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DOT Physical: What You Need to Know [2023]

DOT physical medical exam

Trucking carriers, schools, bus companies, and other employers who rely on CDL drivers to transport cargo or passengers must ensure they take and pass Department of Transportation (DOT) physicals both before employment and every two years.

A DOT physical is required to protect public safety and prevent accidents.

At iprospectcheck, we coordinate DOT physicals and DOT drug tests for employers in every state.

Here’s important information you should know regarding DOT physicals.

What Is a DOT Physical?

A DOT physical is a comprehensive physical examination that the Federal Motor Carrier Safety Administration (FMCSA) requires for people who hold commercial driver’s licenses (CDLs) and are employed as commercial vehicle drivers.

CDL drivers must take and pass this exam every 24 months. It is required to protect public safety by ensuring commercial drivers are physically and mentally fit to drive.

Who is Required to Get a DOT Physical?

The following drivers must get DOT physicals:

  • Those who transport hazardous materials requiring them to affix a placard to their trucks
  • Those who operate vehicles designed to carry 15+ people
  • Those who are employed to operate vehicles carrying more than eight passengers
  • Those who operate vehicles with gross weights of more than 10,000 pounds

What Does a DOT Physical Consist of?

1. Vision Test

CDL drivers must have a minimum 20/40 visual acuity in both eyes. This can include corrected vision with eyeglasses or contact lenses.

The examiner will also test to ensure the driver has a minimum peripheral vision of at least 70″ in both eyes.

2. Hearing Test

Examiners test the driver’s hearing to see whether he or she can hear a “forced whisper” from five feet away or less.

A driver can pass the hearing exam with or without the use of hearing aids.

The forced whisper test checks to see whether the driver has a hearing loss in their good ear of fewer than 40 decibels.

3. Blood Pressure and Pulse Checks

The blood pressure and pulse rate of the driver will be taken.

The examiner will check for irregular heartbeats and hypertension.

4. Urine Test

Drivers must undergo urine tests as a part of the DOT physical.

The examiner will analyze the sample for indicators of underlying health conditions, including diabetes.

5. Sleep Apnea Test

Drivers who report the following symptoms might have to undergo a sleep apnea test:

  • Daytime fatigue or drowsiness
  • Headaches in the morning
  • Sore throat/dry mouth upon waking
  • Gasping while sleeping
  • Heavy snoring

6. Physical Examination

During the physical examination, the medical examiner will check the driver’s:

  • Overall appearance
  • Eyes (to check for specific conditions, including glaucoma, cataracts, macular degeneration, and others)
  • Ears (to check for problems such as perforated ear drums, tympanic membrane scarring, and others)
  • Throat and mouth (to check for swallowing or breathing problems)
  • Heart (to listen for extra sounds, heart murmurs, and other issues)
  • Chest and lungs (to check for respiratory conditions)
  • Driver’s abdomen (to check for muscle weakness, liver enlargement, and visceral issues)
  • Vascular system (to check for abnormal pulse rates, varicose veins, and carotid problems)
  • Genito-urinary system (to look for hernias)
  • Extremities (to check for limb deformities or defects that could interfere with driving)
  • Spine and musculoskeletal system
  • Neurology (to check for neurological impairments and reflexes)

DOT Disqualifying Medical Conditions

Drivers with certain physical or mental health conditions will be disqualified from driving.

Depending on the disqualifying condition, however, they might be able to get an exemption from the FMCSA based on a statement from their doctor that they are safe to drive.

Disqualifying Physical Conditions

Under 49 CFR, part 391 § 391.41, the following physical conditions can disqualify drivers:

  • Loss of a hand, foot, leg, or arm unless they have received a skill performance evaluation certificate
  • Hand or finger disorders that prevent grasping
  • Limb defects or impairments that prevent drivers from safely operating a commercial vehicle
  • Diabetes mellitus, including insulin-controlled diabetes without an exemption
  • Cardiovascular disease or congestive heart failure
  • Respiratory disease that could result in loss of consciousness
  • High blood pressure that could interfere with the safe operation of a commercial vehicle
  • Musculoskeletal disorders that could interfere with the safe operation of a commercial vehicle
  • Epilepsy and other conditions that could result in a loss of consciousness
  • Visual acuity in either eye with or without correction of greater than 20/40
  • Peripheral vision of less than 70″ in either eye
  • Red/green colorblindness
  • Hearing loss that can’t be corrected to less than 40 dB or less from five feet away

Disqualifying Mental Conditions

Drivers must also meet the DOT mental health requirements, including rules for taking certain prescription drugs such as antidepressants.

Some disqualifying mental conditions include the following:

  • Major depressive disorders with a history of suicidal or homicidal ideations, psychosis, or suicide attempts
  • Psychotic disorders
  • Antisocial personality disorders
  • Obsessive-compulsive disorders
  • Bipolar disorders

DOT Disqualifying Medications for 2023

Under FMCSA rules, drivers will be disqualified if they use any Schedule I controlled substance. This prohibition includes marijuana even if the driver has a prescription for it.

The FMCSA also states that a CDL driver who takes a prescription medication without a valid prescription will be disqualified.

In addition to the DOT physical, CDL drivers must submit a urine sample for a DOT drug test, which checks for recent use of the following illicit substances:

  • Marijuana
  • Cocaine
  • Amphetamines (methamphetamine, amphetamine, MDMA, or MDA)
  • Opiates (heroin, oxycodone, hydrocodone, morphine, codeine, oxymorphone, hydromorphone)
  • Phencyclidine (PCP)

Drivers can also be disqualified for taking any other scheduled drug, including amphetamines, benzodiazepines, and others that are habit-forming or narcotic.

