What are DOT physicals? They are federally mandated medical checks that commercial drivers must pass to ensure they can safely operate large vehicles on public roads. These exams, regulated by the FMCSA, cover necessary health standards such as vision, hearing, blood pressure, and overall physical fitness. This article guides you through why these physicals are so important, who is required to have them, and what to expect throughout the process.

Key Takeaways

  • DOT physicals are comprehensive medical exams mandated by the FMCSA for commercial drivers, assessing critical health aspects such as vision, hearing, blood pressure, pulse rate, and overall physical condition to ensure public and driver safety.
  • The exam consists of a medical history review, a physical assessment including vital signs and urinalysis, aimed at detecting medical conditions that may affect the driver’s ability to operate a commercial vehicle safely.
  • Certain conditions can disqualify a driver in a DOT physical, such as unmanaged diabetes, high blood pressure, and significant vision or hearing impairments, but failing the exam allows for re-evaluation after addressing the health concerns.

Defining DOT Physicals: What Are DOT Physicals?

Commercial driver operating a vehicle

A DOT physical, also known as a dot exam or dot medical exam, in essence, is a comprehensive medical exam required by the Federal Motor Carrier Safety Administration (FMCSA) for commercial drivers. It’s not your ordinary physical exam; it’s designed to assess crucial aspects of your health that directly impact your ability to drive safely. This includes evaluating:

  • your vision
  • your hearing
  • your blood pressure
  • your pulse rate
  • and even includes a thorough physical examination.

The oversight of these affordable physical examinations is carried out by the FMCSA, contributing to public safety by assessing the physical health of commercial drivers to verify they are capable of carrying out their job responsibilities safely.

Having defined a DOT physical, we’ll now explore its importance and determine who should take it.

The Purpose of DOT Physicals

Not merely a routine check-up, the affordable DOT physicals serves as a crucial tool for safeguarding the health and safety of commercial drivers and the public at large. As a commercial driver, you’re tasked with the responsibility of operating large or passenger-carrying vehicles, which can pose a significant risk if not handled by a physically fit individual. Therefore, these examinations are crucial in verifying the physical well-being of commercial drivers and their capability to meet the job requirements safely.

The DOT physical aims to ensure certain safety sensitive health standards, which the dot physical consist of:

  • Vision
  • Hearing
  • Blood pressure
  • Pulse rate
  • Physical examination

The findings are recorded on a medical examination report, providing a comprehensive overview of the driver’s health status. This is all part of the regulatory foundation established by the FMCSA mandating DOT physicals for commercial drivers, with the findings recorded on a medical examiner’s certificate that remains valid for up to 24 months. Indeed, commercial drivers must have DOT physicals every two years to keep their commercial driving licenses active.

Who Requires a DOT Physical?

Who then, is required to undertake this physical examination before driving commercial motor vehicles? The Department of Transportation (DOT) mandates physical examinations for drivers operating vehicles such as those transporting hazardous materials, vehicles carrying more than 15 passengers, and vehicles with a gross combined weight of 10,000 pounds or more. Passing the DOT physical is a requirement for obtaining commercial motor vehicle certification.

Even drivers transporting hazardous materials are subject to a federal regulation requiring a DOT physical.

Components of a DOT Physical Exam

Medical history review

Having identified the need and reasons for a DOT physical, it’s time to understand what the exam encompasses. A DOT physical examination is typically comprised of three main components: a review of your medical history, a physical assessment, and a urinalysis. Each of these components plays a vital role in painting a detailed picture of your overall health status.

Medical History Review

The medical history review is an integral part of the DOT physical. The examiner conducts a comprehensive review of your past and current health conditions, which includes a thorough examination of your medical history. Being prepared for this review is of utmost importance. This means:

  • Bringing a list of all current medications
  • Bringing a list of allergies
  • Bringing a comprehensive medical history
  • Bringing any pertinent documents, including a valid form of identification and your medical records.

You should also disclose specific health conditions such as:

  • hypertension
  • respiratory dysfunction
  • diabetes
  • vision impairment
  • epilepsy
  • mental disorders

during the medical history review. Beyond your health conditions, the medical history review also takes into account all medication usage, whether prescribed, illegal, over-the-counter, or supplements. Previous surgeries are also taken into account during the examination, and the medical examiner will thoroughly assess your medical history, including any pre-existing conditions or previous surgeries.

