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 - North Carolina

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North Carolina DOT Physical - What You Need to Know

The Department of Transportation mandates a thorough health check-up for all commercial motor vehicle operators. The DOT physical is a key assessment to confirm that these drivers are safely equipped, both physically and mentally, to handle large vehicles on busy streets. Conducted by a certified medical professional listed in the National Registry, passing this test enables the issuance of a DOT medical certificate, necessary for maintaining a CDL license under FMCSA norms. If other DOT agencies regulate you, call 800-221-4291 for guidance.

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 | DOT Breath Alcohol | DOT Consortium Services | MVR Reports Also Available

What is checked in a DOT Physical?

Health assessment review and medication evaluation
Vision check (corrective eyewear permissible; basic standards applicable)
Hearing test (whisper or audiometry)
Blood pressure and pulse tracking
Physical check (system evaluation)
Urine test (specific gravity, protein, glucose)

In North Carolina, once completed successfully, the Medical Examiner's Certificate (MEC) can be valid for 24 months. Some cases may warrant shorter validity or specialist references.

Who needs a DOT Physical?

You are required to hold a valid DOT medical certificate (card) if you:

Own a commercial driver's license (CDL) class A, B, or C for inter-state business.
Drive vehicles above 10,001 lbs. GVWR for inter-state business.
Transport over eight passengers (if hired) or 15+ passengers (non-hire).
Carry hazardous substances needing DOT compliance placarding.
Work for employers under DOT bodies like FMCSA, FAA, or other where DOT medical clearance is essential in North Carolina.

What to bring with you to a DOT Physical?

Official photo id
Prescription glasses/contacts and related prescription
Medication list & dosages
CPAP usage records (if relevant)
Specialist authorizations (e.g., cardiology, sleep apnea, diabetes)
Recent A1C/blood pressure data if monitored

Remember, in North Carolina, ensuring all these necessary materials are brought can smooth the health clearance process.

What happens if I fail a DOT Physical?

No medical card will be granted
Temporary disqualifications
Referral to your primary clinician for treatment
Possible FMCSA exceptions for specific health issues
Alerting your employer
Steps forward (resolve medical concerns and redo exam)

Be aware, in North Carolina, it's crucial to address these concerns for a successful reassessment.

What Will Fail a DOT Physical?

Medical Conditions That Can Fail a DOT Physical

Vision & Hearing: Vision below 20/40 in each eye (even with correction), inability to recognize traffic colors, or hearing loss that makes it hard to discern a whispered sound at five feet.
Blood Pressure & Heart Disease: Unmanaged high blood pressure (≥180/110 mmHg), recent heart events, unregulated angina, or a non-cleared implanted defibrillator.
Diabetes: Unregulated diabetes causing frequent low sugar levels or complications (e.g., neuropathy) impacting safe driving.
Sleep Apnea & Respiratory Issues: Unmanaged sleep apnea causing drowsiness, or severe respiratory diseases hindering proper oxygenation.
Neurological Disorders: Epileptic conditions (unless exempted) or illnesses causing loss of consciousness, dizziness, or intense tremors.
Substance Abuse: Current use of illicit drugs, habitual alcohol misuse, or prescription medication misuse impairing oneâ€™s driving capabilities.
Psychiatric & Cognitive Disorders: Significant unmanaged psychiatric conditions (e.g., schizophrenia) or cognitive dysfunction affecting decision-making or reaction speeds.

Some circumstances may temporarily disqualify you until you show the required medical documentation (e.g., managed diabetes). Issues like untreated seizure disorders or non-cleared defibrillators are typically seen as permanently disqualifying by FMCSA norms.