Who this is for: CDL drivers, CDL applicants, fleet managers
DOT Physical — Conditions That May Affect Certification
The DOT physical evaluates vision, hearing, cardiovascular health, and a range of medical conditions. Some conditions result in shorter certification periods; others may be disqualifying unless a waiver or exemption applies. All certification decisions are made individually by a certified medical examiner — this page is an educational overview only.
Important Notice
This page is an educational overview. Certification decisions are made by a certified medical examiner based on your individual health status and current federal standards. Standards may change. This is not medical advice — consult a certified medical examiner and your treating physician.
How the medical examiner evaluates your health
A certified medical examiner reviews your health history form (MCSA-5875), conducts a physical examination, and applies the federal physical qualification standards in 49 CFR Part 391, Subpart E. The examiner determines whether you meet the standards, may need further evaluation, or do not currently qualify. The examiner may consult with your treating physician or request additional documentation.
Vision standards
Federal standards require at least 20/40 acuity in each eye, with or without corrective lenses; field of vision of at least 70 degrees in the horizontal meridian in each eye; ability to recognize traffic signal colors. Drivers who cannot meet monocular vision standards may apply for a federal vision exemption program through FMCSA.
Hearing standards
The driver must perceive a forced whispered voice at five feet or more, with or without hearing aids, in at least one ear. A hearing aid is permitted. Drivers who do not meet the whisper test may use an audiometric device as an alternative. Contact the medical examiner about alternative testing options.
Cardiovascular and blood pressure
Drivers with blood pressure of 140–159 / 90–99 (Stage 1) are certified for one year. Those at 160–179 / 100–109 (Stage 2) receive a three-month certificate to allow treatment. Blood pressure of 180/110 or higher is disqualifying until controlled. Certain heart conditions, including a history of myocardial infarction, may require further evaluation and documentation from a cardiologist.
Diabetes and insulin use
Insulin-treated diabetes mellitus (ITDM) was historically disqualifying under federal rules. FMCSA has an exemption program that allows qualifying insulin-treated diabetic drivers to operate in interstate commerce. Non-insulin-controlled diabetes that is well-managed generally does not disqualify a driver, but the examiner will assess overall health. The FMCSA diabetes exemption program has specific requirements — see FMCSA's official program information.
Neurological conditions
A history of seizures or epilepsy has historically been disqualifying in federal standards unless the driver has been seizure-free for an extended period without medication. FMCSA has an epilepsy/seizure exemption program. Other neurological conditions — such as sleep apnea — may result in a conditional certificate or require treatment documentation. Sleep apnea that is untreated may disqualify a driver; treated and controlled sleep apnea typically does not.
Substance use and mental health
A current clinical diagnosis of alcoholism is disqualifying. Use of certain Schedule I substances or habit-forming drugs may also be disqualifying. Mental health conditions are evaluated individually. Drivers taking medications that affect alertness or have side effects affecting safe driving should disclose all medications to the examiner. The examiner determines whether the medication and condition are compatible with safe CMV operation.
Frequently Asked Questions
Can I still drive if I fail a DOT physical?
If a medical examiner determines you do not meet federal standards, you may seek a second opinion from another certified examiner, provide documentation from your treating physician showing the condition is controlled, apply for an available federal exemption program, or — depending on the condition — wait until the condition is treated and controlled before retesting. Not meeting interstate standards does not automatically prevent intrastate commercial driving, which may be governed by state medical rules.
Where can I find official information about medical exemption programs?
FMCSA publishes information on its exemption programs at its official website (fmcsa.dot.gov). Programs exist for vision, epilepsy/seizure disorder, insulin-treated diabetes, and skill performance evaluation (for limb impairments). Do not rely on third-party summaries for program eligibility — consult FMCSA directly.
Can a driver see the results of their DOT physical?
Yes. Drivers can request a copy of their completed health history form (MCSA-5875) and exam results from the examiner. The Medical Examiner's Certificate itself is provided to the driver at the appointment. Drivers can also check their certification status through FMCSA's driver portal.