Medical Requirements to get a Commercial Driver’s Licenses (CDL) and Commercial Learner’s Permits (CLP)

All CDL applicants must pass a physical exam administered by a U.S. Department of Transportation (DOT) certified physician before being issued a CDL and periodically for as long as the continue to drive trucks. The exams are intended to prevent drivers with medical conditions that could impair their ability to safety operate a commercial motor vehicle from driving. The medical exam requirement is intended to keep the highways safe — for both truck driver and passengers in vehicles sharing the roads. Like many CDL requirements, the medical exam will cover everything required under DOT/FMCSA regulations, as well as any state-specific issues of concern.

What is included in a DOT physical exam for a CDL?

The medical examination for truck drivers is much like any other physical exam; however, in conducting the examination, physicians are required to consider specific medical conditions that might prevent one from qualifying for a CDL if not properly treated. Physicians also conduct tests that may result in your license being permanently suspended if treatment is ineffective or unavailable.

1. Vision Test

CDL holders must pass a vision test and meet the following thresholds. Those unable to meet the requirements without corrective lenses will pass if the lenses sufficiently improve their vision.

  • 70” peripheral vision
  • 20/40 acuity in each eye

2. Hearing Test

The ability to hear at an adequate level is very important for CDL drivers. Before changing lanes, truck drivers must listen for vehicles that may be in momentary blind spots. When driving, particularly in urban areas, they need to recognize safety warnings ranging from emergency vehicle sirens to the shouts of people at crosswalks.

The test requirement for hearing is the ability to hear a “forced whisper” from a distance of five feet. Hearing aids are allowed if needed to meet this requirement.

3. Blood Pressure/Heart Rate

As your physician like does any time you visit the office for any medical reason, your blood pressure will be taken and your heart rate will be checked.

Blood pressure is important because of the many emergency medical situations it can create if uncontrolled. If the physician determines your blood pressure is not within safe limits, it may be controlled through medication, lifestyle changes, or both. Keep in mind, however, some blood pressure medications cause drowsiness, a side effect that may impact your ability to safely drive a truck.

Your heart rate will be checked for a number of reasons including the dangers presented by rates too slow or too fast, irregular heartbeats that signal underlying conditions, and related issues.

4. Urinalysis

The DOT exam includes a urinalysis intended to determine if you may have conditions including pre-diabetes, diabetes A or B, kidney issues, and other condition a urinalysis might reveal. The DOT urinalysis is NOT intended as a drug-screening test. Testing for controlled substances is normally the responsibility of your employer after you have been hired.

A particular concern related to the urinalysis is diabetes. The physician will want to know if you have a history of diabetes or a current diabetic condition requiring insulin injections. A “red flag” for these conditions is a blood sugar level above 200.

5. Other

Again, DOT exams are not much different than the standard physical exam conducted when you periodically visit your doctor for diagnosis of otherwise unnoticeable conditions, determine medical issues you may be predisposed to in the future, and getting recommendations to prevent any existing or potential conditions from becoming worse.

The following are they typical conditions a physician will be looking for during an exam, and if you have a history of any of these conditions, you should be up-front and honest. In most cases, treatments are available, and you’ll be able to earn or maintain your CDL.

  • Cardiovascular issues
  • Loss of hearing
  • Dizziness/Fainting
  • Spinal cord injuries
  • Stroke
  • Neurological/Brain disorders
  • Epilepsy or seizures
  • Digestion system issues
  • Chronic pain
  • Psychiatric disorders
  • Kidney disease
  • Paralysis
  • Sleep apnea
  • Use of controlled substances

Again, your state may require additional testing. You should contact your state’s DMV or CDL-issuing authority for specific information.

For more information on taking the DOT medical exam, watch this video.

For more information on preparing for the DOT medical exam, watch this video.

Does sleep apnea affect my ability to get a CDL?

Sleep apnea (OSA) is a condition affecting millions of Americans. It may result from a “mechanical” problem like when a person’s tongue relaxes while asleep and blocks an airway (Obstructive Sleep Apnea or OSA). Or it may be the result of an “electrical” problem where the a disconnect exists interfering with the brain telling a sleeping person to breath. In any case, among the most dangerous issues a person with sleep apnea faces is “drowsy driving.” The issue is of even greater concern when the driver is hauling a trailer with a heavy load making it difficult to stop within short distances.

During your medical exam, your physician may recognize signs suggesting you might have sleep apnea. If so, you may be referred to a sleep specialist for testing. And if the test reveals that you have sleep apnea to the extent it interferes with safely driving a truck, you’ll be prescribed treatment. Most often, the treatment is a Continuous Positive Airway Pressure (CPAP) machine. You simply wear a mask while a sleep and a pump blows air into your airway to keep it open. The result is deeper, more productive sleep that makes you more alert while driving.

Depending on the physician, you may have to take a temporary break from driving while the impact of CPAP treatment is measured. Likewise, the physician will likely require periodic evaluations throughout your course of treatment. Some people are able to change their lifestyles and eating habits, lose weight, and become “cured” from sleep apnea.

What happens following my DOT medical exam?

