The New Paradigm in Personal Health Care

DMV Physical

Federal DOT Medical Examination Requirements
Please read carefully BEFORE your visit as you are responsible for this information and any required documentation for your conditions. Please contact Regency Urgent Care (530.674.7000) with questions PRIOR to your appointment.

We strongly encourage all drivers to present for their exam 60 days before their previous certification expires with appropriate documentation to prevent a lapse in certification.

As of May 2014, massive regulatory changes have gone into effect governing DOT examinations as well as those providing the examinations. The medical regulations given are interpreted as LAW. The Medical Examiner has the right, per FMCSA regulations, to alter certification periods based on medical examination/opinion not to exceed two years, as well as disqualify based on medical examination/opinion ALONE. The list provided below is a summation of the most common conditions that have had modifications, however this is NOT an exhaustive list. That is, you may have a condition not listed here that may prevent or delay your certification. You may access the exhaustive list at: https://www.fmcsa.dot.gov/.

Please note that a specialist (IE: cardiologist, neurologist, etc.) stating that you are cleared to drive DOES NOT guarantee certification. The Medical Examiner determines certification. Many physical conditions REQUIRE DOCUMENTATION to accompany your DOT Long Form and this MUST BE available for review AT TIME OF THE EXAM. There are very specific waiting periods and testing that must be followed in addition to this clearance.

VISION: If you require correction to your vision, you must wear your corrective lenses during your exam. If you have been told that your vision is worse than 20/40 in both eyes with correction or you are legally blind in one eye, you will not pass. (There is an exemption for monocular vision, however you MUST have that documentation available at the time of the exam.)
HEARING: Should you require hearing aids, you must bring them to your appointment and undergo a hearing assessment with them on the day of your exam. If you do not pass, you will need to see an audiologist and will not be certified on the day of the exam.
CARDIAC HISTORY: If you have ANY cardiac history, you will need a letter from your cardiologist/treating provider that you are medically optimized. Below are some of the conditions requiring such documentation, however, this list is NOT all inclusive:

  • MYOCARDIAL INFARACTION (Heart Attack): Mandatory waiting period of two months after MI (even if cleared by cardiology). You must have a letter from a cardiologist/treating provider indicating you are medically optimized. You MUST have stress test and echocardiogram results available at your DOT exam.
  • CORONARY ARTERY STENTS: Mandatory waiting period of one week minimum and longer if associated with a MI. Stress test results are required EVERY OTHER YEAR and you will need to have a completed document with results and statement from provider at time of DOT exam.
  • CORONARY ARTERY BYPASS GRAFT (CABG): Mandatory waiting period of three months regardless of cardiology clearance. You MUST have echocardiogram. Five years following surgery, a yearly stress test is required with results available at your DOT exam.
  • HEART DISEASE: Must have letter of medically optimized state by cardiologist/treating provider.
  • ARRYTHMIA: Mandatory waiting period of one month after being diagnosed. Will need echocardiogram, cardiologist clearance and a stress test with documentation available at your DOT exam.
  • ANGINA (Chest Pain): Requires stress test and documentation from provider available at your DOT exam.
  • PACEMAKER: You must bring documentation of your most recent annual pacemaker check and this MUST BE dated within the past twelve months. You will also need a letter from your cardiologist/treating provider stating the specific indication for your pacemaker. Having a DEFIBRILLATOR will disqualify a driver immediately.
  • HYPERTENSION (High Blood Pressure): Maximum certification is one year. Blood pressure MUST BE 140/90 or less DURING your DOT exam or your certification may be delayed or you may be disqualified.
  • ANEURYSM (Dilated Blood Vessels): For abdominal, thoracic, other, or surgery for an aneurysm, you will need a letter from your VASCULAR surgeon clearing you to drive a commercial vehicle. Maximum certification is one year. If an aneurysm is present and measures over 5 cm, you will not pass per federal regulations.

NEUROLOGY: If you have had a stroke or mini-stroke, severe head injury, intracranial bleeding, brain infection, dizziness or passing-out spells (syncope), a neurology consult will be required BEFORE your DOT exam. Documentation from the specialist is required at your DOT exam.
DIABETES: There are very tight regulations on diabetes management. If you take insulin, you will not be certified to drive if you do not have an exemption from the NRCME. To begin the exemption process, call (708) 448-3094. This does take UP TO SIX MONTHS, so please plan accordingly. Regulations suggest that Hemoglobin A1C be less than 10% and blood sugars are within 100-400. If these requirements are not met, certification may be delayed so that you may see your provider for treatment regulation.
LUNG DISEASE: If you are a smoker over the age of 35, have asthma, COPD or other respiratory illness, you will need to have spirometry completed during your visit. There are specific regulations regarding these results that may delay certification.
SUBSTANCE ABUSE: You must have documentation from a SAP (Substance Abuse Professional) who works directly within the DOT standards. You will NOT be certified without this documentation. You may find these providers by online search in your area.
BLOOD THINNERS: Warfarin (Coumadin) requires documentation of monthly INR results and the reason you are on Coumadin. You must have a therapeutic INR within one month of your certification. Documentation must be provided at your DOT exam.
LOSS OF LIMB/FUNCTION: There is an exemption available for drivers who have lost a limb or part of a limb, but can still drive. This must be present at your exam for certification. This can be obtained through the FMCSA.
SLEEP APNEA: All patients will undergo a sleep apnea screening during the DOT exam.
** This list does not state ALL requirements for each category. Questions should be directed to Regency Urgent Care. **

WHAT TO BRING TO YOUR DOT EXAMINATION APPOINTMENT:
o COMPLETE medication list to include any over-the-counter medications and supplements you take
o Full list of your medical and surgical history
o All required documentation as outlined above

WHAT TO EXPECT DURING EXAMINATION:
o Complete appropriate paperwork PRIOR TO EXAMINATION (Medical Examination Report Form is available at the office)
o Medical Assistant will obtain height, weight, vital signs and urine sample
o Discussion of medical history and exam with Medical Examiner
o Completion of paperwork and final decision regarding certification

PLEASE NOTE: If additional testing (IE: spirometry or audiogram) is required for certification based on your medical history/exam, we offer this at a discounted rate to you. Many employers will include this in your exam fee, however some will not and the patient is responsible for the balance. DOT Exams cannot be used as a “Wellness Exam” under private insurance.
We understand that there are many changes that you may not know about and that may cause frustration, particularly as this deals with your employment. However, as DOT Medical Examiners, we MUST follow the regulations as dictated and are not allowed to alter the regulations regardless of consequences to a driver’s certification.

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