A DOT Exam (Department of Transportation) is mandated for many workers in the transportation industry, primarily for safety reasons. But who exactly needs a DOT Exam? And who can administer DOT exams?


Many mistakenly believe that only those who have a CDL (commercial driver’s license) or who are getting a CDL need a medical exam specified by the Department of Transportation. This may or may not be the case since it all depends on what size of vehicle and/or the weight of the vehicle you will be driving. Furthermore, there are different regulations for interstate commerce (which is Federally-mandated) versus intrastate commerce (which is operating within one state only).


Those operating the following vehicles in interstate (or multiple states) will need a DOT exam:

  • Vehicles with a gross vehicle weight (GVW), gross vehicle weight rating (GVWR), gross combination weight (GCW), or gross combination weight rating (GCWR) of 10,001 pounds or more
  • Vehicles designed to transport more than 15 people or more than eight people when there is direct compensation involved
  • Vehicles transporting hazardous materials that require the vehicle to be placarded

The confusion in DOT exams comes from the need for a CDL. You will need a CDL when you operate a vehicle weighing 26,001 pounds or more. The weight criterion for which a DOT physical is needed is 10,001 pounds. Thus, interstate drivers of vehicles between 10,001 and 26,001 pounds (not including hazmat) need to have a DOT medical exam but do not need to have a CDL.

What this means for you is if you intend to drive vehicles over 26,000 pounds outside of your home state, you’ll need a DOT exam by a certified examiner.


For intrastate drivers, the rules differ from state to state. Some states have adopted the same standards as the DOT and others have different weight restrictions.


After completing the DOT exam, you will be certified for two years. If you have a CDL or intend to get one, your medical exam will be transmitted and stored electronically in the Commercial Driver’s License Information System (CDLIS).

Non-CDL drivers who are subject to the medical exam requirement must have a valid medical certificate (DOT medical card) in their possession while driving, and employers are required to keep a copy of the certificate in the driver’s qualification file.

Drivers who hold a CDL or commercial learner’s permit (CLP) must provide the certificate to their state licensing agency and carry a copy for at least 15 days after issuance until their state driving record (MVR) is updated. The employer must also have a copy of the certificate in the employee’s file for up to 15 days. By the end of those 15 days, a new MVR must be placed in the employee’s file as proof of medical certification.

Note: the completed medical examination report (the “long form”) is not required to be in the driver’s file. Only the medical examiner’s certificate is required to be in the file, or (for CDL drivers) a copy of the most current driving record showing medical certification.


You must go to a Certified Medical Examiner on the Federal Motor Carrier Safety Administrator (FMCSA) National Registry. To be FMCSA certified, a medical examiner is usually recognized by the National Registry of Certified Medical Examiners. Certified Medical Examiners must undergo special training specific to the test and the health conditions the DOT Exam is looking for. These healthcare professionals are required to complete training every five years to maintain certification and must pass an exam every ten years, which is to ensure the medical examiner is up to date on all the DOT regulations, which can change periodically.


Mount Vernon Chiropractic in Mount Vernon, IL, offers DOT exams for only $89. With little wait time, we can get you in and out quickly, so there’s no delay in your work and/or job application. Contact Mount Vernon Chiropractic today for your DOT exam.


There’s something about exams that gets your nerves up. You may perspire more, chew your fingernails or play with your hair, or bounce your leg uncontrollably. Whatever your coping mechanism may be for exams, Mount Vernon Chiropractic wants to put you at ease for your upcoming DOT exam.

