Drivers must know and follow medical requirements to maintain CDL

man getting medical exam
Today, the FMCSA has tighter control over who can perform a DOT medical examination. Doctors must be licensed to perform examinations and must pass a certification test before being allowed to perform DOT physicals.

As it has in many areas, the Federal Motor Carrier Safety Administration (FMCSA) has tightened the rules for obtaining a medical certification. The requirement for drivers of commercial vehicles to obtain a valid medical examiner’s certificate hasn’t changed for many years; however, the method of obtaining one has become more difficult.

In days past, drivers were required to carry the certificate whenever operating a commercial vehicle. Where the driver got that certificate — or whether the doctor who issued it was qualified — were not matters for concern; it was only important that the driver possess one. So, a driver who failed a Department of Transportation (DOT) physical could simply try again with another doctor, or dentist, chiropractor or anyone that offered the exam.

Drivers who have borderline medical problems, such as high blood pressure or blood sugar, might fail to qualify one day and then be able pass the next. Some examiners allowed them to try several times before officially failing the exam.

Today, the process is a little more difficult. For one thing, the FMCSA took tighter control over who can perform the examinations, creating the National Registry of Certified Medical Examiners. Doctors must be licensed to perform examinations and must pass a certification test before being allowed to perform DOT physicals.

Drivers who need to locate a registered medical examiner can find a list at

Because the FMCSA requires medical examiners to register, it also changes the way drivers report their results. Rather than providing the medical examiners’ certificate to their carrier or simply carrying the card in the truck while driving, results must now be provided to the state that issued the driver’s commercial driver’s license (CDL). Failure to provide the certification can result in suspension of commercial driving privileges. Some states will completely revoke a driver’s CDL status, issuing a passenger-vehicle license in its place.

Another requirement added is self-certification. Drivers must report to the state whether they are operating in interstate or intrastate commerce and whether they’re excepted from the medical requirements. Excepted positions — those for which a CDL is required but a medical examiner’s card is not — include operating a fire truck, driving a school bus, government-employee positions such as military or police, transporting farm machinery or crops as a part of a farming operation, and others.

Each driver should check with the state that issued to his or her CDL to determine exception status. Drivers working in non-excepted driving positions must have a medical examiner’s certificate or risk a CDL suspension.

While obtaining a medical certification and reporting it to the CDL issuing state are the responsibility of the driver, there is a greater responsibility that is more often neglected — that of staying healthy enough to pass the DOT physical in the first place.

According to the Centers for Disease Control (CDC), one-third of U.S. adults 20 years and older suffer from hypertension, commonly referred to as high blood pressure. Of those, more than half are not receiving treatment. Nearly 30% suffer from hypercholesterolemia, cholesterol levels that are dangerously high. Another 16% suffer from diabetes.

It doesn’t help that 71.6% of adults are overweight, with well over half of those qualifying as “obese.” These numbers are for the general population; they get worse when only truck drivers are considered.

Despite these statistics and the relative ease of treatment, drivers continue to fail DOT physicals for the conditions noted here. Hypertension, for example, gets worse with both age and weight gain. Once a person is treated for high blood pressure, it isn’t likely that treatment can be stopped without some serious changes in the driver’s lifestyle. A driver who is prescribed daily medication to control blood pressure is not likely to suddenly stop needing it without losing weight and improving exercise. Other conditions, such as diabetes, present similar conundrums.

Every year, however, thousands of drivers fail DOT physicals because they stopped taking prescribed medication. Some finished a prescription but never went back for a refill. Others stopped taking the drugs as soon as they received their medical cards and were good to drive — for a while.

The reality is that time marches on. Every driver will get older. Without a serious diet and exercise program, chances are they’ll get heavier, too. Once medication is prescribed for hypertension or diabetes there’s a very good chance it will be needed for a lifetime.

Many drivers complain that rigorous work schedules don’t permit extra time for workouts, and eating healthy on the road ranges from difficult to impossible. Taking a pill each day, however, doesn’t add much difficulty to the driver’s day. Visiting a doctor once per year to make sure the medication is working and adjust the dosage when necessary isn’t difficult, either.

Once a driver fails a DOT physical, the FMCSA requires that the problem be corrected before he or she can drive a commercial vehicle again. Medical examiners may require a visit to the driver’s personal physician for treatment and may require days, or even weeks, of treatment to make sure the condition is under control before issuing a medical certification card. Drivers can lose weeks of income while waiting for certification.

Worse, if untreated, hypertension, diabetes and other medical issues can lead to dangerous conditions on the road. For example, high blood pressure can lead to a heart attack, and untreated diabetes can result in dizziness or blackouts. The cost of failing to follow doctor’s orders can be far greater than the loss of a week or two of pay.

Every driver should know the process for obtaining a medical examiner’s certification and reporting it to their home state. More importantly, every driver should keep up with treatment for any conditions that could impact that certificate or put others on the road in danger.

For over 30 years, the objective of The Trucker editorial team has been to produce content focused on truck drivers that is relevant, objective and engaging. After reading this article, feel free to leave a comment about this article or the topics covered in this article for the author or the other readers to enjoy. Let them know what you think! We always enjoy hearing from our readers.


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