A Guide to Preparing for Your DOT Physical Exam

A Guide to Preparing for Your DOT Physical Exam

Commercial motor vehicle drivers might feel intimidated before their Department of Transportation (DOT) physical examination, given that the results hold a bearing on whether they are able to continue driving for a living. Even if you’ve passed a DOT physical exam in the past, it’s important to determine if you still check all the boxes to clear it again. If you’re a first-timer, knowing what the process entails might hold you in good stead.

What is a DOT Physical Exam?

The U.S. Department of Transportation requires drivers of commercial motor vehicles to pass a physical examination to demonstrate that they are physically, mentally, and emotionally fit to do their job and maintain their commercial driver’s license (CDL). Only licensed medical examiners approved by the Federal Motor Carrier Safety Administration (FMCSA) National Registry can conduct these exams.

A medical examiner’s certificate is typically valid for 24 months. However, an examiner might issue a certificate for less than 24 months if there’s a need to monitor an existing condition like high blood pressure, diabetes, or non-sustained ventricular tachycardia.

What Are the New DOT Physical Requirements?

Title 49, Subtitle B, Chapter III, Subchapter B, Part 391, Subpart E of the Code of Federal Regulations provides details of the most up-to-date physical qualifications and examinations. If you get your medical examiner’s certificate owing to a medical variance, you need to carry a skill performance evaluation certificate or an exemption letter when on duty.

Passing a DOT physical exam requires that you provide details about your medical history, answer questions that your medical examiner asks, and go through different health-related tests. For example, a urine exanimation helps identify underlying conditions like diabetes mellitus or kidney disease. Other tests relate to:

·    Vision

·    Hearing

·    Blood pressure

·    Reflexes and movement

·    Lung function

·    Cardiovascular function

·    Neurological function

what is a dot physical

Does DOT Physical Test for Alcohol?

If you admit to drinking alcohol regularly and based on your responses, your medical examiner might require further evaluation before issuing a medical certificate, which might include additional assessments like CAGE, TWEAK, or AUDIT. If you display signs of alcohol use disorder (AUD), your examiner might consider you for certification after you go through the required treatment and/or counseling.

The regular urine examination does not test for alcohol or drugs. However, if you perform a safety-sensitive function, you will be subject to your employer’s DOT drug/alcohol testing program.

How to Prepare for Your DOT Exam?

If you’re wondering how to pass your DOT exam, know that preparing in advance and following a few simple measures can increase your likelihood of success.

Visit Your Primary Care Physician

If your medical history includes a diagnosis of a heart condition, high blood pressure, diabetes, or any other medical problem, you should ideally consult your treating physician before your DOT exam to ensure that you are managing it well. For example, simply having high blood pressure does not lead to failing the exam. If you’re wondering how to pass a DOT physical with high blood pressure, you need to ensure that it stays below 140/90mmHg (with the ideal ranging from 90/60mmHg to 120/80mmHg).

Since you need to take a DOT exam at least once every two years, staying in touch with your treating physician in between your exams is important. This is because your physician can then adjust your medications and make other recommendations to keep your medical problem/s in check.

Make Healthy Choices

If you don’t follow a healthy regimen, you need to start doing so at least three to four weeks prior to your DOT exam. During this period, eat healthy foods like fruits, vegetables, nuts, and items made using whole grains. Refrain from eating things that have high sodium content and stay away from sugary foods and beverages. Eating three to four small meals every day is better than having two large ones.

While maintaining good eating habits is important, so is getting enough exercise. Remember that truck drivers have to sit in one position for long hours and this can lead to stiffness in joints, aches, and pains. Walking and jogging are easy ways to stay fit. A kettlebell can provide a great full-body workout. Tuck drivers are also known to carry resistance bands, Pilates rings, and jump ropes as these take little room. Some truck stops have gyms, which you may consider using during your breaks.

