DOT Physical: What It Is, Requirements & What It Consists Of

If you work in the transportation industry—or are planning to become a professional truck driver—you’ll need to pass a Department of Transportation (DOT) physical to obtain or maintain your commercial driver’s license (CDL). This medical exam is required for anyone whose job is considered “safety-sensitive”, meaning their actions can affect both their own safety and the safety of the public.

The DOT physical is designed to ensure that commercial drivers are medically fit to operate large vehicles safely. Driving a commercial motor vehicle (CMV) comes with significant responsibility, from handling long hours on the road to managing stressful and sometimes physically demanding schedules. That’s why the Federal Motor Carrier Safety Administration (FMCSA) mandates these exams, following strict federal guidelines to protect drivers and the public alike.

If you’re a first-time CDL applicant or it’s been a while since your last exam, you may feel unsure about what the process involves. This guide will walk you through what a DOT physical entails, what to expect before and after the exam, how results are determined, and who conducts the exam.

What is a DOT physical?

A DOT physical is a medical examination required by the U.S. Department of Transportation (DOT) and administered under the regulations of the Federal Motor Carrier Safety Administration (FMCSA). Its purpose is to ensure that drivers of commercial motor vehicles (CMVs)—such as semi-trucks, buses, and vehicles carrying hazardous materials—are physically, mentally, and emotionally capable of operating these vehicles safely.

The exam evaluates whether a driver can perform critical tasks such as:

• Hearing and responding to sounds on the road
• Seeing road signs and traffic signals clearly
• Staying alert and awake during long drives
• Managing medical conditions or medications that could impair safe driving

The FMCSA mandates DOT physicals for drivers operating CMVs across state lines. Some states may also require it for intrastate drivers. Typically, any driver responsible for large trucks, buses, or vehicles carrying hazardous materials must pass this examination to remain compliant and safe on the road.

Why is a DOT physical important?

The DOT physical is a vital, mandatory examination for individuals operating commercial vehicles. This comprehensive assessment ensures that drivers of commercial motor vehicles are physically, mentally, and emotionally equipped to operate their vehicles safely.

The Federal Motor Carrier Safety Administration (FMCSA) requires this examination to protect public safety on the roads. This thorough evaluation helps maintain high safety standards by ensuring commercial drivers are in optimal health to perform their duties. DOT physicals are essential for improving safety, not only for the drivers themselves but also for other road users. The CDL physical, governed by the same DOT regulations, assesses a driver’s ability to manage the physical, mental, and emotional demands of long hours and operating heavy machinery.

By verifying that commercial drivers meet established health and fitness standards, the examination reduces the risk of accidents caused by medical conditions or impairments. This proactive screening process promotes safer roadways, protects drivers and the public, and minimizes health-related risks on the highway.

Who is required to get a DOT physical?

The Federal Motor Carrier Safety Administration (FMCSA) requires certain commercial drivers to pass a DOT physical to ensure they are medically qualified to operate a Commercial Motor Vehicle (CMV), especially in interstate commerce.

You must obtain a DOT physical if you:

1. Hold a Commercial Driver’s License (CDL) and operate a CMV across state lines

2. Operate a heavy vehicle with:

• A Gross Vehicle Weight Rating (GVWR) of 10,001 pounds or more, or
• A Gross Combination Weight Rating (GCWR) of 10,001 pounds or more, or
• An actual gross vehicle or combination weight over 10,000 pounds

This requirement typically applies to large trucks, tractor-trailers, and certain commercial vans.

3. Operate a passenger transport vehicle designed to carry

• More than 15 passengers, including the driver
• More than 8 passengers for compensation (paid transportation)

This includes many bus drivers, shuttle operators, and certain ride services.

4. Transport hazardous materials that require placarding under federal regulations, regardless of vehicle size.

What does a DOT physical consist of?

A DOT physical is a comprehensive medical examination required for commercial drivers to ensure they can safely operate a CMV. A medical examiner, certified by the FMCSA,  performs the exam and determines whether you meet federal medical standards.

The DOT physical consists of a thorough health review, physical assessment, vision and hearing tests, blood pressure check, urinalysis, and an evaluation of mental and behavioral health—ensuring drivers meet all commercial driver health requirements. 

1. Medical history review

You will complete the Medical Examination Report and answer detailed questions about your health. The examiner reviews and discusses your responses, including:

• Past surgeries
• Current and past medical conditions
• Prescription and over-the-counter medications
• Tobacco, alcohol, or drug use
• Prior failed drug tests or substance dependence
• Current symptoms
• Mental health history

You must answer honestly. Inaccurate information can result in the disqualification or revocation of your medical certificate.

