DOT Physical for Truckers: How It Works and What to Expect

All people with commercial driver’s licenses (CDLs) must pass a physical exam to drive commercially in the U.S. These medical exams serve several purposes for the benefit of the drivers and others on the road.

Passing medical tests can be intimidating, especially if your career hinges on one. So, having questions is natural. Read on to learn more about the U.S. Department of Transportation (DOT) physical exam for commercial vehicle drivers.


What Is the DOT Trucking Physical Exam?

The DOT physical exam includes medical, vision, and hearing tests to ensure drivers can safely do their jobs.

The Federal Motor Carrier Safety Administration (FMCSA) branch of the DOT regulates these tests.


Do I Need a Medical Exam if I Have a CDL B or C?

Yes, all CDL drivers must pass a physical exam no matter what class of license they have. Remember, those with CDL Bs or Cs can drive larger vehicles, sometimes with passengers. So, they must meet the same high safety standards as those driving large tractor-trailers.


Why Do I Have to Get a Medical Exam to Be a Truck Driver?

You need a physical exam to work as a commercial driver to help ensure you and other drivers stay safe.

Non-commercial drivers typically only need to demonstrate physical health by passing a vision test. Occasionally, they need to prove conditions like seizure disorders are under control.


When Do I Get a DOT Physical Exam?

You need to get a DOT physical exam at least every two years. However, if you have an issue that could cause loss of consciousness, like diabetes or high blood pressure, you may need more frequent exams.


When Do CDL Students Get DOT Medical Exams?

CDL students typically have physical exams within the first few days of training. This ensures they don’t waste resources if they’re not allowed to drive due to physical health limitations.

Of course, you can get a checkup at your doctor before school. This won’t count as your DOT-approved exam, but it may give you an idea of if this is the right time to start CDL training. You could bring the DOT physical requirements to give your doctor an idea of your concerns.


What Do Trucking Physical Exams Look For?

Medical examiners look for many potential risk factors while examining CDL holders.

They check for things that could inhibit your ability to drive safely. These include vision problems or illnesses that could cause unconsciousness or poor reflexes.


Overall Physical Exam for Truck Drivers

The physical exam given to truck drivers isn’t too unlike a typical annual exam. It’s performed by a general practitioner of some sort and covers more than 10 areas, including:

  • Abdomen and Internal Organs: Pain and muscle weakness
  • Ears: Physical abnormalities like perforated eardrums
  • Extremities: Ensuring limbs, hands, and feet work correctly.
  • Eyes: Signs of physical and medical issues in the eyes
  • Genitourinary: Hernias, in particular
  • Heart Exam: Strange sounds, irregular bets, pacemakers, etc.
  • How You Look: Obvious symptoms or concerns, like evidence of drug use
  • Lungs and Chest: Breathing challenges
  • Mouth and Throat: Swallowing and breathing issues
  • Musculoskeletal System: Pain or movement issues, including in the spine
  • Neurological System: Reflex, balance, and speech issues

The practitioner may refer you to a specialist if they see something outside their expertise. So, if you have evidence of recent clearance for that illness, be sure to bring it.


Hearing Tests for Truck Drivers

You need to hear a loud whisper at no more than 5 feet. You don’t need perfect hearing, but at least one ear can have no more than 40 dB loss.


Vision Tests for Truck Drivers

You need at least 20/40 vision in each eye (with or without corrective lenses) and 70 degrees peripheral vision in both eyes. You must be able to distinguish colors in standard traffic signals, including being able to determine if a light is red, green, or amber.


Urine Testing for Truck Drivers

Truckers must take urine tests to check for diabetes, kidney problems, or other issues.


Blood Pressure and Pulse

Examiners make sure drivers have normal heartbeats and blood pressure. Issues with either could mean higher risks of heart attack or loss of consciousness.


Truck Driver Mental Health Checks

Study results are mixed on how mental health affects commercial vehicle driving ability. So, this topic is more complicated than physical exams. As such, there aren’t specific psychological exams for truck drivers. But, behaviors and medications related to mental health can affect licensure.

Unpredictable or aggressive behavior may put your CDL at risk, but a diagnosis alone shouldn’t. In fact, getting help may be a good idea so interventions can happen.

That said, some mental health meds aren’t allowed with commercial vehicle drivers, particularly those that can cause drowsiness.


Drug Testing and the DOT Physical Exam

The traditional CDL medical exam doesn’t include drug testing. But, drug and substantial alcohol use—or any alcohol use on the job—are banned for commercial vehicle drivers.

