Tag Archives: DOT PHYSICAL

DOT MEDICAL GUIDELINES -DIABETES

DOT MEDICAL GUIDELINES -DIABETES

The Department of Transportation (DOT) Medical Examination is very highly regulated as illness complications can have serious consequences for the driver, the examiner, and the general public. DOT medical guidelines outline the health criteria that commercial vehicle drivers must meet to qualify for certification. One health condition that is closely reviewed by the DOT is diabetes. Individuals with known or suspected diabetes are required to provide specific medical information to the DOT-certifying physician regarding diabetic control. The DOT definition of diabetic control often causes confusion for individuals seeking certification, as well as their employers. The following information provides answers to common questions and clears up misconceptions about diabetes and DOT certification. The maximum certification for a person with diabetes is one year. According to DOT guidelines, a person with diabetes, whether controlled with diet alone or diet plus medication, must meet the following criteria:

  • Maintain a glycosylated hemoglobin (Hemoglobin A1C or “HBA1C”) of 10% or less.

The HBA1C is a measure of the average amount of sugar in the blood over the last 3 months. A normal HBA1C is less than 5.7%. Values between 5.7 and 6.4% are classified as being in the pre-diabetic range. These individuals should be closely monitored. If the level is above 6.4%, then the person is diabetic. The HBA1C correlates very well with end organ (blood vessels, nerves, kidneys, heart, or eyes) damage and therefore is a popular marker for disease control. Red blood cells have a lifespan of about 90 days before they are removed by the spleen. Glucose sticks to the hemoglobin in red blood cells. Therefore, the glycosylated hemoglobin can be a good estimate of the average blood sugar and is much more accurate in assessing diabetic control than a fasting blood sugar that varies from day to day. Obviously, it takes about 3 months for the HBA1C to drop, generally by 1 percentage point.

  • The driver must not have a history of the following:

(a) One or more hypoglycemic episodes in the past 12 months, or 2 or more occurrences in the past 5 years resulting in:

1. Seizure

2. Loss of Consciousness

3. Need for Assistance from another person

4. Period of Confusion

(b) Signs of End Organ Damage: 1. Retinopathy 2. Macular Degeneration 3. Peripheral Neuropathy 4. Congestive Heart Disease 5. Stroke 6. Peripheral Vascular Disease 7. Kidney Failure

Diabetic individuals seeking DOT certification must provide current (within six months) diabetic control information to the examining physician. This information should be available as part of routine diabetes care through the individual’s primary care physician. To avoid delays in certification, SameDayDOT Physical Drug & Alcohol Testing recommends individuals meet with their primary care physician in advance of the examination to obtain copies of the required laboratory information, then bring that information to the DOT appointment. Diabetics who require insulin for control cannot be approved for DOT certification unless they have a waiver. The diabetic waiver application and program details can be found on the Federal Motor Carrier Safety Administration website. The process for obtaining a waiver is cumbersome and only a small number of drivers have received this exemption since the waiver program was instituted in 1996. “These medical guidelines can be quite complex,” says Michael Tigges, DC, Nationally Registered Certifed Medical Examiner. “The DOT team at Same Day DOT Physical Drug & Alcohol Testing understands the DOT regulations and their importance in promoting driver health, wellness and public safety. We are always available to answer any questions

All drivers diagnosed with diabetes must bring a printed copy of their most recent hemoglobin A1C from his or her primary care physician. This lab value must be 10% percent or less and be done within the last 3 months. The driver will receive a one year certificate if cleared. If the A1C levels are between 10-12% then the driver will receive a 3 month certificate. If, after 3 months, the new AIC levels are 10% or less at the end of the 3 months, the driver will receive a 9 month certificate based on the previous physical exam.

If the driver does not have the lab results available or his or her urine is positive for sugar, a random blood test (RBT) will be done. If this is 250 or less the driver will receive a 3 month certificate in which he should see his primary care physician and obtain an AIC lab. Once he or she returns with the report and it is less than 10% then 9 months will be added to your medical certification expiration date.