  • Relax. Yes, this test is important, but nerves will only make it worse, especially if you’re worried about passing the blood pressure portion of your test.
    Avoid caffeine before your DOT physical. This is important, especially if caffeine affects you. Coffee, tobacco, and energy drinks can raise your blood pressure by as much as 20 points, so avoid all of these 24 hours before your exam.
  • Be prepared for the questions. If you’ve been through a DOT exam before, you’ll know the drill. However, if this is your first DOT exam, you’ll want to be prepared to answer any and all questions related to your health as well as related to your family history. If you have had a recent diagnosis such as heart disease or diabetes, or one you know the DOT medical examiner would be interested in that could affect your driving, you’ll want to be prepared to discuss that in detail. Any pertinent paperwork or data you have from your current physician will be helpful to the DOT medical examiner as well. Be prepared to discuss any current medications you may be on. If you do have a sleep condition such as sleep apnea, the DOT medical examiner will want to know, and it’s a good idea to bring your CPAP (continuous positive airway pressure) machine with you to your DOT exam.
  • Bring whatever you need to safely drive. If you are required to wear glasses while driving, make sure you don’t forget them at home. This goes for contacts and hearing aids as well. An important part of the DOT exam is the vision and hearing test administered.
  • Get enough sleep the night before. You’ll want to be awake during the exam and not yawning, which would not make the best of impressions. Driving while drowsy is a major problem on our highways and interstates. The National Highway Traffic Safety Administration estimates that drowsy driving was responsible for 72,000 crashes, 44,000 injuries, and 800 deaths in 2013. However, the number of fatalities may be grossly underestimated. Not getting enough sleep is the primary cause of these numbers.
  • Arrive early. If you are prone to high blood pressure, rushing to your DOT exam appointment will not help it. Leave early and be prepared for any inclement weather or traffic delays.
  • Hydrate. The DOT exam does involve a urine test. However, this test is not a drug test and is simply a health screen of your blood sugars, protein, and blood that could indicate other health conditions. Plus, drinking plenty of water is good for your overall health — which is the whole point of the DOT exam.


If you do fail the DOT exam and aren’t issued a medical card, you have the right to a second opinion and a second exam by another certified DOT examiner. Be aware that you can’t just hop from doctor to doctor, searching for someone to pass you. After the initial exam, you’ll have to let the initial DOT examiner know you do intend to get a second opinion.


Mount Vernon Chiropractic gets many questions about DOT exams, particularly with regards to medications you can take, what jobs you can obtain, and if a drug test is included. Below, we try to answer your most frequently asked questions about the DOT exam. Mount Vernon Chiropractic in Mount Vernon, IL, offers DOT physicals. Contact us today to schedule your exam!

Does the DOT exam have a drug test involved?

No, the DOT physical does not test for drugs. It’s merely a physical assessment of your health in order to help determine if you’re at risk while on the road. Most likely, your future employer will require a drug test as a condition of employment. That drug test would be administered separately, by a third party your potential employer has selected.

Why do I need a urine test as part of my DOT physical?

The urine test is not a drug test. It’s to test mainly for signs of pre-diabetes or troubles with your kidneys. Only sugars and proteins will be tested in your blood sample. Protein in the blood is not an immediate disqualifier for the DOT card; however, it is reported and may require a follow-up visit from a physician as a condition of employment, or your DOT administrator may time-limit your DOT card until you can see a medical practitioner. On the other hand, sugar in the blood will immediately disqualify you from a DOT card because it indicates a medical condition that is not under control. Occasionally, blood is found in urine. While this is not a condition for disqualification, it is an alarm for you to see your doctor as soon as possible. It’s most probably an infection that can be cleared up quickly with temporary medication. Again, your DOT examiner may find it alarming enough based on other factors found to time limit your DOT card.

Can I obtain a DOT card if I’m being treated for a medical condition?

This depends on the circumstances. Everyone is different, and your DOT test administrator may require documentation from your healthcare provider (a good idea to bring ahead of time to the DOT exam). Ultimately, it depends on the level of risk you’d pose while being on the road, and it’s up to your trained DOT test administrator to make that conclusion.

What should I bring with me to the DOT exam?

