Can high blood pressure make you fail a DOT physical?

Yes. Drivers with blood pressure at or above 180/110 mmHg will fail the DOT physical. Lower levels of hypertension may result in shorter certification periods if under treatment.

Does diabetes disqualify you from a DOT physical?

Not always. Controlled diabetes with proper documentation may be allowed. Uncontrolled diabetes with frequent hypoglycemia or complications can cause disqualification until managed.

Will sleep apnea cause you to fail a DOT physical?

Untreated or uncontrolled sleep apnea that causes daytime drowsiness can disqualify a driver. However, drivers who are compliant with CPAP or other treatments may qualify with documentation.

DOT Physical Exams

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DOT Physical - What You Need to Know

A DOT physical is a comprehensive medical examination required by the Department of Transportation (DOT) for all commercial motor vehicle (CMV) drivers. This exam ensures that professional drivers are physically, mentally, and emotionally fit to safely operate large vehicles on public roads. The DOT physical is performed by a certified medical examiner (CME) listed on the National Registry of Certified Medical Examiners (NRCME). Passing the exam allows drivers to receive a DOT medical certificate (Medical Examinerâ€™s Certificate, also called a DOT medical card), which is required to maintain a valid CDL license under FMCSA regulations. If you are regulated by another DOT agency and need assistance determining which DOT physical is required, call us at 800-221-4291

During your exam, the medical examiner will complete a thorough health assessment to determine if you meet the Federal Motor Carrier Safety Administration (FMCSA) medical standards. The process typically includes:

What Does a DOT Physical Include?

Health History Review
Vision Test

Hearing Test
Urinalysis

Vital Signs
Physical Examination

DOT Testing I DOT Breath Alcohol I DOT Consortium Services I MVR Reports Also Available

What is checked in a DOT Physical?

Health history review and medication assessment
Vision screening (corrective lenses allowed; minimum standards apply)
Hearing assessment (forced whisper or audiometry)
Blood pressure and pulse rate
Physical examination (systems review)
Urinalysis (specific gravity, protein, glucose)

Upon successful completion, your Medical Examiner's Certificate (MEC) may be issued for up to 24 months. Some conditions may require shorter certification or specialist documentation

Who needs a DOT Physical?

You must have a valid DOT medical certificate (card) if you:

Have a commercial driver's license (CDL)- class A,B, or C for interstate commerce
Drive a vehicle over 10,001 lbs. GVWR in interstate commerce
Transport more than 8 passengers (for hire) or more than 15 passengers (not for hire)
Transport hazardous materials that require placarding under DOT regulations
Work for employers regulated by DOT agencies such as FMCSA, FAA, FRA, FTA or USCG where DOT medical qualification is required

What to bring with you to a DOT Physical?

Government-issued photo
Glasses/contacts & prescription
List of medications & dosages
CPAP usage data (if applicable)
Specialist clearances (cardiology, sleep apnea, diabetes, etc.)
Recent A1C/blood pressure logs if monitored

What happens if I fail a DOT Physical?

No Medical card will be issued
Temporary disqualification
Referral for treatment to your primary care doctor
FMCSA exemptions for certain medical conditions
Employer Notification
Next Steps (address the medical issues and retake the exam)

What Will Fail a DOT Physical?

Medical Conditions That Can Fail a DOT Physical

Vision & Hearing: Vision worse than 20/40 in each eye (with correction), inability to distinguish traffic signal colors, or hearing loss that prevents hearing a forced whisper at 5 feet.
Blood Pressure & Heart Disease: Uncontrolled hypertension (â‰¥180/110 mmHg), recent heart attack, stroke, uncontrolled angina, or an implanted defibrillator without clearance.
Diabetes: Uncontrolled diabetes with frequent low blood sugar episodes or complications (neuropathy, vision impairment) that interfere with safe driving.
Sleep Apnea & Respiratory Issues: Untreated obstructive sleep apnea causing daytime drowsiness, or severe lung disease impairing oxygenation.
Neurological Disorders: Epilepsy/seizure disorders (unless exempted), conditions causing sudden loss of consciousness, dizziness, or uncontrolled tremors.
Substance Abuse: Current use of illegal drugs, alcohol dependence, or misuse of prescription medications that impair driving.
Psychiatric & Cognitive Disorders: Severe uncontrolled psychiatric illness (e.g., schizophrenia, bipolar disorder with recent episodes) or cognitive impairment affecting judgment and reaction time.

Temporary vs. Permanent Disqualification

Some issues may only temporarily disqualify you until you provide medical clearance or documentation (e.g., controlled blood pressure, diabetes management). Others, such as untreated seizure disorders or implanted defibrillators, are generally considered permanently disqualifying under FMCSA rules.