INSULIN

Insulin is used to treat high blood sugar in diabetes. Insulin has the potential to cause very low blood sugars which can cause drivers to black out or go into a coma; therefore diabetic drivers who require insulin for treatment cannot be approved for DOT certification. However, some drivers may qualify for a waiver which is a special process requiring additional clearance from your primary care physician and endocrinologist as well as more frequent assessments to maintain the driver’s medical certification.

More information is available through the FMCSA through the Federal Diabetes Exemption Program at:

http://www.fmcsa.dot.gov/documents/safetyprograms/Diabetes/diabetes-exemption-package0706.pdf.

Tips for managing your blood sugar:

  • Eat healthy food portions at least three times a day.
  • Avoid sugary drinks and processed foods. Keep healthy snacks with you.
  • Do a moderate activity for 30 minutes 3-4 times a day. Doing laps along a rest stop is a good way to stay active during long hauls.
  • Carry you glucose meter with you during trips to check your levels. If you experience symptoms of low blood sugar, be sure to carry glucose tablets with you.
  • Maintain good blood pressure and have a yearly eye exam with an eye professional to avoid diabetic complications that reduce your ability to drive.

Contact us for any questions you may have: https://samedaydot.com/contact-us/

 

Preparing for Your DOT Medical Exam

Preparing for Your DOT Medical Exam

The DOT’s National Registry of Certified Medical Examiners (NRCME) program has ushered in a new era of driver and employer responsibility in regard to understanding the DOT medical examination process. The NRCME program aims to elevate the DOT medical exam to its originally intended level of scrutiny that can ensure safer drivers and safer roads across the country.

By requiring certification of all medical examiners, the DOT made an obvious statement about quality and their continued efforts to eliminate “doctor shopping” by drivers, the practice of visiting provider after provider until someone finally issues a medical card, whether it is warranted or not.

Certain conditions have always led to shorter card terms or disqualification, and the new certification program has brought these to the forefront for many examiners who either never knew the regulations or never paid close enough attention to allow the regulations to guide their decision making.

The goal, hopefully is that medical examiners across the country will be holding drivers to a more consistent standard when issuing cards.

In preparation, drivers and employers should pay particular attention to the conditions below that may exclude drivers from certification or require intermittent medical monitoring.

Assembling the necessary documentation in advance of the exam can save drivers and employers considerable time and money.

These are the most common health problems associated with DOT medical certification or recertification that require documentation during the DOT exam to help expedite certification.

History of Asthma / COPD

If you have a history of lung disease (asthma or COPD) or have symptoms of shortness of breath, cough, chest tightness, wheezing, or drivers over the age of 35 who smoke, you will need spirometry. You can arrange to have this done at your doctor’s office or occupational medicine clinic.

Sleep Apnea

  • A letter from the doctor treating for the sleep apnea stating that your current CPAP treatment is effectively controlling your sleep apnea
  • Documentation that verifies your equipment (CPAP machine) is operating effectively and shows that you are compliant with the use of the CPAP (smart card printout)

Diabetes

  • A letter from the doctor treating you for the diabetes stating you are being treated for diabetes is required. A list of the medications you are taking and that the medications are tolerated and would not interfere with the ability to drive must also be provided. The frequency of your glucose control and efficacy of treatment monitoring must be documented, along with verification that you have had no severe hypoglycemic reactions in the last 12 months. The date and results of your last hemoglobin A1C level must be provided. Any complications from diabetes (example: renal, cardiovascular or neurological concerns) must be documented.

Diabetic on insulin is disqualifying, unless you have a federal diabetes waiver.

A letter from your eye doctor or the doctor treating you for your diabetes must state the date of your last eye exam and that there is no retinopathy.

  • Unstable proliferative or unstable nonproliferative retinopathy is disqualifying.
  • If you are on incretin mimetic treatment, such as Byetta (exenatide) or Bydureon (exenatide extended-release), a letter from your doctor prescribing this medication describing your tolerance to the medication is required.
  • How frequently you are monitored for adequate blood glucose control and efficacy of treatment must also be documented.