To qualify for a DOT physical, you must:

• Be at least 18 years old
• Hold a valid driver’s license
• Provide your Social Security number
• Complete the required medical questionnaire
• Meet renewal timelines (typically every 24 months, unless otherwise specified)

2. Vision test

The examiner checks your vision to ensure you meet DOT standards. You must have:

• At least 20/40 visual acuity in each eye, with or without corrective lenses
• At least 70 degrees of peripheral vision in each eye (horizontal field)
• The ability to recognize traffic signal colors

You may wear glasses or contact lenses during testing.

3. Hearing test

The examiner evaluates your hearing to confirm you can:

• Hear a forced whisper at 5 feet or less, with or without a hearing aid
• Meet the equivalent standard of less than 40 dB hearing loss in the better ear

This requirement ensures you can hear warnings and emergency signals while driving.

4. Blood pressure and pulse check

The examiner measures your:

• Blood pressure (must generally be below 140/90 mmHg)
• Pulse rate (to detect irregular heart rhythms)

If your blood pressure exceeds acceptable limits, the examiner may issue a temporary certificate or require follow-up evaluation.

5. Urinalysis

A urinalysis is required during every DOT physical. The test checks for:

• Glucose (possible diabetes)
• Protein
• Blood
• Specific gravity

These results help detect underlying medical conditions.

Note: The DOT physical urinalysis is not the same as a federally mandated DOT drug test, but urine may also be screened for substances if required under separate testing regulations.

6. Comprehensive physical examination

The examiner performs a head-to-toe physical evaluation to assess your overall fitness for duty. This includes examining:

• General appearance (signs of illness or distress)
• Skin
• Eyes (cataracts, glaucoma, macular degeneration)
• Ears (scarring, perforated eardrum)
• Mouth and throat (breathing or swallowing issues)
• Heart (murmurs, abnormal sounds, pacemaker presence)
• Lungs and chest (respiratory function, abnormal breathing)
• Abdomen and viscera (enlarged organs, muscle weakness)
• Vascular system (abnormal pulses, carotid issues, varicose veins)
• Genitourinary system (including hernia checks)
• Extremities and joints (limb impairment, range of motion)
• Spine and musculoskeletal system (prior surgery, tenderness, mobility limits)
• Neurological system (reflexes, coordination, balance, speech patterns)
• Gait (walking pattern)
• Circulatory system (arteries, veins, lymphatic system)

The examiner looks for any condition that may impair safe driving.

7. Mental and behavioral health evaluation

The examiner evaluates your mental and psychological stability. They assess conditions such as:

• Severe depression
• Anxiety disorders
• Substance abuse or addiction
• Epilepsy
• Certain heart conditions
• Insulin-treated diabetes
• Severe hypertension

A diagnosis does not automatically disqualify you. The examiner determines certification based on stability, treatment compliance, and risk to public safety.

8. Additional testing (if needed)

Based on your medical history, the examiner may require additional testing, such as:

• Sleep apnea evaluation if you report symptoms like loud snoring, daytime sleepiness, or gasping during sleep
• Cardiac testing
• Specialist clearance letters

9. Required DOT physical forms

Several official forms are associated with the DOT physical:

• Medical Examination Report (MER) – Form MCSA-5875: This form documents your medical history and examination findings.
• Medical Examiner’s Certificate (MEC) – Form MCSA-5876: If you meet all requirements, the examiner issues this certificate, commonly called your DOT medical card.
• Insulin-Treated Diabetes Mellitus Assessment – Form MCSA-5870: Drivers with insulin-treated diabetes must have this form completed by their treating clinician within 45 days before the DOT exam. The examiner cannot issue a certificate without it.

What to bring to a DOT physical?

Preparing in advance for your FMCSA DOT physical can help avoid delays and ensure a smooth certification process. Bringing complete and accurate documentation is especially important if you have ongoing medical conditions.

Here’s a comprehensive checklist of what to bring:

1. Valid identification

• A valid Driver’s License or Commercial Driver’s License (CDL)
• Any required photo ID

2. Completed health history form

• Fill out the driver’s portion of the medical exam form ahead of time (if available) to save time at the clinic.
• Bring documentation of any action items or restrictions noted by your previous DOT medical examiner, if applicable.

3. Complete medication list

Bring a detailed list that includes:

• All current prescription and over-the-counter medications
• Dosages and frequency
• Prescribing doctors’ names and contact information

If you take medications that may cause drowsiness, are controlled substances, or include blood thinners like warfarin (Coumadin), bring:

• A letter from your prescribing doctor confirming that the medication will not impair your ability to safely operate a commercial motor vehicle.
• A recent blood level (INR) report and a clearance letter from your physician.