Assuming you pass your medical exam and are deemed physically fit, you will be issued a CDL medical card. A copy will be sent to DOT. As long as you continue to operate a commercial motor vehicle, your medical card must be periodically updated, and you must carry the card or a copy in your vehicle at all times.

If you fail to pass your examination, it could be on the basis of missing a single threshold that tests reveal, or your physician may have concerns about several physiological systems that combine to prevent the physician from confidently certifying you as physically fit in terms of driving a commercial motor vehicle. Your physician will likely order more tests to determine if the concerns are valid or prescribe drugs or other treatments that will improve your overall health. Until the physician deems you physically fit, you will not be able to legally operate a commercial motor vehicle.

If you do not follow state-prescribed medical card renewal procedures, you will likely receive a notice that you are no longer authorized to hold your CDL.

Do not fear taking your medical examination. If you feel you will not pass, you will either have to surrender your CDL or give up your hopes of working as a truck driver. Remember, driving exemptions may allow you to drive with a condition you might think disqualifies you from holding a CDL. Examples of exemptions might include controlled diabetes, missing limbs, and other conditions.

What if I don’t pass my DOT medical exam?

Failure to pass a medical exam means that you are not deemed in proper physical condition to allow you to safely operate a commercial motor vehicle. The impact of your physical condition and options for treatment may or may not cause it to make you ineligible (temporarily or permanently) to hold a CDL.

Your physical exam will allow you and your doctor to decide what, if any, medical conditions need to be addressed. Your physician will likely be able to prescribe medication or offer recommendations for lifestyle changes to improve your health and allow you to pass another medical exam in a month or two. On the other hand, you may fool yourself and pass your exam with flying colors!

Keep in mind, your examination may reveal conditions that if not treated could impact not only your ability to drive a truck but your ability to live a long, quality-filled life.

How often must I get a DOT medical exam?

Truck drivers must get a DOT medical exam every two years. In some cases, physicians may recommend more frequent exams. Your physician’s recommendations and DOT review of your exam report will impact the amount of time a medical certification is valid. Sometimes, exams or specific portions of exams may be required at intervals as short as three months.

What is the Americans with Disabilities Act of 1990 (ADA) and does it apply to freight carriers?

The Americans with Disabilities Act has been federal law for over three decades. The intent of the act, among other things, is to prohibit employers from discriminating against applicants or existing employees based on known disabilities, prior disabilities, or perceived disabilities (i.e., an employer recognizes a physical condition and assumes you cannot operate a clutch based on perception). All employers, especially those with a significant number of employees, are very familiar with the ADA, and freight carriers are no exception. In fact, chances are lawsuits have been filed against carriers based on the same disability creating you concern. Case law and precedence for your issue may have already been set and addressed. If so, an employer’s legal team may already know what is or is not required in your situation.

How might ADA affect me getting my CDL?

Even if you fall into the first category and are someone who has a known disability and that disability interferes with safely operating a commercial motor vehicle, ADA has provisions that may enable you to gain or maintain your CDL. Under ADA, an employer must make “reasonable accommodations” for employees and applicants with disabilities. Taking the steps to make reasonable accommodations are the employer’s responsibility and at the employer’s expense.

How can I file an ADA complaint or request for accommodation without angering my employer?

First, the ADA specifically prohibits an employer from taking any adverse action against an employee cover under the law. But if you approach your concern from the standpoint of being a “team player,” you are far less likely to run into problems.

Keep in mind that you are the person living with the disability, and your experience can help an employer find a reasonable accommodation based on your needs. For example, in attempting to comply with ADA, an employer may consider expensive options and even put a design team to work to address your disability. But your experience living with the disability has caused you to use ingenuity. You may already know of a simple, inexpensive fix that solves the problem. Perhaps a change of steering wheels will take care of the issue. Don’t use ADA as a sword for offense unless an employer refuses to take reasonable action to address your needs. Work with the employer to find solutions that minimize the impact of your disability while driving and minimize the burden an employer faces in accommodating your needs.

What is a “reasonable accommodation”?

ADA is vague concerning the definition of what is an accommodation one should consider as reasonable. What is reasonable for one employer may not be reasonable for another. For instance, if the cost of an accommodation is $10,000 the employer is very small with narrow profit margins, the cost may not be reasonable. The same cost, on the other hand, would likely be considered reasonable for a major carrier. As an example, modifying a truck so the throttle is controlled with a mechanism attached to the steering wheel may be a reasonable accommodation for a driver missing or having paralysis in a leg. Or, if you have a spinal condition that interferes with turning your neck as far as needed to drive your truck, a reasonable accommodation might be as simple as replacing OEM sideview mirrors with special mirrors increasing the driver’s range of vision or eliminating blind spots.

In some cases, your disability can be accommodated without any changes to your truck. The issue may be created by an employer’s policies and procedures. For instance, perhaps a carrier’s policy calls for a new driver to be assigned the carrier’s oldest truck. In your case that truck has a manual transmission, and your disability makes shifting gears difficult. At no cash expense, the company may exempt you from the policy and assign you another truck with an automatic transmission. Problem solved!