Remember, the whole point of the DOT physical is to determine if you’re healthy enough to drive a huge truck. You’ll need to bring any doctor’s notes if you’re on a prescribed medication, any letters from specialists whose care you may be under, eye glasses, hearing aids, and recent blood tests if you have diabetes, showing your condition is under management. Bring anything with you that you need to safely operate a motor vehicle (except your dog).

Are the results immediate with a DOT test?

Yes. You will have a result by the end of the exam. You’ll be issued a certificate by your DOT examiner to take with you to the driver’s license office. We aim to get you on the job as soon as possible.

What conditions can cause an immediate disqualification for the driver?

  1. Epilepsy
  2. Diabetes that requires insulin
  3. If you fail the hearing and vision portion of the exam
  4. If you use Methadone
  5. If you use any narcotics, amphetamines, or other habit-forming drug without a prescription from a qualified medical professional
  6. Loss or impairment of a limb (arm or leg) that interferes with you driving a commercial vehicle or other tasks related to driving
  7. Alcoholism

Note: Exemptions can be applied if you don’t meet the vision standards or you have diabetes. Visit the Federal Diabetes and Vision Exemption Program.

Who pays for the DOT exam?

The answer is it depends. Sometimes the potential employer will cover the charge, or sometimes the driver pays. Some insurances cover this exam as an annual exam, and some don’t. Check with your employer or potential employer and your insurance provider to find out if your DOT exam will be covered.

Do I get a copy of my DOT medical card?

Yes, you will receive a copy of your DOT medical card (assuming you passed). You should also ask your DOT examiner for a copy of the actual Medical Examination Report. This is important not only so you can see the results of your tests, but also to see why you didn’t pass the DOT exam. Your DOT medical examiner must keep your results on file for at least three years. If you need a copy in that time frame, check with him or her first.

How long are DOT exams good for?

DOT exams are good for two years as long as you pass with no restrictions (i.e. medical conditions that arose and need to be revisited). Some conditions may warrant a lesser time frame. Some of these medical conditions that can limit your DOT medical card and results include high blood pressure, a sleep disorder, and diabetes.

What’s a 3-month DOT medical card?

A 3-month DOT medical card may be issued for only three months. These are issued when a medical condition that normally would cause you to fail the medical exam has the potential to be rectified and ameliorated in three months. High blood pressure is the most common reason for issuing these DOT medical cards. If you are issued a 3-month medical card, you must see a DOT medical examiner once again in order to obtain a one-year DOT approved medical card. Then, after one year, you can obtain a one-year DOT medical card, presuming you pass the medical exam.

What are the blood pressure requirements for the DOT exam?

High blood pressure is the most common reason people are denied DOT medical cards. These standards are set by the Federal Motor Carrier Safety Regulations (FMCSRs). However, some employers may institute more stringent standards.

  • Blood pressure either at or below 140/90 is considered normal, and a two-year DOT medical card will be issued.
  • If you have blood pressure from 140 to 159 and/or 90 to 99, you will only be certified for one-year as this is classified as stage one hypertension.
  • If you have blood pressure between 160 and 179 and/or 100 to 109, you will be issued a 3-month temporary DOT medical card. This is considered stage two hypertension, and drug therapy is recommended to bring your blood pressure down.
  • If you have blood pressure of 180 or higher and/or 110 or higher, you will fail the DOT medical exam. This is considered stage three hypertension. In this case, you have to lower your blood pressure to the normal rate, which will then yield you a six month certified DOT medical card to be renewed every six months thereafter.
  • Drivers who have Type 1 or Type 2 diabetes or kidney disease are held to more stringent standards since their risk of heart disease (and thus a heart attack while driving) is increased. They must have a blood pressure of 130/80 or lower in order to be certified by the DOT medical examiner for the standard two-years.

DOT physical card and DOT medical certificate are one in the same — different terms for the same thing. Most people say DOT medical certificate when talking about the actual DOT medical card itself and say DOT physical exam when talking about the process of obtaining DOT certification.