4. List of treating physicians

• Names and addresses of all doctors managing your health conditions
• Copies of recent office visit summaries, if you have chronic medical issues

5. Vision and hearing aids

• Eyeglasses or contact lenses (if required for driving)
• Hearing aids (if used)

You will be tested using your corrective devices if applicable.

6. Additional documents for specific medical conditions

If you have certain health conditions, you must bring condition-specific documentation:

Sleep apnea

• Your Continuous Positive Airway Pressure (CPAP) machine compliance report showing at least 90 days of use
• Documentation reflecting at least 70% compliance with an average of 4 hours per night
• Bring your CPAP machine data if requested

Diabetes

• Most recent Hemoglobin A1C (HbA1C) result (typically within the last 6 months) – A1C generally must be below 10
• Blood sugar logs
• If insulin-treated, a physician’s note confirming stable management and no recent complications

Heart conditions

• A clearance letter from your cardiologist stating you are safe to operate a DOT-regulated vehicle
• List of current cardiac medications
• Results of recent cardiac testing (such as a stress test or echocardiogram within the last two years, if applicable)

Neurological conditions (Stroke, seizure disorder, brain tumor, or brain bleeding)

• A clearance letter from your neurologist
• Relevant medical records confirming stability and treatment compliance

Hypertension (high blood pressure)

• Blood pressure must be 140/90 or lower on the day of the exam
• If previously elevated, you may need documentation showing it is under control

Limb impairment

• A letter from your physician explaining the condition
• Documentation of any work restrictions
• Clearance confirming your ability to perform driving duties safely

If you are seeing a new medical examiner or specialist, bring copies of relevant medical records to prevent delays. Having all necessary documents ready can help ensure you receive your medical certificate without unnecessary follow-up visits.

Where to get a DOT physical?

A DOT physical must be performed by a medical examiner certified by the National Registry of Certified Medical Examiners (FMCSA). Only certified professionals are authorized to evaluate commercial drivers and issue a DOT medical certificate.

Certified examiners can include:

• Doctors of Medicine (MD)
• Doctors of Osteopathy (DO)
• Doctors of Chiropractic (DC)
• Physician Assistants (PA)
• Advanced Practice Nurses (APN) / Nurse Practitioners (NP)

You can locate a certified medical examiner in your area using the FMCSA DOT Medical Examiner Registry. Many clinics, hospitals, and occupational health centers offer DOT physicals.

How often do you need a DOT physical?

In general, a standard DOT medical certificate is valid for up to two years. During your exam, if no health concerns are identified, you’ll receive a 2-year certificate.

However, the duration of your medical certificate can be shorter depending on your health:

• 1-year certificate – issued if you have mild conditions such as low or high blood pressure that require monitoring.
• 3-month certificate – issued for more serious, yet treatable conditions, like very high blood pressure or other medical issues. Once the condition improves, you may be eligible for a 1-year or 2-year certificate.

It’s important to note that if you develop a medical condition after receiving your certificate that could make driving unsafe, you must stop driving immediately, treat the condition, and complete a new DOT physical before returning to work.

What to expect after a DOT physical exam?

After your DOT physical, your medical examiner will review your results and record them on the Medical Examination Report Form. It’s important to ask questions if anything is unclear, including the meaning of your results and any follow-up actions.

Here are the possible outcomes: 

In some cases, additional action may be required, and the examiner will explain any next steps you may need to take:

• Follow-up testing or treatment: If your examiner identifies a medical issue, you may need to visit your healthcare provider for further evaluation, treatment, or documentation. Once the issue is addressed, you may then receive your medical certificate.

• Disqualification: If a health condition makes it unsafe for you to operate a commercial vehicle, you may not receive a certificate. Your examiner will clearly explain the reasons and guide what needs to be done.

How to prepare for your DOT physical?

Proper preparation can help ensure a smooth DOT physical and increase your chances of passing. Here’s a complete guide for getting ready:

1. Gather your medical documents

Bring all relevant records to your appointment, including:

• A list of current medications
• History of any medical conditions
• Recent test results (blood work, eye exams, sleep studies, etc.)

Ensure all records are up-to-date and organized to help the examiner complete your evaluation efficiently.

2. Manage your health

In the weeks leading up to your exam:

• Take medications as prescribed
• Monitor blood pressure and blood glucose if applicable
• Maintain a healthy diet and avoid excessive salty or sugary foods
• Exercise regularly and maintain a healthy weight
• Consider quitting smoking or vaping
• Avoid alcohol and substance misuse

3. Eye and vision care

• If you wear glasses or contacts, have your eyes checked and ensure your prescription is current.