Cardiovascular Disease

  • History of heart attack, angina, or post-PCI: You will need a letter from your cardiologist stating that you are cleared to drive a commercial motor vehicle with no restrictions. DOT requires an exercise stress test every 2 years. You will need to bring a copy of the stress test results to your exam. The above has occurred in the past year, a copy of the most recent Echocardiogram is also required.
  • History of cardiac bypass surgery: A letter is required from you cardiologist stating that you are cleared to drive a commercial motor vehicle with no restrictions. After 5 years from the date of surgery you will need a yearly exercise stress test. Please bring the stress test results to the DOT exam. If the bypass surgery is within the past year, a copy of your most recent echocardiogram will be required.

Anticoagulant Therapy

If you are taking warfarin for cardiovascular disease, please bring a copy of the most recent INR results to your DOT exam.

Anticonvulsant Medication

If you a taking topamax, neurontin (gabapentin), or other seizure medication for other than a seizure disorder (example: chronic pain or migraine prophylaxis), bring a letter from the doctor prescribing the medication stating that the medication is not being prescribed for seizure. Also, if you are experiencing side effects, the letter must state that the side effects would not interfere with driving a commercial motor vehicle.

Histories Requiring Limited Certification (one year or less):

  • High blood pressure
  • Diabetes
  • Sleep Apnea
  • Cardiovascular Disease
  • Heart Surgeries

Medications Requiring Limited Certification (one year or less):

  • Lithium
  • Byetta
  • Provigil
  • Warfarin (cardiovascular disease)
  • Antidepressants

Pristiq, Cymbalta, Effexor, Effexor XR, Celexa, Lexapro, Prozac, Prozac Weekly, Sarafem, Paxil, Paxil CR, Zoloft

  • Antipsychotics

Abilify, Abilify Discmelt, Saphris, Zyprexa, Zyprexa Zydis, Seroquel, Seroquel XR, Risperdal, Risperdal M-Tabs, Geodon, Symbyax, Nardil, ESAM, Parnate

Note: The medications listed above require a safety letter from the driver’s Primary Medical Provider indicating the prescribed medication is tolerated and no side effects interfere with driving a commercial motor vehicle.

More questions, call ahead, communication is what makes everything run smoother.

By Michael Tigges DC, NRCME

SameDayDOT.com

Call 615-452-1575

OCCUPATIONAL RESOURCES ON THE WEB

Occupational Health Resources on the Web

For Occupational Health information, including state and federal regulations, take a look at some of the sites listed here:

1.   Occupational Safety and Health Association (OSHA): www.osha.gov

2.   Department of Transportation (DOT): www.dot.gov

3.   National Registry of Certified Medical Examiners (NRCME): https://nationalregistry.fmcsa.dot.gov/NRPublicUI/Drivers.seam

4.   Federal Motor Carrier Safety Administration (FMCSA): http://www.fmcsa.dot.gov/

5.   FMCSA Drug and Alcohol Testing information: http://www.dot.gov/odapc/part40

6.   Center for Disease Control (CDC): www.cdc.gov

7.   National Institute for Occupational Safety and Health (NIOSH): www.cdc.gov/niosh

8.   Department of Public Health (DPH): www.state.ma.us/dph

By Dr. Michael Tigges

DOT Checklist Need to know what to bring to your DOT physical?

DOT Checklist

Need to know what to bring to your DOT physical?

