DOT Medical Exam and Commercial Motor Vehicle Certification

DOT Medical Exam and Commercial Motor Vehicle Certification

About the Exam

A Department of Transportation (DOT) physical examination is conducted by a licensed “medical examiner.” The term includes, but is not limited to, doctors of medicine (MD), doctors of osteopathy (DO), physician assistants (PA), advanced practice nurses (APN), and doctors of chiropractic (DC).

To find a medical examiner to conduct the DOT physical exam you may contact your primary care provider to inquire if they will conduct a “DOT physical exam.” You may also find a medical examiner in the yellow pages of your telephone book, or on the Internet by using an Internet directory or search engine. Look under “Occupational Health.” If your medical examiner does not have a Medical Examination Report, one may be downloaded.

A DOT physical exam is valid for up to 24 months. The medical examiner may also issue a medical examiner’s certificate for less than 24 months when it is desirable to monitor a condition, such as high blood pressure.

What should Motor Carriers and Bus operators expect from the new National Registry of Certified Medical Examiners?

Dr Michael TiggesWhat should Motor Carriers and Bus operators expect from the new National Registry of Certified Medical Examiners?

On April 18, 2012, a new safety rule was announced by DOT. The final rule requires healthcare professionals who perform medical exams for commercial truck and bus drivers to be certified by FMCSA. Training and testing standards can be found at FMCSA’s National Registry of Certified Medical Examiners website. Effective May 21, 2014, interstate truck and bus drivers must obtain their required medical exams from a certified examiner on the National Registry website.

The National Registry of Certified Medical Examiners (National Registry) is a new Federal Motor Carrier Safety Administration (FMCSA) program designed to help improve highway safety and driver health. The program will require all medical examiners (MEs) who wish to perform DOT physical examinations for commercial vehicle drivers to be certified by May 21, 2014.
◾All medical examiners must be trained and pass a certification test to be listed on the National Registry
◾All Interstate CMV drivers must obtain their physical exams and a medical examiner’s certificate from a certified medical examiner listed on the National Registry. Drivers are required to provide the medical certificate to the State agency issuing their CDL license.
◾The National Registry will not change how often drivers need to obtain a medical examination (at a minimum every 2 years). However, medical examiners may determine that an individual driver may need more frequent exams based on the driver’s medical history.
◾Employers must verify that drivers who complete a medical exam after May 21, 2014 have used an examiner listed on the Registry. They must search the registry for the ME who provided the driver’s medical certificate by name or registry number.
◾Drivers will still receive a medical certificate from the medical examiner after passing their exam; however, the certificate will now include the certified medical examiner’s National Registry Number

By: Dr. Michael Tigges

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High Blood Pressure: How Does This Affect Your DOT Medical Card?

One of the most frequent concerns we hear from commercial drivers regarding the DOT physical exam, is about high blood pressure.

Here is the excerpt from FCMSA Rules and Regulations Part 391.41(b)(6) regarding blood pressure:

“A person is physically qualified to drive a commercial motor vehicle if that person has no current clinical diagnosis of high blood pressure likely to interfere with the ability to operate a commercial motor vehicle safely.”

Here are the medical guidelines according to the Federal Motor Carrier Safety Regulations (FMCSRs). Note that employers are allowed to impose more stringent CDL requirements.

Normal: Medically certified to drive for a two-year period

Normal – Corresponds to a BP of 90 – 119 systolic and /or a BP of 60 – 79 diastolic.

PreHypertension – Corresponds to a BP of 120 – 139 systolic and /or a BP of 80 – 89 diastolic.

A driver with a blood pressure of less than 140 systolic and 90 diastolic, is qualified and may get their DOT medical card to drive for a two-year period.

Stage 1 Hypertension: Medically certified to drive for a one-year period

Corresponds to a BP of 140 – 159 systolic and /or a BP of 90-99 diastolic.

A driver with a blood pressure in this range is at low risk for hypertension-related acute incapacitation and may get their DOT medical card to drive for a one-year period. A DOT physical exam should be done annually thereafter and should be at or less than 140/90. If less than 160/100, certification may be extended one time for three months.

Stage 2 Hypertension: One-time medical certification of three months

Corresponds to a BP of 160-179 systolic and/or a BP of 100-109 diastolic.

The driver is given a one-time DOT medical card of three months to reduce his or her blood pressure to less than or equal to 140/90.

A driver with a blood pressure in this range is a candidate for antihypertensive drug therapy. Provided treatment is well tolerated and the driver demonstrates a BP value of 140/90 or less, they may get their medical card for one year from the date of the initial exam. The driver should do a DOT physical exam annually thereafter.

Stage 3 Hypertension: Disqualified

Corresponds to a BP at or greater than 180 systolic and / or 110 diastolic.

A driver with a blood pressure in this range is considered a high risk for an acute BP-related event, and is disqualified.

The driver may not be qualified for a DOT medical card, even temporarily, until blood pressure is reduced to equal to or less than 140/90 and treatment is well tolerated. The driver may be certified for 6 months and biannually (redo their DOT physical exam every 6 months) thereafter if at recheck BP is equal to or less than 140/90.

Bottom Line For Commercial Drivers:

Your Blood Pressure Needs To Be BELOW 140/90.

Dr Michael Tigges
Dr. Michael Tigges
Nationally Registered Certified Medical Examiner

By: Dr. Michael Tigges

National Registry of Certified Medical Examiners Final Rule



DCs Have Full Authority to Serve as DOT Medical Examiners

In the final rule, chiropractic physicians have full authority equal to medical doctors, osteopaths, nurse practitioners and physician assistants as certified medical examiners. Commercial drivers are required to use a certified medical examiner in the national registry for their commercial driver’s license (CDL) physicals beginning April 21, 2014. Find a Certified Medical Examiner here for your area.

