What is the DOT Physical?
Now that you’re well on your way to getting your CDL, an important step in your journey is getting your DOT (Department of Transportation) physical examination. As much as we all hate going to the doctor, this part is inevitable. You will be subject to a variety of tests: hearing, vision, blood pressure, urinalysis, and a physical exam, which will be explained in detail later.
To get your CDL, you need a Medical Examination Report (for Commercial Driver Fitness Determination), which is completed by your examiner. Afterwards, you receive your Medical Examiner’s Certificate if you are determined to be physically qualified to operate a commercial motor vehicle.
Your certification will usually be valid for two years, unless you have a certain condition that requires more frequent recertification and monitoring, such as high blood pressure. After two years, you need to renew.
Where Can I Get My DOT Medical Card?
The DOT Physical must be conducted by a certified medical examiner listed on the Federal Motor Carrier Safety Administration (FMCSA) National Registry. You can click on their website HERE for a list of certified examiners.
One popular testing center is Concentra, but you have many options to select from.
Some CVS Pharmacies even have certified personnel to conduct your exam, however, they do not accept insurance and payment is required upfront. The national average price for the exam according to MDSave is about $243, though prices may vary.
The DOT Physical Broken Down
Overall, the DOT physical is not a terribly difficult trial to pass. The medical exam isn’t a military physical fitness test, but there are certain medical conditions that simply cannot be overlooked and will prevent you from getting your medical certificate. Don’t be discouraged though, as many conditions can be granted a waiver, even a missing limb!
Without further ado, let’s look at what the exam is, what condition(s) can disqualify someone, and what exceptions/waivers there are for each case:
- Driver’s Information and Health History:
The first two sections are filled out by the driver. All you need is to know your personal information and social security number. Next, complete the health history and be as truthful as you can. Remember, lives can hang in the balance if you are wrongfully qualified to drive yet did not answer truthfully about serious medical conditions such as a history of seizures, fainting spells, or even a history of drug or substance abuse.
Even in the case that you are clinically diagnosed with alcoholism, your examiner may recommend you to a specialist, and you may be reconsidered for certification. Do your best to remember onset dates (when you first started experiencing the condition) if you do have a serious condition. The DOT exam is not to disqualify you from your dream job: it is to ensure you are safe behind the wheel and do not endanger others’ lives as well as your own.
According to the Medical Examination Report, a qualifying applicant has:
- At least 20/40 vision acuity in each eye with or without correction
- At least 70 degrees peripheral vision in each eye
- The ability to perceive the colors of traffic signals, showing the standard red, green, and amber.
For those who wear glasses or contacts, this often comes as a great relief. If you can’t see very well without them, you are allowed to wear your glasses or contacts. For instance, if without glasses your vision is 20/45, but with glasses or contacts it is 20/40 or better, you’re fine!
As long as you are comfortable and well-adapted to wearing your contact lenses, they are permitted, but they must both be used for either far or near correction, not a combination of both.
The DOT physical requires that both lenses must be used either for distance-vision acuity or for near-vision acuity.
Unfortunately, if you have monopsia, or monocular vision, you are not qualified to drive. This type of vision means that you use each eye separately.
Compared to binocular vision, which we normally have, your field of view in increased, but depth perception is limited.
Depth perception is very important for driving, especially as a truck driver, and not having adequate depth perception is extremely dangerous.
Lastly, you need to be able to distinguish the colors of a standard traffic signal. If there are some doubtful findings about your ability to perceive these colors, a controlled test using these three colors may be administered to determine if you are able to differentiate between each color. This means you can have some degree of color perception deficiency, as long as you can tell apart those three important colors.
This part of the DOT physical is pretty simple: you must be able to perceive a forced whisper from at least five feet away in each ear; or the average hearing loss in the better ear must be less than or equal to 40 dB.
If you fail the whisper portion of the test, the audiometric test is then administered. You may use a hearing aid, and if you need it to pass the hearing test, you must always use the hearing aid while driving. You must also have an alternate power source for the hearing aid in your possession.
- Blood Pressure/ Pulse Rate:
Having abnormal blood pressure does not disqualify you from receiving your certification. Instead, it simply changes the recertification timeline. If you have a less than or equal to 140/90 blood pressure reading, you are qualified for two year renewals. If you are between 140-159/90-99, your expiration date is after one year; if 160-179/100-109, you may receive a one-time certificate for three months. See the Medical Examination Report (form 649-F) for more specific information.