To contact us directly to discuss what you need to bring to a DOT Physical, Click Here

All drivers

Drivers who have high blood pressure

 

Drivers who require eyeglasses, contact lenses, or hearing aids

  • Bring your glasses, contacts, or hearing aids
  • You will be required to pass a vision and hearing test

Drivers who have diabetes

  • Your blood sugar should be controlled
  • Bring the most recent results of a lab test called a Hemoglobin A1C (HgAIC) and your blood sugar logs or other records related to your diabetes.
  • For info click here DOT MEDICAL GUIDELINES -DIABETES

Drivers who have nighttime sleep disturbance (sleep apnea) and use a CPAP machine

  • Bring a reading from your machine documenting your proper use of the machine; a letter from your sleep specialist may also be required
  • Bring at least 90 days of data, but data from the past year is best
  • Click here for more info on OBSTRUCTIVE SLEEP APNEA (OSA): How To Know If You Have It

Drivers who have heart-related issues, (including the use of stent, valve replacement, pacemaker, open-heart surgery, cardiac bypass surgery, or heart attack)

  • At minimum, bring a letter from your cardiologist (heart specialist) that outlines your medical history and current medications and indicates you are safe to drive a DOT vehicle
  • You may also need to bring the results of a recent stress test, ECHO cardiogram, or other testing completed within the past 1-2 years
  • For more info on DOT REGULATIONS AFTER A HEART ATTACK click here

Drivers who have suffered a stroke, a brain tumor, seizure disorder, or bleeding in the brain

  • Bring a letter from your neurologist (brain and nerve specialist) that outlines your medical history, current medications, and current neurologic and psychiatric state

Drivers who have experienced the permanent loss of use in an arm or a leg

  • Bring an overview from your physician of the injury and if you have any work restrictions due to the injury
  • You may need a Skilled Performance Examination in order to qualify for your DOT card

Drivers who are taking any medications that may cause sedation or sleepiness or controlled substances (includes narcotics, sleeping pills, anxiety medication, ADHD medication)

Drivers who are taking the blood thinner Coumadin (Warfarin)

  • Bring a recent INR (blood level and clearance) letter from your doctor

Does a DOT Physical Include a Drug Test ?

The DOT physical exam requirements do not include a drug test. You will still have to give a urine sample which is used for a kidney screen for potential medical conditions.

However, companies do often require a pre-employment drug test.

So your company may request to have a drug screen done at the same time as you take your DOT physical.

Not all medical examiner’s offices that conduct DOT physicals have a drug testing service at Same Day DOT Physicals Drug & Alcohol testing we are certified to provide drug & alcohol testing and participate in the required consortium utilizing Team CME services.

If you are uncertain if you will qualify for a DOT card, you may want to schedule a visit with your primary or specialty physician BEFORE your re-certification date. Each physical examination, just like each DOT applicant, is unique. AS always if you have questions or concerns call us at 615-452-1575 or email your questions to [email protected].

The above are guidelines only, and not meant to be all inclusive or as a guarantee of passing the exam. Additional testing or/information may be required by your DOT examiner.

Contact us with any questions you may have.

Contact Us

We’d love to hear from you. Please use one of the various methods below and we’ll look forward to connecting with you soon!

Phone Number: 615-452-1575

Email Address: [email protected]

Our Location: 529 Hartsville Pike Gallatin, TN 37066

Right next to Sumner Regional Medical Center across from Perkins Drugstore. Parking for your big rig next door in the Food Lion parking lot.

By Dr. Michael Tigges         Dr. Michael Tigges

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Dr. Tigges knows how important it is that you continue your livelihood as a commercial driver. With his extensive knowledge of the DOT Physical Exam medical guidelines, Dr. Tigges will steer you through the DOT Physical Exam requirements so you can Keep on Truckin’.

Does a DOT Physical Include a Drug Test ?

Does a DOT Physical Include a Drug Test ?

Urine Sample

“Does a DOT physical include a drug test” is a recurring question asked by CMV drivers. Most CMV drivers are required to take a DOT physical exam every 2 years to maintain their DOT medical certificate and CDL. For many, the DOT physical is extremely stressful, since it can determine the fate of their careers.

Being prepared and knowing what to expect from your DOT physical can make all the difference.

For Drivers Wondering if a DOT Physical Includes a Drug Test, SameDayDOT Physicals Drug & Alcohol Testing Offers Answers

What will my DOT physical evaluate?