Physical Assessment

Following the medical history review, a physical assessment will be conducted by the examiner. This involves checking your vital signs, such as blood pressure and pulse, as well as assessments of your vision, hearing, and balance. The vision test is conducted to evaluate your visual acuity, peripheral vision, and ability to differentiate colors, to ascertain compliance with the standards established by the DOT.

Hearing is another crucial aspect assessed during the DOT physical. The hearing test involves assessing your ability to hear a forceful whisper from a minimum distance of 5 feet using your best ear. The examination also includes a detailed evaluation of the musculoskeletal system, reviewing the Skill Performance Evaluation certificate, and conducting a physical examination to assess for abnormalities, pain or tenderness, and musculoskeletal function.


A urinalysis concludes the DOT physical, offering meaningful insights into your health status. During this test, a urine sample is collected and tested for specific gravity, protein, blood, and glucose levels to detect potential underlying health conditions.

The urinalysis can identify medical conditions such as:

  • Glucose, which may indicate the presence of diabetes or other underlying health issues
  • Protein, which could be a sign of kidney dysfunctions or infections, often associated with hypertension and diabetes
  • Blood, which might indicate urinary tract infections or cancer
  • Abnormal specific gravity levels, which could suggest dehydration or kidney dysfunctions

During a DOT Physical urinalysis, indications of diabetes may include high levels of glucose. It is important to note that these indicators are not definitive and further testing may be required for a proper diagnosis.

Typical urinalysis findings would include negative results for substances such as glucose, protein, and blood. Conversely, abnormal findings would indicate the presence of these substances, potentially signaling underlying health concerns.

Preparing for Your DOT Physical

Preparing for DOT physical, What are DOT physicals.

A successful DOT physical entails more than merely attending your appointment. Proper preparation, which includes gathering necessary documentation and managing your health conditions, is a crucial step towards ensuring overall wellness and acing your DOT physical exam.

Gathering Necessary Documentation

Before your DOT physical, ensure all required documentation is in order. This includes a valid form of personal identification, such as a driver’s license. If you use vision aids, such as glasses or contact lenses, or hearing aids, make sure to bring them along.

It’s also crucial to prepare your medical history for the exam. This involves compiling a list of all your current medications, allergies, and a comprehensive medical history. You should also bring pertinent documents, including a note and medical records from your treating physician concerning the safety of operating a DOT vehicle while taking medications.

Managing Health Conditions

Effective management of your health conditions is essential when preparing for your DOT physical. This can include:

  • Increasing water intake
  • Refraining from caffeinated beverages
  • Minimizing salt and sodium consumption
  • Furnishing the examiner with updated medical information.

Engaging in regular exercise, maintaining a balanced diet, and managing weight can also contribute to the successful passing of a DOT physical.

Certain health conditions such as:

  • diabetes
  • high blood pressure
  • vision impairment
  • epilepsy
  • mental disorders

necessitate regular medication management for a DOT physical examination.

Potential Disqualifying Medical Conditions

Driver undergoing vision and hearing test

Despite its role in ensuring the safety of drivers and the public, certain underlying medical conditions can lead to disqualification in the DOT physical. These include vision and hearing impairments, high blood pressure, and diabetes.

Vision and Hearing Impairments

For a DOT physical examination, drivers are required to have a visual acuity of at least 20/40 in each eye. If you need corrective lenses to meet this requirement, it is permissible to use them during the examination.

The role of your hearing is crucial in the safe operation of a commercial vehicle. During the DOT physical, your hearing ability will be tested. The test involves assessing your ability to hear a forceful whisper from a minimum distance of 5 feet using your best ear. It is permissible to utilize a hearing aid to successfully complete the hearing test during a DOT physical exam, provided that you can pass the basic hearing test with or without their use.

High Blood Pressure and Diabetes

High blood pressure can also be a disqualifying factor. If your blood pressure reading exceeds the established limits, usually above 140 systolic and/or 90 diastolic, you may be disqualified from passing the DOT physical.

Just like high blood pressure, diabetes needs to be well-managed and controlled to pass the DOT physical. The examiner will carefully assess for any indications of diabetes and may suggest additional evaluation if deemed necessary.

Costs and Locations for DOT Physicals

Finding a certified medical examiner

Though the to get a DOT physical plays a pivotal role in road safety, it’s worthwhile to consider the associated costs and potential locations for the examination. The cost of a DOT physical can vary, and drivers can find certified medical examiners through various resources.

