all mandatory exams to pass a DOT physical.

What Happens if I Fail a DOT Drug Test?

Failing a DOT drug test, or refusing to take one will lead to the removal of the driver of all sensitive duties. To start driving again, the driver must go through the Substance Abuse Program.

The program includes the following steps:

  1. The driver meets with a therapist. They get a drug or alcohol treatment program which includes counseling as well. The program will vary depending on the severity of the driver’s problem.
  2. The driver must complete the program and meet with the counselor to review the treatment.
  3. After the driver successfully completes the program, they need to take a Return to Duty test. This test is DOT-mandated. 
  4. The Return to Duty test includes breath and urine alcohol and drug tests. Both must be passed.
  5. The driver will additionally undergo six random breath and urine alcohol and drug tests. These are DOT-mandated as well. The assigned therapist can prescribe additional tests for up to five years, should they deem it necessary.

Can You Fight a Failed Drug Test?

99% of the time, the reason why a driver fails a DOT physical is either they didn’t state they were on a prescribed medication prior to the test, or they actually consume drugs or regulated substances. However, there can be false positives.

You can request a retest within 72 hours of getting a positive test result and after a consultation with your MRO.

In order to fight a failed drug retest, you will need to hire a lawyer and take the case to court.

How Long Does a Failed DOT Drug Test Last?

Failing a DOT drug and/or alcohol test results in a violation. This violation stays on the driver’s record for three years, and for at least five years within employer records.

Can You Retake a DOT Drug Test?

You have the option to request a retest within 72 hours of receiving a positive test. First, you need to consult with your MRO.

Can I Lose my CDL if I Fail a Drug Test?

No. However, drivers who fail the drug test must go through the Substance Abuse Program and Return to Duty protocol.

How Do I Get My CDL Back After Failing a Drug Test?

You do not lose your CDL after failing a drug test. However, drivers who fail the drug test must go through the Substance Abuse Program and Return to Duty protocol to start driving again.

How Many Times Can You Take a DOT Physical?

This depends on the context. All drivers must take a DOT exam at least once every two years (or 24 months) if they are to operate a commercial motor vehicle.

However, if the driver has failed the exam, they will be asked to go through the Substance Abuse Program and Return to Duty protocol which are similar to a DOT physical exam.

Can You Fail a DOT Physical for Being Overweight?

Being overweight can not directly lead to failing a DOT exam. Having said that, the health conditions that come with being overweight can lead to failing the exam.

Such conditions include heart disease, kidney disease, high blood pressure, among others.

Do They Watch You Pee During a DOT Drug Test?

The majority of drivers report that during a DOT urinalysis drug test, an examiner accompanies you while you fill-up the sample to prevent manipulations.

Can You Drink the Night Before a DOT physical?

As much as you might want this to be true, it can lead to big trouble. Stay away from tobacco, coffee, and energy drinks as much as possible in the 24 hours prior to your exam. 

This means no alcohol in that 24 hour period as well.

Can You Pass a DOT Physical with Sleep Apnea?

Yes. However, if you are suffering, and have a diagnosis for sleep apnea and refuse to use the treatments given to you or refuse treatment altogether, you will lose your CDL.

But, there are many drivers out there who suffer from severe sleep apnea and they do their job right with the proper treatment for their condition.

Can You Pass a DOT Physical with Epilepsy?

Most of the time, no. However, a person with epilepsy can request an exemption from Section 391.41(b)(8), which prohibits an individual with epilepsy or a seizure disorder from operating commercial motor vehicles.

The applicant will be subjected to rigorous testing and checking to make sure they will maintain a level of safety equivalent to, or greater than, the level achieved without an exemption.

For more information on how to request an exemption, follow this FMCSA resource.

What is the Highest Blood Pressure for DOT Physical?

During the DOT exam, the driver’s blood pressure must be below 140/90 to pass. You can pass the test even if you are a bit above this limit, but you will require a note from the physician treating you that your condition is being treated and the treatment shows results.