DOT Physical Requirements: What Actually Gets Checked

A DOT physical takes about 30 minutes and follows a federal checklist. The examiner is not grading you on general health. They are answering one question: can you safely operate a commercial vehicle for the next two years. Everything below comes from 49 CFR 391.41, the qualification standard every certified examiner works from.

Who can perform the exam

Only a medical examiner listed on the FMCSA National Registry. That includes medical doctors, doctors of osteopathy, nurse practitioners, physician assistants and chiropractors, as long as they have passed the federal certification. Your family doctor of 20 years cannot issue your card unless they are on the registry. This has been the rule since May 2014.

Every location on this site is pulled directly from that registry. If a clinic appears here, somebody on staff can legally certify you.

Vision

You need at least 20/40 in each eye and 20/40 with both eyes together, corrected or uncorrected. Glasses and contacts are fine. You also need at least 70 degrees of peripheral vision in the horizontal meridian in each eye, and you must be able to distinguish red, amber and green.

If you cannot meet the standard in one eye, you are not automatically done. FMCSA runs an alternative vision standard that lets an examiner certify a driver with a stable vision deficiency, with an ophthalmologist or optometrist report and a road performance history.

Bring your glasses or contacts. Not the prescription, the actual glasses. Drivers get sent home over this constantly.

Hearing

You must perceive a forced whisper at five feet or less in at least one ear, with or without a hearing aid. If you fail the whisper test, the examiner can run an audiometric test instead: average hearing loss no worse than 40 dB at 500, 1000 and 2000 Hz in the better ear.

Hearing aids are allowed. If you use one, wear it to the exam and bring spare batteries.

Blood pressure

This is the single most common reason a driver walks out with a short card. The thresholds:

• Under 140/90: you qualify for a full 2 year certificate
• 140 to 159 over 90 to 99 (stage 1): 1 year certificate
• 160 to 179 over 100 to 109 (stage 2): one 3 month certificate, and if you get it under 140/90 in that window, a 1 year certificate after that
• 180/110 or higher (stage 3): disqualified until it comes down, then 6 month certificates that have to be renewed every 6 months

Read blood pressure and your DOT physical if yours runs high. There is a lot you can do in the week before the appointment.

Urinalysis

The examiner tests a urine sample for protein, blood, sugar and specific gravity. This is a screen for kidney disease and undiagnosed diabetes. It is not a drug test. DOT drug testing is a separate program run through your employer or your consortium, and it happens at a different collection site.

If sugar shows up, expect questions and possibly a request for an A1C before certification.

Medical history

You fill out the health history section yourself, and it carries real weight. The examiner reviews it and will ask follow-ups about anything flagged. Be straight about it. Lying on the form is falsification of a federal document, and if something later causes a crash, that form gets pulled.

Conditions that trigger a deeper look:

• Heart attack, stent, bypass, pacemaker, defibrillator
• Stroke or TIA
• Seizures or epilepsy
• Diabetes, especially insulin treated
• Sleep apnea
• Any surgery in the last five years
• Missing or impaired limbs
• Psychiatric conditions and the medications for them

None of these are automatic disqualifications on their own. See what disqualifies you for how each one is actually handled.

Medications

Bring a complete list: name, dose, how often, and who prescribes it. The examiner is checking whether anything on the list is disqualifying or needs a clearance letter from the prescribing doctor.

Two things worth knowing. Schedule I drugs disqualify you, and marijuana is still Schedule I federally no matter what your state says, including medical cards. And methadone is disqualifying for interstate driving.

What to bring

1. Photo ID and your CDL, or your permit if you do not have the license yet
2. A complete medication list with prescriber names
3. Glasses, contacts or hearing aids, the physical items
4. CPAP compliance report if you have sleep apnea, covering at least the last 90 days
5. Recent A1C and a blood sugar log if you are diabetic
6. Clearance letter from your cardiologist if you have had a cardiac event, a stent, a bypass or a device implanted
7. Neurologist letter if you have a seizure history
8. Your last medical examiner's certificate, if you still have it

Missing paperwork does not usually mean failing. It means the examiner holds your certificate until the letter arrives, and you make a second trip.

After the exam

Since June 2025, certified examiners submit exam results to FMCSA electronically, and FMCSA passes CDL results to your state licensing agency. CDL and CLP holders no longer need to hand a paper copy to the state themselves.

Non-CDL interstate drivers still carry the paper certificate. Either way, keep a copy. Take a photo of it with your phone the day you get it.

How long the card lasts

Two years is the maximum. Anything shorter means the examiner wants to monitor something: blood pressure, blood sugar, a cardiac condition, apnea compliance. A 3 month card is not a punishment, it is a recheck. Fix the underlying number and the next card gets longer.

Find a certified examiner near you and call before you drive out. The registry lists who is certified, not when they work.