The objective of a DOT physical is to evaluate whether or not a driver is healthy enough to operate a commercial motor vehicle. A driver with health issues like sleep apnea, diabetes, poor vision and high blood pressure could be hazardous if their medical conditions become unmanageable while driving. The job of a DOT physical is to keep unsafe CMV drivers off the road, making a safer road for everyone.

Does the DOT physical exam include a drug test?

The DOT physical exam requirements do not include a drug test. You will still have to give a urine sample which is used for a kidney screen for potential medical conditions.

However, companies require a pre-employment drug test.

So your company may request to have a drug screen done at the same time as you take your DOT physical.

Not all medical examiner’s offices that conduct DOT physicals have a drug testing service.

SameDayDOT Physicals Drug & Alcohol Testing are qualified to perform CDL/DOT physicals in Tennessee, as well as BAT (Breath Alcohol Testing) and Drug Testing through a split urine collection (in compliance with the DOT employment drug test requirements).

What drugs will I be tested for?

The medical examiner will take urine samples that test for marijuana, cocaine, opiates, phencyclidine and amphetamines/methamphetamines.

What if I fail the drug test?

Failing any portion of the DOT physical exam could cause your DOT medical certificate to be denied. On top of that, if a driver tests positive for drugs, he/she could lose his CDL and be required to meet with a substance abuse professional.

What if I refuse to take the drug test?

According to the FMCSA website, refusing to take a drug test is generally treated the same as testing positive and could follow the same consequences.

SameDayDOT Physicals Drug & Alcohol Testing offers the best healthcare for the best price and works with your schedule. SameDayDOT Physicals Drug & Alcohol Testing knows that health needs are not always planned, which is why we welcome Walk In’s, Monday thru Friday. No appointment needed.

The content presented on this page is not intended to diagnose health problems or take the place of professional medical care.

Contact us with any questions you may have.

Contact Us

We’d love to hear from you. Please use one of the various methods below and we’ll look forward to connecting with you soon!

Phone Number:
615-452-1575

Email Address:
[email protected]

Our Location:
529 Hartsville Pike
Gallatin, TN 37066

Right next to Sumner Regional Medical Center across from Perkins Drugstore. Parking for your big rig next door in the Food Lion parking lot.

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Medical Condition – Medical Release Opinion

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.
DOT CERTIFIED AD1

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Your Best Driver Failed a DOT Drug Test, Now What?

failed drug
What CDL Drivers & Employers Need to Know

For many employers it can be a stressful and confusing time when an employee tests positive on a DOT mandated drug or alcohol test.

Does the employer now have to “DO” anything?

Must the employee be fired? How long will the driver be out?

Can the driver be re-hired?

The key is to precisely follow the DOT regulations in order to handle the situation correctly and maintain regulatory compliance.

Once an employer has received a verified positive drug test result, the employer must immediately remove the employee from DOT covered safety sensitive functions. The employer should not wait for a written report from the Medical Review Officer or the results of a split specimen test (if one has been requested by the employee).

A verified positive DOT drug or alcohol test is a direct violation of the federal drug and alcohol testing regulations.

Employers who are required to comply with DOT regulations must provide an individual who has tested positive for drugs or alcohol on a pre-employment (including an applicant or new employee), random, reasonable suspicion or post-accident test with information about qualified Substance Abuse Professionals (SAPs). Employers are not required to pay for the employees evaluation or treatment; however they must provide a list of locally available DOT SAPs. Employers may provide the list of SAPs through a Third Party Administrator (TPA).

In order to be eligible to perform safety sensitive duties, the employee in violation must successfully complete the DOT Return to Duty Process. This process involves being evaluated by a DOT qualified Substance Abuse Professional (SAP), completing treatment and/or education as recommended by the SAP, and a follow-up evaluation by the SAP. The time it takes to complete the DOT SAP process varies and depends upon the level of treatment and education recommended for the employee, as well as the employee’s dedication to the process. The SAP is not an advocate for the employee or the employer. Rather the SAPs function is to protect the public’s interest in safety.

