DOT Physical: What You Need to Know [2025]

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 2025

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 2025

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.

Hearing

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

Those who have a blood pressure reading of less than 140/90 but no hypertension diagnosis can be certified for two years under 49 CFR, part 391 § 391.41(b)(6).

Drivers who are diagnosed with hypertension and undergoing treatment must be certified annually.

If it is the first time the driver’s blood pressure has been elevated, the FMCSA has different rules based on the stage of hypertension:

• Stage 1 – Blood pressure of 140/90 to 159/99 – Certification for one year
• Stage 2 – Blood pressure of 160/100 to 179/109 – Certification for three months; if testing at three months shows a blood pressure of 140/90, may be certified for one year at that time
• Stage 3 – Blood pressure of 180/110 or above – Driver is disqualified but can be retested for certification every six months

Proposed Rule Change for Seizures

While it is not yet an official change, the FMCSA published an announcement of a proposed rule that would amend 49 CFR 391.41(b)(8), which is the agency’s seizure standard for drivers.

Currently, drivers who have a history of epilepsy or seizures are disqualified.

Under the proposed rule, a driver who has had a seizure in the past but has a certification from a treating neurologist that they have been seizure-free for three or more years would not be disqualified.

Action is not expected on the proposed rule until July 2024.

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.