When a CDL driver has a valid prescription from a licensed medical doctor for a non-schedule I drug, they won’t be disqualified if the doctor has advised them that the drug will not adversely affect their ability to drive after reviewing their medical history.

How to Get a DOT Physical

Employers can locate certified medical examiners in their area by searching the FMCSA’s National Registry of Certified Medical Examiners.

You can also contact iprospectcheck for help with coordinating DOT physicals, DOT drug tests, and pre-employment background checks for your applicants and employees.

New DOT Physical Requirements for 2023

FMCSA Medical Qualifications

To receive a medical certification, drivers must meet the qualifications under 49 CFR, part 391 § 391.41.

Visual Acuity

Under 49 CFR, part 391 § 391.41(b)(10)(i), CDL drivers must have visual acuity with or without corrective lenses of at least 20/40 in each eye.

They must also have a peripheral vision of at least 70″ in both eyes.

However, under 49 CFR, part 391 § 391.44, a driver might still be qualified to drive if they fail either the visual acuity or peripheral vision tests in one eye but passes the other physical qualifying conditions and/or passes a skills performance assessment.


Under 49 CFR, part 391 § 391.41(b)(11), a driver must hear a forced whisper from five feet or less away with or without a hearing aid with the better ear.

If the driver passes the hearing test while using a hearing aid, they must wear it whenever they operate a commercial vehicle.

Blood Pressure

Drivers will pass the blood pressure test if their blood pressure is less than 140/90 under 49 CFR, part 391 § 391.41(b)(6).

FAQs for Employers and Job Applicants

1. Where can I get a DOT physical near me?

To complete a DOT physical, you can search for a local provider who is certified as a medical examiner by the FMCSA.

Contact iprospectcheck for help with coordinating the DOT physicals for your employees.

2. Who can perform a DOT physical?

DOT physicals can only be performed by certified medical examiners who are listed on the FMCSA’s National Registry.

They can include medical doctors, doctors of osteopathy (DOs), doctors of chiropractic (DCs), advanced practice nurses (APNs), physician’s assistants (PAs), and others.

Before a medical provider can become certified to perform DOT physical examinations, they must complete the following steps:

  • Register online
  • Take a certified medical examiner training course
  • Pass an exam
  • Have their medical license validated by the FMCSA

3. What can I expect during my exam?

You will need to bring a list of your medications and the names and addresses of your prescribing doctors.

You will need to complete a health history form, which can be completed before the appointment to save time.

The DOT physical examination will be much more comprehensive than a regular annual physical.

The medical examiner will check to see whether you have any underlying conditions that could affect your ability to drive a commercial vehicle and will check your vision, hearing, general health, heart, lungs, abdomen, genito-urinary tract, spine, and vascular system.

They will check for eye problems such as cataracts or glaucoma, hernias, sleep problems, and others.

You will also be required to provide a urine sample to test for conditions like diabetes.

4. How much does a DOT physical cost?

The cost of a DOT physical varies, depending on your location.

Some employers pay for the cost of DOT physicals. Health insurance might also cover it.

5. How long is a DOT physical good for?

In general, a DOT physical is good for 24 months.

However, if the employee has a medical condition that requires monitoring, the medical examiner can provide a certification calling for a shorter period.

6. How long does a DOT physical take?

On average, a DOT physical takes between 30 to 45 minutes.

7. What happens if you fail a DOT physical?

If a commercial driver fails a DOT physical, their license could be changed to a regular driver’s license.

They would no longer be able to operate commercial vehicles requiring a CDL.

8. How soon can I retake a DOT physical?

CDL drivers must take and pass DOT physicals every 24 months.

If you fail a DOT physical, you can get a second opinion. However, the reason for disqualification should appear unreasonable.

You will need to provide the second examiner with your complete medical history.

If the second doctor finds that you are safe to drive, you will need to apply to the FMCSA to resolve the conflict between your DOT medical exams under 49 CFR, part 391 § 391.47.

9. What forms are needed for a DOT physical?

A DOT physical involves the following forms when applicable:

Coordinate Your DOT Physical through iprospectcheck Today

DOT physicals help to prevent accidents and protect the safety of the public.

Transportation employers that hire CDL drivers should ensure they take and pass DOT physicals before allowing them to begin their safety-sensitive duties.

At iprospectcheck, we coordinate DOT physicals for USA-based employers and provide an array of drug testing and clinical services, including DOT drug tests, reasonable suspicion tests, pre-employment tests, random drug tests, return-to-duty tests, and post-accident tests.

To learn more about our clinical services or to receive a free quote, call us today: (888) 509-1979

DISCLAIMER: The resources provided here are for educational purposes only and do not constitute legal advice. Consult your counsel if you have legal questions related to your specific practices and compliance with applicable laws.

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About the Author
Matthew J. Rodgers

Matthew J. Rodgers

Matthew J. Rodgers is a highly accomplished business executive with over 30 years of experience providing strategic vision and leadership to companies ranging from the fortune 500 to iprospectcheck, a company which he co-founded over a decade ago. Matthew is a valued consultant who is dedicated to helping companies create and implement efficient, cost effective and compliant employment screening programs. Matt has been a member of the Professional Background Screeners Association since 2009 . When not focused on iprospectcheck, he can be found spending time with his family, fly fishing, or occasionally running the wild rivers of the American west. A lifetime member of American Whitewater, Matt is passionate about protecting and restoring America’s whitewater rivers.