It is important to note that only a DOT qualified SAP may provide the required evaluation, recommendations and determination of successful compliance required to become eligible for consideration for a return to safety sensitive duty by an employer. In order to be qualified to act as a DOT SAP, the SAP is required by federal regulations to have specialized training, maintain specific professional credentials and undergo continuing education. They are also required to adhere to specific rules and regulations regarding facilities in which they recommend for treatment and education.

Once the employer has been notified by the DOT SAP in writing that an employee has successfully completed the recommendations, the employer may choose to return the employee to safety sensitive duty pending a negative return to duty test. The employer must also ensure that the employee is in follow-up testing as recommended by the SAP.

What if I fail or refuse a test?

You fail a drug or alcohol test by testing positive to a drug test, or registering a 0.04 or greater alcohol content. Either of these results requires you to be immediately removed from performing safety-sensitive functions (i.e., driving CMVs) until successful completion of the return-to-duty process with a DOT-qualified substance abuse professional.

Your refusal to submit to a drug or alcohol test is generally equivalent to testing positive to a drug or alcohol test. You must immediately be removed from performing safety-sensitive functions (i.e., driving CMVs) until successful completion of the return-to-duty process with a DOT-qualified substance abuse professional. The DOT regulations outline refusals to test for drugs and alcohol. Some refusals are determined by medical review officers (49 CFR Part 40 Subpart G) and alcohol technicians (49 CFR Part 40 Subpart N). For others, the determination is the employer’s responsibility. Refusals to submit to a drug or alcohol test are defined in §382.107. The employee handbook available on the ODAPC Web site provides examples of conduct that the regulations define as refusing a test (49 CFR Part 40 Subpart I and Subpart N) and what happens if you test positive, refuse a test, or violate FMCSA regulations. It is, therefore, critical to understand the specific circumstances that define a refusal, which can be found in §40.191, §40.261 and §382.107.

DOT Drug & Alcohol Testing Services, Evaluations and Drug Free Workplace Solutions Need a Drug and/or Alcohol Test? Call Same Day DOT Physicals Drug & Alcohol Testing.

Contact Us

We’d love to hear from you. Please use one of the various methods below and we’ll look forward to connecting with you soon!

Phone Number:
615-452-1575

Email Address:
[email protected]

Our Location:
529 Hartsville Pike
Gallatin, TN 37066

Right next to Sumner Regional Medical Center across from Perkins Drugstore. Parking for your big rig next door in the Food Lion parking lot.map for DOT

About Us

Dr. Michael J. Tigges

Certified DOT Medical Examiner
Chiropractic Physician

Dr. Michael TiggesDr. 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.
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If You Take These Medications, You Might Not Get A CDL

benzo4

If You Take These Medications, You Might Not Get A CDL

If you suffer from anxiety, depression or other mental illnesses but take medication to treat the symptoms, you may be ineligible for a CDL or you may need a Medical Release Opinion letter.

Millions of Americans suffer from anxiety, depression and other mental illnesses or chemical imbalances. The symptoms of these illnesses can range from minor to severe and most are easily controlled with medication. The medications given for mental illnesses can help suffers live a normal, happy life.

According to the FMCSA, “individuals who live under chronic emotional upsets may have deeply ingrained maladaptive or erratic behavior patterns. Excessively antagonistic, instinctive, impulsive, openly aggressive, paranoid or severely depressed behavior greatly interfere with the driver’s ability to drive safely. Those individuals who are highly susceptible to frequent states of emotional instability (schizophrenia, affective psychoses, paranoia, anxiety or depressive neurosis) may warrant disqualification.

For more information follow this link: https://goo.gl/9t6ttF

“Careful consideration should be given to the side effects and interactions of medications in the overall qualification determination. See Psychiatric Conference Report for specific recommendations on the use of these medications and potential hazards for driving.”