4. Day of preparation

• Get a good night’s sleep before the exam
• Stay hydrated and eat a balanced meal
• Avoid excessive caffeine or stimulants
• Arrive early to reduce stress and ensure a calm, relaxed appointment

By following these steps, you’ll help the examiner get accurate results and improve your chances of receiving a favorable DOT medical certificate, keeping you compliant and ready to drive safely.

Ready for your DOT physical? Here’s the bottom line

A DOT physical isn’t something to stress over—it’s a routine health check designed to keep you and everyone on the road safe. It plays a critical role in ensuring that commercial drivers are physically and mentally fit to operate safely. When you understand the requirements, prepare properly, and maintain your health, the process becomes straightforward and manageable.

Whether you’re applying for your CDL for the first time or renewing your medical certificate, knowing what to expect can help you feel confident and prepared. Keep your medical records organized, follow your prescribed treatment plans, and schedule your exam before your certificate expires. Taking a proactive approach not only helps you pass your DOT physical but also keeps your CDL valid and your career on track.

Frequently asked questions on DOT physical

Who can perform DOT physicals?

DOT physicals are conducted by certified medical examiners—healthcare professionals specially trained to determine whether a person is fit to operate a CMV safely. These examiners understand the physical, mental, and emotional demands of driving commercial vehicles.

To maintain their certification, medical examiners must complete refresher training every five years and pass a certification exam every ten years. This ensures they are up-to-date on the latest FMCSA standards and can accurately assess a driver’s health in the context of commercial driving.

You can locate a certified medical examiner using the National Registry of Certified Medical Examiners, which allows searches by city, state, or zip code. After selecting an examiner, you can contact their office directly to schedule your DOT physical.

How much does a DOT physical cost?

The cost of a DOT physical generally ranges from $85 to $150, depending on your location and the medical provider you choose. Some clinics may charge more if additional tests are needed to evaluate your fitness for driving.

In most cases, the driver pays for the exam, but many trucking companies or CDL training programs cover the cost as part of their benefits or training package. Since DOT physicals are typically not covered by health insurance, it’s a good idea to check with your employer or training program to see if any assistance is available for exam fees.

Does age affect the DOT physical exam?

Age itself does not change the requirements for a DOT physical. All drivers, regardless of age, must meet the same health and safety standards to operate a commercial vehicle safely.

That said, as drivers get older, age-related health issues—such as high blood pressure, vision changes, or other chronic conditions—may affect the ability to pass the exam. Staying on top of regular check-ups and properly managing any medical conditions is key to maintaining your DOT medical certification.

How to obtain a DOT medical card?

Once you successfully pass your DOT physical, your medical examiner will issue a Medical Examiner’s Certificate (MEC), commonly referred to as your DOT medical card. This certificate, together with your commercial driver’s license (CDL), allows you to legally operate a commercial vehicle for up to two years—as long as you don’t have any medical conditions that require more frequent monitoring.

Certain health conditions may limit your certificate to one year or less, including:

• Diabetes
• High blood pressure (hypertension)
• Heart disease

How long does a DOT physical exam take?

A DOT physical typically lasts 30 to 60 minutes, depending on your medical history and any additional tests your examiner may require.

During the exam, the medical professional will:

• Review your medical history and ask health-related questions
• Assess your lungs, heart, digestive system, and coordination
• Conduct basic tests, including:
• Blood pressure measurement
• Vision screening
• Hearing test
• Urinalysis for glucose and drug screening

This comprehensive evaluation ensures you meet the health and safety standards required to operate a commercial vehicle.

What happens if you fail your DOT physical?

Failing a DOT physical on the day of the exam is very uncommon. If the examiner cannot immediately certify you, they may issue a 45-day pending status. This allows time to gather additional medical records, test results, or other required documentation. Once all necessary information is submitted, you can return for a recheck and potentially receive your medical certificate.

Failing the exam does not automatically disqualify you from driving. Work with your doctor to address the condition that caused the issue. If the condition can be managed or treated, you can develop a plan to improve your health and attempt the exam again.

How to pass a DOT physical with common health conditions?

You can still pass a DOT physical even if you have conditions like high blood pressure, diabetes, or sleep apnea, as long as they are properly managed. To improve your chances of passing:

• Take medications as prescribed and follow your treatment plan.
• Maintain a healthy lifestyle, including a balanced diet and regular exercise.
• Follow your doctor’s guidance for managing your condition effectively.

Bring all relevant medical records and documentation to your exam to demonstrate that your condition is under control.