Average DOT Physical Costs

The cost of a DOT physical examination can vary widely, typically ranging from $50 to $225, with an average cost falling between $85 and $200. The costs can also vary by state, with average costs ranging between $85 and $150 in different states.

In Charlotte North Carolina, the Tebby Chiropractic and Sports Medicine Clinic charges $70.00 for the DOT physical INCLUDING the urinalysis. A medical health card is issued the same day to those who pass.

While the DOT physical might seem like an added expense, it’s crucial to keep in mind that this examination plays a key role in maintaining safety on the roads. Some providers that offer low-cost DOT physicals include:

  • NaoMedical
  • Tebby Chiropractic and Sports Medicine Clinic
  • Concentra
  • TeamCME
  • CVS MinuteClinic

These providers provide affordable options for commercial drivers.

Finding a Certified Medical Examiner

To undergo a DOT physical, you’ll need to find a certified medical examiner. The National Registry of Certified Medical Examiners (NRCME) is a Federal program that sets forth standards for healthcare professionals conducting medical evaluations for commercial drivers.

You can use the online search tool on the NRCME website to find certified medical examiners for DOT physicals in your area. The tool allows you to input a city and state, or a zip code, and provides advanced search options for more specific requirements, such as the language spoken by the examiner. Remember, a DOT physical must be conducted by a certified medical examiner, so ensure that the professional you choose is certified.

After the DOT Physical: What to Expect

After completing your DOT physical, understanding what follows next is crucial. Depending on the results of the exam, you’ll either pass and obtain a medical card or fail and need to address any disqualifying health issues.

Passing the Exam and Obtaining a Medical Card

Passing the DOT physical examination brings you a step closer to upholding your status as a commercial driver’s license. The dot physical requirements for successfully completing a DOT physical examination involve:

  • Undergoing a comprehensive health history review
  • Undergoing a thorough physical examination
  • Meeting the minimum vision standard of having at least 20/40 visual acuity in both eyes.

Upon successful completion of the exam, your medical examination provider will document your physical assessment and submit a report to the NRCME. You will then be issued a valid DOT medical card, upon passing the physical assessment. This card is valid for a period of 2 years, allowing you to maintain your status as a commercial driver within this timeframe.

Bear in mind that it’s incumbent upon you to maintain a current medical examiner’s certificate on record with your CDL and renew this certificate periodically by successfully completing a DOT physical examination every 1-2 years.

Failing the Exam and Next Steps

Failing the DOT physical doesn’t signify the end of your journey. It’s important to understand why you failed and take the necessary steps to address the specific health issue that resulted in the failure.

Once you’ve addressed the identified disqualifying letter and medical records or issues, you can undergo the examination again. This might involve:

  • Seeking clarification on the specific reasons for the failure
  • Considering obtaining a second medical opinion
  • Addressing the identified disqualifying medical issues.


In conclusion, the DOT physical exam plays a vital role in ensuring the safety of our roads. By assessing the health and fitness of commercial drivers, it helps to ensure that those behind the wheel of large or passenger-carrying vehicles are physically up to the task. Whether you’re preparing for your first DOT physical or your fifth, knowing what to expect, how to prepare, and the potential disqualifying medical conditions can help ensure a smooth process. Remember, maintaining your good health, not only improves your chances of passing the exam but also contributes to safer roads for everyone.

Frequently Asked Questions

What does DOT stand for in physical?

The term “DOT” in physical refers to the Department of Transportation. A DOT physical examination is required for those who drive commercial vehicles to ensure they are physically, mentally, and emotionally fit for the job.

What do they test in urine for DOT physical?

During a DOT physical, the medical examiner will test your urine for drugs such as cocaine, amphetamines, opioids, THC (marijuana), and PCP. This urine test is typically requested by your employer.

What happens if you fail a DOT physical for high blood pressure?

If you fail a DOT physical for high blood pressure, you may be disqualified, but you can reapply once you’ve lowered your blood pressure. This disqualification is not permanent.

What is checked during a physical?

During a physical exam, your weight, blood pressure, temperature, heartbeat, and various body parts such as ears, nose, lungs, throat, and eyes are checked. Some individuals may also undergo a pap smear (women) or a genital exam (men) to assess different risk factors.

What is a DOT physical and why is it necessary?

A DOT physical is a mandatory medical exam for commercial drivers that evaluates their health to ensure they can drive safely. It assesses vision, hearing, blood pressure, and physical fitness.

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