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 - Iowa

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Iowa DOT Physical - What You Need to Know

A DOT physical is a thorough medical checkup mandated by the Department of Transportation (DOT) for all commercial motor vehicle (CMV) drivers. This examination verifies that professional drivers are physically, mentally, and emotionally capable of safely operating large vehicles on public roads. Conducted by a certified medical examiner (CME) listed on the National Registry of Certified Medical Examiners (NRCME), passing this exam grants drivers a DOT medical certificate (Medical Examiners Certificate, also known as a DOT medical card), essential to maintain a valid CDL license under FMCSA guidelines. For assistance in determining which DOT physical applies to you, especially if regulated by a different DOT agency, 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 | DOT Breath Alcohol | DOT Consortium Services | 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 completion, your Medical Examiner's Certificate (MEC) may last up to 24 months. Some conditions may need shorter certification or specialist input. This applies for drivers in Iowa.

Who needs a DOT Physical?

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

Hold a commercial driver's license (CDL)- class A, B, or C for interstate commerce
Operate a vehicle over 10,001 lbs. GVWR for interstate travel
Transport over 8 passengers (for hire) or more than 15 passengers (not for hire)
Handle hazardous materials that require placarding under DOT rules
Work for employers governed by DOT bodies such as FMCSA, FAA, FRA, FTA, or USCG where DOT medical certification is necessary

Including criteria for Iowa.

What to bring with you to a DOT Physical?

Government-issued photo ID
Glasses/contacts & prescriptions
Medication list & dosages
CPAP usage data (if applicable)
Specialist clearances (cardiology, sleep apnea, diabetes, etc.)
Recent A1C/blood pressure logs if monitored

This pertains to all medical exams conducted in Iowa.

What happens if I fail a DOT Physical?

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

These procedures apply for medical exams in Iowa.

What Will Fail a DOT Physical?

Medical Conditions That Can Fail a DOT Physical

Vision & Hearing: Vision less than 20/40 in each eye (with correction), trouble distinguishing traffic signal colors, or hearing loss that prevents recognizing a forced whisper at 5 feet.
Blood Pressure & Heart Disease: Unmanaged hypertension (Ã¢â€°Â¥180/110 mmHg), recent heart attack, stroke, uncontrolled angina, or an implanted defibrillator without approval.
Diabetes: Uncontrolled diabetes with frequent hypoglycemia or complications (neuropathy, vision impairment) affecting safe driving.
Sleep Apnea & Respiratory Issues: Untreated obstructive sleep apnea causing daytime sleepiness, or severe respiratory diseases affecting oxygen levels.
Neurological Disorders: Epilepsy or uncontrolled seizure disorders (unless exempted), conditions causing unexpected consciousness loss, dizziness, or uncontrolled tremors.
Substance Abuse: Use of illicit drugs, alcohol dependence, or misuse of medications impairing driving abilities.
Psychiatric & Cognitive Disorders: Severe untreated psychiatric illnesses (e.g., schizophrenia, bipolar disorder with recent episodes) or cognitive impairments affecting judgment and response time.

Temporary issues may temporarily disqualify you until you provide the necessary medical clearance or documentation (e.g., controlled blood pressure, diabetes management). Other conditions, such as untreated seizure disorders or implanted defibrillators, are usually considered permanently disqualifying according to FMCSA rules.