One of the complications of getting your medical certificate is if you have a medical condition that may pose a risk to safety while operating a commercial motor vehicle.

How does this play into the FMCSA DOT physical exam?

The medical examiner has a responsibility to ensure that a commercial driver does not have any medical condition which could impact that driver’s ability to meet all the physical and mental demands of the job, now or for the period for which the medical card will be issued.

Here’s what the DOT doctor is checking for:
•Have you had a medical condition which poses a risk to safety?
•Do you have symptoms that may indicate an undiagnosed condition?
•Do you currently have a diagnosed condition?
•Is the condition being treated?
•Is the treatment effective, and safe, for you to drive a CMV?
•Is the medical condition stable, and safe, for you to drive a CMV?

If a medical condition is a concern, the medical examiner must evaluate whether the condition is a risk for incapacitation:
•Is the onset of incapacitation symptoms so rapid as to interfere with safe driving?
•Is the onset so gradual that you may be unaware of diminished capabilities?

Medical Release Opinion

To ensure that the medical examiner can complete the DOT physical exam at your appointment you should bring a Medical Release Opinion letter from your treating physician. You can download instructions and a letter template here, or refer your treating physician to this page for the necessary information.

Download Medical Release Opinion information here.

If you do not have the necessary documentation with you, for the DOT physical exam, the medical examiner may have to temporarily disqualify your medical certificate. You will need this documentation before you can be reconsidered for qualification for a medical certificate.

Medical Conditions

These are the medical conditions listed on the FMCSA long form for which you should have supporting documentation for the medical examiner:

Illness or injury within the last 5 years • Head/Brain injuries, disorders or illnesses • Seizures, epilepsy • Eye disorders or impaired vision (except corrective lenses) • Ear disorders, loss of hearing or balance • Heart disease or heart attack; other cardiovascular condition • Heart surgery (valve replacement/bypass, angioplasty, pacemaker • High blood pressure • Muscular disease • Shortness of breath • Lung disease, emphysema, asthma, chronic bronchitis • Kidney disease, dialysis • Liver disease • Digestive problems • Diabetes or elevated blood sugar controlled by diet or pills or insulin • Nervous or psychiatric disorders e.g. severe depression • Loss of, or altered consciousness • Fainting, dizziness • Sleep disorders, pauses in breathing while asleep, daytime sleepiness, loud snoring • Stroke or paralysis • Missing or impaired hand, arm, foot, leg, finger, toe • Spinal injury or disease • Chronic low back pain • Regular, frequent alcohol use • Narcotic or habit forming drug use

Role Of A Commercial Driver

It’s important that your primary care physician, who is treating you for the medical condition, also understands the physical, mental, and emotional demands of your job, as well as the responsibilities, work schedule and job stresses you have to deal with.

These are extraordinary factors that a family practice physician or specialist does not encounter when dealing with their general patients. These factors must be considered in the doctor’s Medical Opinion Release letter. See Driver’s Role – FMCSA 49 CFR 391.41 pg4

Qualification For Your Medical Certificate

The DOT doctor, aka certified medical examiner, has been certified for evaluating the special circumstances of a commercial driver.

The Medical Opinion Release letter from your primary care physician helps the DOT doctor to evaluate your medical condition in view of the safety risk in driving a commercial vehicle. However, the decision to qualify or disqualify you for a medical certificate rests with the DOT doctor, not your primary care physician.

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