DOT physical exam guide for commercial drivers
What to expect, what to bring, and important FMCSA health standards. The final certification decision is made by a certified medical examiner based on FMCSA regulations, guidance, the examination and your individual medical history.
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What should I bring to my DOT physical?
- A valid photo ID and any required employer or driver paperwork.
- A current list of medications, including doses and the prescribing clinician’s information.
- Glasses or contact lenses if you use them for driving or distance vision. Bring your glasses even if you usually wear contacts.
- Hearing aids, if you use them.
- If you have obstructive sleep apnea and use CPAP/BPAP: your most recent PAP usage/compliance report, so the medical examiner can review treatment use and effectiveness.
- If you use insulin for diabetes: a completed Insulin-Treated Diabetes Mellitus Assessment Form (MCSA-5870) from the clinician who manages and prescribes your insulin. The DOT exam must begin within 45 days after the treating clinician signs the form.
- Relevant specialist records if you have significant heart, neurologic, vision, hearing or other medical conditions.
Commercial driving with hypertension
High blood pressure does not automatically prevent a driver from obtaining a DOT medical certificate. FMCSA guidance uses blood-pressure ranges to help medical examiners decide certification length and whether treatment or follow-up is needed. Readings above 139/89 should be confirmed with another measurement later in the exam.
| Blood pressure | FMCSA guidance | Typical certification guidance |
|---|---|---|
| Below 140/90 | Not in Stage 1 hypertension range | May qualify for the usual certification period if all other standards are met. |
| 140–159 systolic and/or 90–99 diastolic | Stage 1 hypertension | May be certified for 1 year. At later exams, BP should be 140/90 or less; a one-time 3-month certificate may be considered in certain follow-up situations. |
| 160–179 systolic and/or 100–109 diastolic | Stage 2 hypertension | A one-time 3-month certificate may be given to start or adjust treatment and reduce BP to 140/90 or less. If controlled and treatment is tolerated, certification may be for 1 year. |
| At least 180 systolic and 110 diastolic | Stage 3 hypertension | Should not be qualified until BP is reduced to 140/90 or less and treatment is tolerated. Thereafter, certification may be for 6 months with 6-month recertification. |
Important: certification depends on the complete medical assessment, not a blood-pressure number alone. Medication side effects and complications of hypertension may also affect the examiner’s decision.
Truck driving with sleep apnea and CPAP
Obstructive sleep apnea (OSA) can cause daytime sleepiness and may affect safe commercial driving when not adequately treated. FMCSA guidance directs medical examiners to consider whether moderate-to-severe OSA treatment is adequate, effective, safe and stable.
If you use CPAP or BPAP, bring your compliance report. A recent machine-generated usage report helps document your treatment history. FMCSA regulations do not set a single federal CPAP compliance percentage, number of nights or certification period for OSA; the certified medical examiner evaluates each driver individually.
DOT vision requirements
Under the standard vision rule, a commercial driver generally must have at least 20/40 distant visual acuity in each eye, with or without corrective lenses; at least 20/40 binocular distant vision; at least a 70-degree horizontal field of vision in each eye; and the ability to recognize standard red, green and amber traffic-signal colors.
If corrective lenses are needed to meet the standard, your medical certificate will state that they are required while driving. Drivers who do not meet the standard in the worse eye may be evaluated under FMCSA’s alternative vision standard and may need Form MCSA-5871 completed by an ophthalmologist or optometrist.
DOT hearing requirements
A driver meets the federal hearing standard by perceiving a forced whispered voice in the better ear from at least 5 feet, with or without a hearing aid, or by having an average hearing loss of 40 dB or less in the better ear at 500, 1,000 and 2,000 Hz. Both ears are tested, but only the better ear must meet the standard. If a hearing aid is required to meet the standard, it must be worn while driving.
If you normally use hearing aids, bring them to the exam. If a hearing aid is required to meet the standard, it must be worn while operating the commercial vehicle.
Insulin-dependent diabetes and DOT certification
Drivers with insulin-treated diabetes may qualify when they keep a stable insulin regimen, have properly controlled diabetes and meet the other physical qualification standards.
- Before the DOT exam, the clinician who manages and prescribes your insulin must complete Form MCSA-5870.
- The certified medical examiner must receive the completed form and begin the exam within 45 days after it is signed.
- For the maximum certification period, provide your treating clinician with at least the preceding 3 months of electronic blood-glucose self-monitoring records, from an electronic glucometer that stores dated readings and allows download.
- The maximum certification period under the insulin-treated diabetes standard is 12 months.
- Severe non-proliferative or proliferative diabetic retinopathy is permanently disqualifying under this standard.
- A severe hypoglycemic episode after certification requires stopping CMV operation until evaluated by the treating clinician and return-to-driving requirements are met.
Prepare for your DOT physical
Arriving prepared reduces delays and helps the certified medical examiner complete an accurate evaluation. Take your medications as prescribed and bring your current medical information and any required forms or treatment reports. If you have a chronic condition, additional documentation may be requested before a final certification decision.
Medical disclaimer: this information is for general educational purposes and is not a guarantee of DOT medical certification. FMCSA requirements and guidance may change, and individual certification decisions are made by a certified medical examiner based on current regulations, guidance and the driver’s complete medical evaluation.
Frequently asked questions about DOT physicals
Can I pass a DOT physical if I have high blood pressure?
Possibly. Hypertension does not automatically disqualify a driver. The certification period and need for treatment or follow-up depend on the blood-pressure range, treatment tolerance, complications and the medical examiner’s overall assessment.
What blood pressure is too high for a DOT physical?
FMCSA guidance identifies Stage 3 hypertension as blood pressure at or above 180 systolic and 110 diastolic. A driver in this range should not be qualified until pressure is reduced to 140/90 or less and treatment is well tolerated.
Can I drive a truck if I have sleep apnea?
Yes, many drivers with sleep apnea can be certified when the condition is adequately treated and does not interfere with safe driving. The examiner evaluates symptoms, treatment effectiveness, stability and relevant records.
Do I need to bring my CPAP compliance report?
If you are treated for sleep apnea with CPAP or BPAP, bring your most recent usage/compliance report. FMCSA does not prescribe one universal federal compliance threshold.
Should I bring my glasses to the DOT physical?
Yes. Bring the glasses or contact lenses you use for distance vision or driving. If you need them to meet the standard, you must use them while driving.
Can an insulin-dependent diabetic get a DOT medical card?
Yes, if the driver meets FMCSA’s insulin-treated diabetes requirements and the other standards. A completed MCSA-5870 is required, and the exam must begin within 45 days after it is signed.
What is the DOT vision requirement?
Under the standard rule, drivers generally need at least 20/40 distant vision in each eye and 20/40 binocular vision, with or without correction, plus at least a 70-degree horizontal field in each eye and the ability to recognize red, green and amber traffic-signal colors.
What is the DOT hearing requirement?
The better ear must perceive a forced whisper at not less than 5 feet, with or without a hearing aid, or meet the audiometric standard of an average hearing loss of 40 dB or less at 500, 1,000 and 2,000 Hz.
How long can a DOT card be issued for insulin-treated diabetes?
The maximum certification period under the federal insulin-treated diabetes standard is 12 months.
What should I do before my DOT physical?
Take your medications as prescribed, bring your medication list and required medical documentation, bring glasses/contact lenses and hearing aids if used, and bring condition-specific records such as a PAP compliance report or MCSA-5870 when applicable.
Ready for your DOT physical?
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