Truck driver drug testing may occur:

  • During the hiring process
  • After an accident
  • When there’s reasonable suspicion
  • If returning to duty after a positive or refused drug test
  • Several times after returning to duty to ensure continuing clean results
  • At random

The substance use that tests look for:

  • Blood alcohol concentration of 0.02 or higher
  • Amphetamines/methamphetamines
  • Cocaine
  • Marijuana
  • Opiates
  • Phencyclidine (PCP)

You may be able to get an exemption for prescribed amphetamines, like those for ADHD. But, doctor-prescribed marijuana is prohibited.


What Health Issues Do Truck Driving Medical Exams Look For?

Some diseases and disorders are more likely to affect whether you can legally drive a CMV. Before diving in, you should know many of these have exceptions. So, you don’t need to immediately panic if something you have is on this list.

Some of the health issues the DOT exam looks for are:

  • Alcoholism
  • Cardiovascular conditions, including
    • Angina pectoris
    • Coronary insufficiency
    • Myocardial infarction
    • Thrombosis
    • Other diseases involving syncope, dyspnea, collapse, or congestive heart failure
  • Difficulty hearing
  • Drug abuse
    • Marijuana is banned even if prescribed by a doctor
  • High blood pressure
  • Kidney disease
  • Inner ear issues causing vertigo or balance problems
  • Insulin-controlled diabetes
  • Issues that result in loss of consciousness, such as epilepsy
  • Low vision, even with corrective lenses
  • Mental, organic, functional, nervous, or psychiatric disorders that can hurt driving abilities
  • Missing or significantly limited limbs
  • Physical issues that could hurt driving ability, like:
    • Arthritis
    • Muscular challenges
    • Neuromuscular challenges
    • Orthopedic problems
    • Rheumatic issues
    • Vascular diseases
  • Respiratory issues that could affect driving ability


What Happens if I Don’t Pass My DOT Physical Exam?

If you don’t pass your DOT physical exam, you may lose your CDL temporarily or permanently. However, exemption programs or waivers can resolve most disqualifying medical conditions.

If diagnosed with a condition, you may need treatments until deemed road-ready. At the most basic level, you need to prove your disqualifying medical condition is under control. This typically involves seeing a specialist to sign off on forms or begin treatment.

If you can’t get your CDL back, you might be eligible for unemployment if terminated for medical reasons. You could also look into trucking careers beyond driving, such as managerial positions.


Where Do I Get a DOT Medical Exam?

The FMCSA provides a list of certified medical examiners.

DOT-approved examiners are professionals who already perform physicals and pass FMCSA certification training. These may include medical doctors, nurse practitioners, and physician assistants.

What Do I Bring to My CDL Physical Exam?

In addition to your CDL, you should bring items you would bring to a typical doctor’s visit to your DOT physical. These include, but may not be limited to:

  • Communication from specialists to explain medical conditions and medications
  • Primary care providers’ names and contact information
  • Glasses or contacts, if you need them
  • Hearing aids, if you need them
  • List of medications you are taking
  • Recent lab results
  • Three months of CPAP data, if relevant

The more information you can provide, the better. So, if you think something may be relevant and help you pass your physical exam, bring it.


Who Pays for My Trucking Medical Exam?

You are likely to pay for your own CDL physical exams, though some trucking companies do so. Insurance companies may or may not pay for the test.


How Much Do CDL Physical Exams Cost?

Trucking medical tests typically cost $50 to $300. This is more than an average checkup because of how much paperwork examiners must fill out.


How Can I Make Sure I Pass the Trucking Physical Exam?

Not every medical issue can be predicted. But, you can improve your chances of passing the CDL physical exam by caring for your body and mind.

Of course, this is easier said than done when you spend your life on the road. However, even small changes can make a big difference. Some things you can do include:

  • Avoiding addictive substances, including drugs, cigarettes, and alcohol (to excess)
  • Eating as healthfully as possible
  • Ensuring you’re up to date on vaccines
  • Getting some movement in, even if just walking and stretching, when not driving. Exercising regularly is even better
  • Getting your own yearly physical
  • Keeping your hands and body clean
  • Seeing your dentist regularly
  • Seeking mental health support when needed. Online/telehealth services are available if in-person options aren’t possible
  • Staying hydrated
  • Taking vitamins
  • Using medications as prescribed

Whether or not any current health issues affect your ability to pass your exam, be sure to manage them. Follow doctor’s instructions, keep appointments, and work even harder to stay healthy. Something that may not affect your driving ability today could do so tomorrow.


Where Can I Find More Information About the CDL Physical Exam?

  • FMCSA: This page covers all the nitty gritty details about DOT medical exams.
  • FMCSA Drug and Alcohol Testing: In-depth information about drug testing, re-entry, and other relevant topics are available here.
  • DOT Physical Doctors: You can find local DOT examiners and helpful posts about the exam on this site.
  • Concentra: This healthcare company’s blog has several articles clarifying the finer details of the DOT medical exam.