DOT Physical FAQ
Common questions from CDL drivers, answered straight.
Before Your Exam
What do I need to bring?+
Photo ID, list of current medications with dosages, glasses or contacts, hearing aids if you use them, medical records for existing conditions, and payment.
Should I fast?+
Not for the standard exam. The urine test checks for glucose and protein, not fasting metabolic markers.
Can I drink coffee before my exam?+
Yes, but caffeine can raise your blood pressure. If your BP is borderline, skip it the morning of.
Do I need an appointment?+
Walk-ins are allowed at most clinics. For complex cases, calling ahead helps the examiner prepare.
What should I wear?+
Loose clothing for the BP cuff and stethoscope. Bring your glasses, hearing aids, and any orthotics you wear while driving.
During Your Exam
How long does it take?+
30 to 45 minutes once you're in the exam room. Total visit time is usually under an hour.
Is there a drug test?+
No. The urine test is for glucose and protein, not drugs. DOT drug testing is separate and ordered by your employer.
Will they test my hearing?+
Yes — a forced whisper at 5 feet, with hearing aid if you use one. An audiometric test is sometimes used.
What's the vision standard?+
20/40 in each eye (with correction) and 70° peripheral vision. Bring your glasses or contacts.
What's the BP cutoff?+
Under 140/90 for a 2-year card. 140–159/90–99 = 1 year. 160–179/100–109 = 3 months. Over 180/110 disqualifies until controlled.
Medical Conditions
Can I drive with sleep apnea?+
Yes — with treatment. Bring CPAP compliance data (last 90 days, ≥4 hrs/night ≥70% of nights). Most drivers get a 1-year card.
Can diabetic drivers pass?+
Yes. Insulin-treated drivers need form MCSA-5870 from their treating clinician. A1C should be under 10.
I had a heart attack — am I done?+
Not necessarily. After 2 months and a clear stress test, many drivers return. Bring complete cardiology records.
What about a history of seizures?+
Disqualifying in most cases, but a federal exemption may be possible after a long seizure-free period.
Mental health medications?+
Most are fine. The examiner cares whether the condition is stable, not whether you take medication. Bring records from your provider.
After Your Exam
When does my certificate take effect?+
Immediately upon issue. Since June 2025, results are filed electronically with FMCSA within one calendar day via NRII.
Do I need to give a paper card to the DMV?+
No. As of June 2025, the certificate is transmitted electronically. Some states still update licenses based on the FMCSA feed within a few days.
What if I disagree with the result?+
You can request a written copy of the determination, address the issue, and re-test (with the same or a different examiner).
How long until my license reflects the new card?+
Most state DMVs update within 1–3 business days of FMCSA receiving the result.
The June 2025 Changes
What is NRII?+
National Registry Information Improvement. Effective June 23, 2025, FMCSA-certified examiners must submit your DOT physical results electronically within one calendar day.
Do I still get a paper card?+
Some examiners print one for your records, but it's no longer the official document. The official certification lives in the FMCSA registry.
Does this affect what I bring to the exam?+
No. Same paperwork as before — ID, meds list, condition records.
Will my employer see results faster?+
Yes. Carriers querying FMCSA see updated certifications within 24 hours instead of waiting for paper to clear the DMV.