Getting enough sleep is crucial as well. Ideally, you should sleep for at least seven hours each day. In addition, you need to follow a consistent sleep schedule. Bear in mind that while naps during short breaks are great, getting a good night’s sleep is vital.

Steer Clear of Unhealthy Choices

Passing your DOT exam requires that you avoid unhealthy habits that might have a negative effect on your health. These include:

  • Smoking
  • Drinking
  • Consuming illicit or unprescribed drugs
  • Not sleeping enough
  • High intake of caffeine in the form of coffee or energy drinks
  • High intake of sugar

Ideally, you should stop consuming caffeine around 48 hours before your DOT exam. This is because caffeine can increase your blood pressure and heart rate. If you have high blood pressure during your DOT exam, your medical examiner might view it as a sign of a potential chronic disease, which is not good for your overall score.

Take Your Medications on Time

If you need to take medications for any condition, it’s best to maintain a pattern and take them around the same time every day. Keep track of how much medication you have left, and try to get a refill before you run out. This is because not taking your medications can worsen your medical problem, which in turn, may have an adverse effect on your DOT physical.

dot physical exam

How to Pass DOT Physical With High Blood Sugar

Your medical examiner will look for signs of diabetes during your DOT exam. You might also need to answer questions about whether you have a history of high blood sugar and how you control your sugar levels (insulin, pills, or diet). If your examiner feels you might have diabetes, you may need to go through further investigation.

If you have diabetes, your DOT certification will apply for a maximum of one year, after which you need to go through the exam again. You will also need an annual eye test because diabetes might lead to impaired vision.

Passing a DOT exam with high blood sugar levels depends on the discretionary power of the medical examiner who determines if your existing condition might work as a barrier to you doing your job safely. Even people with Type 2 diabetes can pass their DOT physical exam if they have their condition under control. During your exam, you may need to answer questions like:

  • How often do you monitor your blood sugar level?
  • Are you currently on any medications to control your blood sugar level?
  • Do you feel dizzy, faint, or off-balance?
  • Have you experienced hypoglycemia (lower-than-normal blood sugar level)?

What to Do Just Before the Exam

On the day of the exam, try to relax and calm your nerves. You may do this by meditating, exercising, listening to music, or doing anything that you feel might have a calming effect. If you reach the exam stressed, it might cause your blood pressure to increase. There are a few other aspects that need your attention on the day of your exam.

  • Eat a light breakfast. Eat a healthy and light breakfast on the morning of your DOT exam, and try to include nuts, fruits, vegetables, and oats. Don’t have a heavy breakfast because it can spike your sugar levels which your medical examiner might view as a warning sign of diabetes.
  • Carry your hearing and vision devices/aids. Your DOT physical exam includes hearing and vision tests, so make sure you carry your hearing aids, prescription glasses, and contact lenses with you.
  • Keep your paperwork in order. If your medical examiner is not the same as your treating physician, or if you’re seeing a specialist for an ongoing medical problem, make sure you carry your medical records with you. You should also carry prescriptions for the medications you take. Drivers with histories of heart disease need a letter from their cardiologist stating that their condition does not hamper their ability to drive commercial motor vehicles.
  • Answer questions honestly. Whether it’s the form you need to fill out or the questions your medical examiner asks, make sure you answer honestly. Remain consistent when it comes to information you’ve provided in the past and be forthcoming in including any updates since your last exam. The questions might cover aspects like existing symptoms and illnesses, previous surgeries, medications you take, and substance abuse. Remember that lying in your DOT exam can lead to a revoked license as well as legal action.


Passing your DOT physical exam is crucial if you want to keep driving commercial vehicles for a living, and there are no real shortcuts to achieving desired results. For example, simply drinking a lot of water before your exam will do little to no good in masking any existing medical condition you have. What you need to do, instead, is focus on embracing healthy habits and eliminating ones that might cause harm. Once you have your health in check, passing your DOT exam might be simpler than you think.

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