CDL Medical Card Requirements: DOT Physical Guide

Without a valid DOT medical card, your CDL is essentially worthless. The medical examination ensures you're physically capable of safely operating a commercial vehicle — and the standards are strict. This guide covers every requirement, what can disqualify you, and how to prepare for your exam so you pass the first time. For more on CDL requirements, read our complete guide to getting a CDL.

What Is the DOT Physical?

The DOT physical is a medical examination required by the FMCSA for all interstate commercial drivers. It's conducted by a certified medical examiner — a doctor, nurse practitioner, or physician assistant who has completed FMCSA training and is listed on the National Registry of Certified Medical Examiners. The exam takes about 30–45 minutes and includes:

• Health history review (you'll complete a medical history form)
• Vision test
• Hearing test
• Blood pressure and pulse check
• Physical examination (heart, lungs, abdomen, extremities, spine)
• Urinalysis (checks protein, blood, sugar — not a drug test)
• Height and weight measurement

Medical Requirements: The Numbers You Need to Meet

Vision Requirements

• At least 20/40 acuity in each eye (with or without corrective lenses)
• Field of vision of at least 70 degrees in each eye
• Ability to distinguish red, green, and amber colors
• If you wear glasses or contacts, your medical card will be marked "corrective lenses required"
• Monocular vision (one eye) may qualify with an exemption from the FMCSA

Hearing Requirements

• Must perceive a forced whisper at 5 feet in the better ear (with or without hearing aid)
• Audiometry alternative: no more than 40 dB average hearing loss in the better ear at 500, 1000, and 2000 Hz
• If you need a hearing aid, your card will note "hearing aid required"

Blood Pressure Requirements

Diabetes and Blood Sugar

• A1C must be under 10% for insulin-treated diabetics (ITDM)
• Non-insulin-dependent diabetics can qualify if blood sugar is controlled by diet or oral medication
• Insulin-dependent diabetics must obtain an ITDM exemption from the FMCSA (or qualify under the updated rule that eliminates the blanket ban on insulin users)
• You must have stable blood sugar with no severe hypoglycemic episodes in the past 12 months

Conditions That Can Disqualify You

Certain medical conditions can disqualify you from getting a DOT medical card. Some are absolute disqualifications; others may require an exemption or waiver:

• Sleep apnea: BMI over 35, neck size over 17 inches (men) or 15.5 inches (women), or witnessed apnea may trigger a sleep study. If diagnosed, you must use CPAP and show compliance data
• Seizure disorders: Any history of seizures is disqualifying unless you've been seizure-free and off medication for 8+ years, or qualify for an exemption
• Heart conditions: Recent heart attack (within 3 months), unstable angina, or certain arrhythmias are disqualifying. Pacemaker patients may qualify with documentation
• Loss of limb: May qualify with a prosthetic device and skills performance evaluation (SPE) certificate
• Psychiatric disorders: Severe conditions requiring medication that causes drowsiness may disqualify. Each case is evaluated individually
• Substance abuse: Active substance abuse is disqualifying. History of abuse requires documentation of treatment and recovery
• Narcolepsy: Automatically disqualifying — the risk of falling asleep at the wheel is too high

What to Bring to Your DOT Physical

Being prepared makes the exam go smoothly and increases your chances of passing. Bring:

1. Driver's license and current CDL (if renewing)
2. Medical history form (completed — the examiner's office may send this in advance)
3. List of all medications you take, including dosages and prescribing doctor information
4. Glasses or contacts if you wear them for driving
5. Hearing aid if you use one
6. CPAP compliance report (last 30–90 days) if you use CPAP for sleep apnea
7. Recent blood pressure readings from your primary care doctor if you have hypertension
8. Cardiac clearance letter from your cardiologist if you have a heart condition
9. Diabetes management records including recent A1C results if you're diabetic
10. Medical exemption paperwork if you have any FMCSA exemptions

Medical Card Validity and Renewal

The standard DOT medical card is valid for 2 years. However, the medical examiner may issue a shorter-duration card based on your health:

• 2-year card: No significant medical issues
• 1-year card: Conditions requiring annual monitoring (e.g., stage 1 hypertension, controlled diabetes)
• 6-month card: Some conditions requiring more frequent monitoring
• 3-month card: Temporary conditions or newly diagnosed issues that need evaluation

You must carry your medical card while driving and submit a copy to your state DMV. If you let your card expire, your CDL may be downgraded or suspended. Most states now require you to self-certify your driving type (interstate or intrastate) and submit your medical card electronically.

Frequently Asked Questions