A 2009 FMCSA Medical report states:

It is the opinion of the MEP that all individuals with a history of the following psychiatric disorders should undergo additional medical and psychiatric evaluation to further assess functional ability before being considered qualified to drive a CMV:
•Psychotic Disorders
•Bipolar Disorders
•Major Depressive Disorder with a history of psychosis, suicidal ideation, homicidal ideation or a suicide attempt
•Obsessive Compulsive Disorder
•Antisocial Personality Disorder

The MEP believes that all individuals currently taking benzodiazepines or similar drugs which act on benzodiazepine receptors should be immediately prohibited from driving a CMV.

Individuals who take benzodiazepines for any length of time should not be allowed to drive until the drug has been cleared from their system (i.e., within seven half-lives of the drug and any active metabolites). Chronic users of benzodiazepines (i.e., regular use for more than a month) should also wait an additional week after the drug has cleared from their system before resuming driving to ensure that the drug has been completely eliminated. It is also suggested that FMCSA provide information regarding the half-life and seven half-lives of benzodiazepines and active metabolites to medical examiners for use at the time of examination.

Given the functional impairments and increased crash risk associated with benzodiazepine use, the MEP believes that:
•individuals currently taking benzodiazepines not be allowed to drive a CMV
•individuals who are taking benzodiazepines should stop taking them long enough ahead of driving for them to be cleared from their systems before being allowed to drive a CMV (it takes seven half lives for a drug to be completely eliminated from the body)
•chronic users of benzodiazepines should wait an additional week after the drug has been cleared from the body (i.e., seven half lives plus one week) before driving a CMV to ensure that it has been completely eliminated.

The MEP is of the opinion that all individuals currently taking lithium be excluded from driving a CMV at night.

What to do?

Give your Certified Medical Examiner all the information so he may contact and discuss with the prescribing doctor and if necessary get a ………………..

……………………………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

As always if you have questions drop me a message or a phone call and we will help you in any way we can:

By: Dr. Michael Tigges

Contact Us

We’d love to hear from you. Please use one of the various methods below and we’ll look forward to connecting with you soon!

Phone Number:
615-452-1575

Email Address:
[email protected]

Our Location:
529 Hartsville Pike
Gallatin, TN 37066

Right next to Sumner Regional Medical Center across from Perkins Drugstore. Parking for your big rig next door in the Food Lion parking lot.

About Us

Dr. Michael J. TiggesDr. Michael Tigges

Certified DOT Medical Examiner
Chiropractic Physician

Certification:

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.


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Same Day DOT Physicals Drug & Alcohol Testing Gallatin, TN

http://dotphysicaldoctor.com/tn/dr-michael-tigges/

Dr. Michael Tigges is a Certified DOT Medical Examiner

What Drivers Are Saying

“Great place to go to! Very nice and welcoming from the moment you walk into the door. I would highly recommend everyone to go to Dr Tigges for any medical needs. The lady in the office is extremely nice as well.”
Justin M

“Very short wait time. Super friendly staff. I always get stressed when I get a physical for work, which causes blood pressure issues. The staff kept me calm and got me through it just fine. The doctor had great information to offer that will help me in the future.”
Robert D

“Great experience! Friendly professional staff. I will definitely be using them again and I highly recommend them!”
Damar N

“Very good group of people. I was a walk in. Only wait time I had was me filling out papers. Staff was excellent, made me feel like I was family. Tigges did a great job of explaining things I didn’t know and he didn’t miss a thing in the exam. I would recommend him to anyone. I am even going to send my wife there for chiropractic care. I will return for my next DOT physical.again!”
Dwight C

“From the moment I walked in until my physical was completed the staff & Dr. Tigges was extremely nice, professional, & very welcoming. It made me feel alot more at ease for the DOT physical. I also did not have to wait long at all. I would highly recommend Dr. Tigges to anyone that needs a DOT!! Best in this area!!”
Toya G

DOT Medical Exam Services

  • DOT/CDL MEDICAL EXAM  ~  Our prices are the lowest in the area. $75.
  • Certified DOT Drug Testing
  • Certified DOT Breath Alcohol Testing
  • School Bus Driver Physicals
  • Pre-employment Physicals
  • DOT Random Drug Testing Programs

We will gladly answer any questions you may have prior to your exam.

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