DOT Physical Requirements for CDL Licensing

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DOT Physical Requirements for CDL Licensing

DOT Physical Requirements for CDL Licensing

A basic requirement of all commercial truck drivers is that they undergo a DOT physical. A driver will need to pass the physical in order to get their commercial drivers license. If you’re looking to become a commercial truck driver, but not sure what to expect, we have outlined everything that the physical will involve.

What do they test for in the DOT physical?

DOT physicals test for a variety of different medical conditions. Physicians are given a specific protocol when examining a prospective driver and they fill out a federal form that gets submitted to the DOT. Prior to the physical, you will need to provide any medical conditions you know of, including any medications you’re on, surgeries you’ve had, or anything else that may inhibit your ability to drive a truck. The medical conditions the physical tests for includes heart-related issues, mental or neurological conditions, vision, hearing, and if the driver has any substance abuse issues.

Once the DOT physical is done and you’re cleared to drive, you will be given a medical examiner’s certificate (MCE) for a maximum of 24 months. However, depending on what medical conditions the examiner finds, they may set your medical certificate for less than 24 months.

What is included in the DOT physical?

The DOT physical consists of four tests: blood pressure / pulse rate, vision test, hearing test, and urinalysis. As a prospective driver or as a carrier, you should be familiar with these four tests.

Blood Pressure / Pulse Rate

One of the tests is a reading of your blood pressure and pulse rate. What they’re looking for here is hypertension. Having high blood pressure will have a direct impact on the length of your medical certificate or if you can get certified at all. If you have a reading of 140-159/90-99 the driver will be granted a one year certificate. Readings of 160-179/100-109 will result in a 3 month temporary certificate (discretion of the physician). Anything above 180/110 is disqualifying. If blood pressure is too high, medication can be taken as long as it does not impair the driver.

Vision Test

Remember the eye chart you would see (or wouldn’t see) at the optometrists office? Your vision will be tested with one of those. The basic CDL requirement for vision is that drivers have at least a 20/40 vision and that it is correctable in each eye (using glasses or contact lenses). Also, drivers should be able to discern the difference between the colors green, yellow, and red, which may exclude people who suffer from some forms of color blindness.

Hearing Test

The hearing test will measure how well a driver can hear tones at specific frequencies and from how far away. For example, one of the tests will evaluate the driver's ability to hear somebody whispering from 5 feet away. Hearing aids can be used to meet the hearing requirements.


Part of the DOT physical is a urine analysis. The urinalysis is done solely to screen the kidneys for any potential medical issues or diseases such as diabetes. If you have diabetes, you will need to bring in your latest hemoglobin A1C from your primary care physician to have that be evaluated. Typically, if you have an A1C under 10% you will be given a 12 month certificate. If you have an A1C between 10-12% you will be granted only a 3 month certificate. After the 3 months, you will be given a 9 month certificate if you are able to lower your A1C under 10%. However, if you have an A1C above 10% after those 3 months, you will not be cleared to drive.

One misconception many prospective drivers have is that the urinalysis will test for drugs. However, that is NOT the case. The urine test for the DOT physical is strictly to evaluate potential kidney related conditions. However, many employers and trucking companies WILL test for drugs as part of their pre-employment screening.

Additionally, physicians will check specific parts of a driver’s body during the physical. This includes:

  • General Appearance - Your general appearance can say a lot about a person’s health. For example, signs of obesity is an obvious thing that doctors can see through a quick general inspection.

  • Mouth and Throat - Check for any issues that may obstruct breathing.

  • Abdomen and Organs - Checks for any potential breathing or pulmonary issues

  • Spine and Skeletal Issues - This is looking for anything that may stop you from operating the truck or sitting in a truck for a prolonged period of time.

What can prevent me from driving?

Fortunately, even having some underlying medical conditions may not exclude you from trucking - at least in the short-term. If your medical condition goes beyond a certain threshold, what will typically happen is you’ll be granted a medical certificate for a shorter period of time. This is given so you can make the necessary adjustments in your health or lifestyle to qualify yourself after the three months.

In the sections below we have outlined some of the more common medical conditions and how this will impact your certification depending on how you manage your illness.


Getting a CDL with diabetes can be tricky. In certain situations, it would require filing a Federal Diabetes Exemption. People with type 2 diabetes not on insulin can get a CDL as long as they meet guidelines set by the state. However, if you have type 2 diabetes and require insulin or if you have type 1, you will need to file a Federal Diabetes Exemption.