Next up for the DOT physical exam is the urinalysis. Your sample is tested for protein, blood, and sugar. This test can detect some common diseases which might disqualify you, such as diabetes.
- Physical Examination:
You’re almost done!
All that’s left to do is for the medical examiner to look you over. First is general appearance. Your examiner looks to see if you are markedly overweight, have tremors, signs of alcoholism, or drug abuse.
Here’s everything that’s checked for in your DOT physical exam:
- Eyes – Your examiner checks for pupillary equality (just checking to see if your pupils are about the same shape, size, and react the same way to light) and a lot of other specifics that just check to see if your eyes are normal. The examiner should ask about retinopathy, cataracts, aphakia, glaucoma, macular degeneration, and then they refer you to a specialist if needed.
- Ears – Checks for for damage, occlusion, and perforated eardrums.
- Mouth and throat – Checks for anything that can interfere with breathing or swallowing.
- Heart – Tests for heart conditions, such as murmurs, extra sounds, an enlarged heart, pacemaker, or implantable defibrillator.
- Chest and Lungs – Tests for abnormal chest expansion, abnormal respiratory rate, abnormal breathing sounds such as wheezing or alveolar rales (i.e. “crackles”), and cyanosis. This does not include a breast exam. Findings may require further testing such as an X-ray or pulmonary test.
- Abdomen and Viscera – Examines your internal organs for an enlarged liver, enlarged spleen, masses, bruits, hernia, and significant wall muscle weaknesses.
- Vascular System – Checks for an abnormal pulse, cartoid or arterial bruits (or as we say in English… “weird murmur sounds”), and varicose veins.
- Genito-Urinary System – Checks for hernias, and next are your extremities. T
- Limbs and Extremities – The examiner checks for any loss or impairment of limbs, any perceptible limp, deformities, abnormal weaknesses or paralyses, insufficient grasp to grip a steering wheel, and insufficient mobility and strength to operate the pedals properly.
- Back – Your spine is checked for previous surgeries, deformities, limitation of motion, or tenderness.
- Neurological System – Evaluated for impaired equilibrium, coordination, or speech pattern as well as asymmetric reflexes, sensory or positional abnormalities and ataxia (loss of full control of body movement).
Congratulations! If you’re healthy and are lucky enough to not have any disqualifying disease, chances are you have met all requirements.
NOTE: There are plenty of exceptions/waivers to certain medical conditions, even diabetes. For instance, according to the Medical Examination Report regarding diabetes, “If the condition can be controlled by the use of oral medication and diet, then an individual may be qualified under the present rule”. See the Medical Examination Report for full details on your specific illness or disease.
Is There a Drug test for the DOT Physical?
There is no drug test for the DOT physical, but illegal drug use does disqualify you from driving. That sounds funny, so how does it work?
All trucking companies require you to take a drug test in addition to your DOT physical exam, as per the Federal Motor Carrier Safety Administration.
The FMCSA tests for five classes of drugs: marijuana, cocaine, opiates (opium and codeine derivatives), amphetamines and methamphetamines, and Phencyclidine (PCP). So while the Medical Examination Report may not catch you, the FMCSA can.
The Department of Transportation also does not prohibit companies from performing additional drug tests if so desired, which means you may be tested for more than those five classes of drugs. There are also random tests while you are employed, as employers are required to submit results for 10% or more of their drivers.
As of 2016, hair follicle testing has become the new requirement over urine testing because drug substances remain in hair follicles longer than in urine. Generally, the test covers a period of 90 days, though this may vary slightly with the growth rate of your hair. The standard test requires more than 40 milligrams of hair (about 50-70 strands) up to 1.5 inches in length. Even if someone is bald, hair can be taken from other body areas to acquire enough. In the rare case where there is no hair available, a complete urine test is the alternative.
While all of these tests seem like a burden, it’s important to keep in mind that they are performed for the safety of the road. Driving a big dangerous truck is a great responsibility. And once you are cleared with your DOT physical, then it’s time to go to CDL training, which ultimately means that you need to decide how to pay for it.