Although a number of groups were opposed to chiropractic inclusion, the Federal Motor Carrier Safety Administration’s response in the final rule was: “The final rule will require all ME candidates to undergo the initial training and the certification testing that objectively measures candidate qualification and ensures that all ME’s have the same level of working knowledge of FMCSA regulation and guidelines … FMCSA will continue to rely on State determination.”

State determination refers to each state’s scope of practice. To perform the CDL physical, your state scope of practice must include performing “physical exams.”

The certification test will be provided at testing centers location across the United States. The certification test is composed of 120 computer questions with multiple-choice answers. Twenty of the questions are ungraded and are being evaluated for use on future tests. Practitioners who pass the certification test will be listed on the national registry.

Certified medical examiners must take refresher training every five years, and must retake the certification test every 10 years. They must also report all completed CDL physicals to the FMCSA monthly.

For further information please contact Dr. Michael Tigges at or contact him at

Dr Michael Tigges
Certified Medical Examiner Dr. Michael Tigges

By Dr. Michael Tigges

What to expect from your DOT Physical in Tennessee


DOT Physical Exam in Tennessee

The requirements to pass a physical for the DOT are set at a high standard to ensure that those who drive vehicles which are heavily loaded will not cause harm to the public.

In order to pass the exam you have to:
•You must have 20/40 correctable vision in each eye.
•You cannot be a diabetic on needle-injected insulin
Blood pressure must meet the following criteria
•140-159 for a 1 year certificate
•160-179 for a 3month temp
•Greater than 180/110 disqualifying

Those who have recently experienced unexplained blackouts may not pass the physical. The doctor may also check for muscle strength, reflexes, any back problems, issues with internal organs, chronic diseases, any acute conditions, etc. In short, you must be relatively healthy to pass the DOT physical.

Upon arrival at Dr. Tigges’s office, you should expect to fill out your DOT Physical and History paperwork.

Over the road, short haul and long haul truckers all require different physical abilities. Truckers must be able to bend, life heavy objects, handle sitting for long periods of time, and the ability to handle very high levels of stress and mental strain. Your body must have sufficient muscle tone in order support the bones in the neck, back and hips during long periods of sitting. Your cardiovascular health should be good in order to avoid the formation of blood clots while sitting.

Your visit to our Gallatin, Tennessee office for a DOT physical should be quick and easy. Walk-ins are available on the same day if we have an opening.

Be sure to wear comfortable clothing to your appointment. You will need to demonstrate certain physical skills, and your clothing should not be a hindrance to your movements. You may be asked to change into a hospital gown for part of the physical, especially if you need to be checked for pre-existing hernias. See are Frequently asked questions:

During your physical, it is important to tell the doctor if you have any pre-existing medical conditions that could interfere with your ability to work. You will be asked to provide a urine sample to check for protein or blood in your urine, this is not a drug test.

The Department of Transportation requires all drivers to pass the exam in order to receive their license. While passing the exam is a stressful for some, it will not serve you to be nervous. You will not experience pain during your exam, and most people who take the exam pass.

Dr. Tigges is one of the first in TN to become a certified DOT Medical Examiner of the United States Federal Government. The National Registry of Certified Medical Examiners requires all medical examiners performing physical examinations for interstate commercial motor vehicle drivers to be trained and certified in FMCSA physical qualification standards.

What can I expect when I get to the office for DOT physical examination?
A nurse will escort you to an examination room when the doctor is ready for you. A nurse will take your vital signs, including your blood pressure, height, weight, heart rate and respiration rate. The doctor will go over your past medical history (3 to 5 years) and your family medical history. Your doctor will notate your list of current prescription medications. He will evaluate your reflexes, hearing, vision and the strength and flexibility of your extremities.

Dr. Tigges strives to provide an efficient, streamlined exam process. Remember, there are many types of physicals. Some require much more extensive testing than the DOT physical. You should be in and out of the office within 30-45 minutes, You will most likely leave the office with your DOT Medical card in hand.

What should I bring for DOT physical?
Bring at least five years of your past medical history so that the doctor can evaluate any injuries and family history. Any medications and habits like smoking or alcohol consumption should also be included in your history. Any and all medical emergencies, especially anything dealing with fainting or a history of anxiety should also be mentioned in your evaluation.

What does the Vision test consist of?
The vision test requires you to have an ability to have a field of vision at least 70 degrees. If you have contact lenses or glasses then you have to be tested at a level of 20/40 or better.

Blood Pressure test: what happens?
With a blood pressure test you have to have a pressure of 140/90 or lower. When the doctor takes your blood pressure, they wrap a cuff around your upper arm. This cuff is then slowly tightened to measure your blood pressure. It’s painless, quick and quite simple.
Blood pressure must meet the following criteria
•140-159 for a 1 year certificate
•160-179 for a 3month temp
•Greater than 180/110 disqualifying

What is the last part of DOT physicals in Tennessee?

Dr. Tigges will examine your neurological functioning including your coordination. In some cases they may toss you a ball, have your squeeze an item tightly and in some cases they will tap your knees to see how fast your nervous system responds. Your equilibrium and neurological functioning is vastly important to your body’s overall functioning.

Whether you need a DOT exam or have other needs, Dr. Tigges’s clinic is open to new patients.

By: Dr. Michael TiggesDr Michael Tigges