To file for an exemption, if a person has type 1 diabetes or type 2 with insulin, the person will have to meet the following guidelines: Not having a hypoglycemic episode in the past 12 months or 2 or more in the past 5 years. Hypoglycemic episodes include loss of consciousness, seizures, or periods of confusion. Also, those applying for an exemption cannot have any signs of end organ damage resulting from diabetes. These exemptions are good for 12 months but depending on the physician’s recommendation can be granted for 24 months.

Bottom line, can you become a driver with type 1 or type 2 diabetes? The answer is yes, but it will require additional work for you and a stricter management on your lifestyle. Trucking traditionally comes with a less healthy lifestyle and is not helpful for someone with diabetes. You’re sitting in the truck for hours on end and fast food is cheap, quick meal when you’re trying to hit a deadline. However, getting exercise in, managing time to exercise and eat healthy (for type 2), and budgeting time for taking medication is absolutely crucial. It’s not just your career on the balance, but it is your health and safety as well as the safety of others on the road that is at risk.

High Blood Pressure

Hypertension or high blood pressure can prevent you from obtaining a CDL license. High blood pressure comes with increased risk for heart attack and strokes which can be disastrous if it happens on the road. Fortunately, high blood pressure is not an automatic disqualification. Depending on the severity, it is still possible for you to get a CDL if you take the proper actions. 

The severity of hypertension is categorized into three stages. What’s required of you to obtain and keep a CDL will depend on what stage you are in.

  • Stage 1 Hypertension (140/90 to 159/99): For stage 1 hypertension, you can receive a one-year certificate. After a year, if you are not at or under 140/90, you will be given a non-renewable three-month certificate. If you haven’t improved your blood pressure after that three months, then your certificate will be suspended until the blood pressure is at or below 140/90. The key takeaway here is that once you’re given a one-year certificate (and definitely once you’re given the three-month certificate), you need to make lifestyle changes to decrease your blood pressure.

  • Stage 2 Hypertension (160/100 - 179/109): If you have stage 2 hypertension, you are only eligible for a three month certificate. Within that three months, you have to lower your blood pressure below 140/90 or else your certificate will be suspended.

  • Stage 3 Hypertension (180/110+): Stage 3 hypertension is an automatic disqualification. If blood pressure is lowered to below 140/90, then you may be given a six-month certificate and will need to recertify every six months.

If you have high blood pressure, it is important to take steps to lower your blood pressure in the short term and in the long term. For the short term, before your DOT physical, things like avoiding smoking, drinking, and caffeine will help lower your blood pressure for a short while. Also, things like hydrating, taking deep breaths, and reducing stress can also help lower your blood pressure right before a physical. This may help you pass a physical or at the very least help you classify in a lower stage. However, it’s in the best interest of your career and health to take ongoing steps to decrease your blood pressure in the long run.

To improve your blood pressure in the long run, you should focus on the following: exercise/weight loss, healthier low sodium diet, decreasing alcohol consumption, decrease caffeine consumption, avoid nicotine, and take greater steps to reduce stress and relax.

Drug Usage

Although not typically seen as a health condition, illicit drug use is definitely something that will exclude you from obtaining and keeping your CDL. The drug screening looks for specific substances which includes:

  • Marijuana

  • Cocaine

  • Amphetamines/Methamphetamines

  • Non Prescribed Opiates (Morphine, Heroin, Codeine)

  • MDMA (Ecstasy)

  • Phencyclidine (PCP)

The test is designed to detect small traces of these substances so it is best to avoid any of these substances prior to the physical (and honestly, at all if you’re on the road). An exception to these guidelines are prescribed opiates and amphetamines to treat medical conditions. As long as you can provide evidence that the substances are prescribed there should be no issues.

One thing to keep in mind though is that medical marijuana is NOT allowed if you are attempting to get or keep a CDL. Although there are many states that have legalized medical marijuana, Marijuana is still seen as a controlled substance under federal law.

So What’s Next?

If you’re planning being a trucker, your next step is to schedule a DOT physical. If you’re like most people who don’t like doctors or if you’re even afraid of going to the doctors , don’t be.  Even if you hear bad news, at least you know about it now and you can take action to improve your health. Either way, this a necessary step in your journey of becoming a trucker.  If you want to learn more about trucking, come check out our other article “How to Start a Trucking Company” or visit our Truckers Bookkeeping Service website to see how to get your own trucking authority.


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