What is a DOT medical card? The Department of Transportation (DOT) mandates that individuals must obtain a DOT medical card certifying their physical, mental, and emotional fitness before operating a commercial motor vehicle (CMV).
In this article, we’ll explore what a DOT medical card is, how to obtain one, and tips for maintaining and renewing a DOT medical card.
Key Takeaways
- What it is: Proof you’re fit to drive a CMV (MEC).
- Who issues: FMCSA-listed examiner after a DOT physical.
- Validity: Up to 24 months; shorter if health conditions.
- File it: Submit your MEC to your state DMV on time.
- Exam includes: Vision, hearing, BP/HR, lungs, neuro/limb, urinalysis.
- Borderline cases: Glasses/hearing aids or FMCSA exemptions may qualify you.
- Disqualifiers: Uncontrolled diabetes, heart disease, severe sleep apnea, seizures, substance abuse.
- Bring to exam: ID, CDL/CLP, medical history, meds, labs, doctor letters, devices.
- Stay compliant: Renew before expiration; you can’t drive a CMV with an expired card.
Table of Contents
Why Do You Need a DOT Medical Card?
Before operating a commercial motor vehicle (CMV), you must obtain a DOT medical card.
A DOT medical card is a medical certification confirming your physical, mental, and emotional fitness to operate a CMV, such as a truck or bus. The certification helps ensure public and personal safety on the road and grants drivers access to jobs in the trucking industry, many of which require the DOT medical card.
A DOT medical card is issued by the Federal Motor Safety Carrier Safety Administration (FMCSA) following a physical examination by an FMCSA-approved medical examiner.
How to Get a DOT Medical Card?
To obtain a DOT medical card, you must undergo a physical exam by a licensed medical examiner listed on the FMCSA National Registry.
You can find an examiner in your local area. Alternatively, your employer may refer you to the appropriate examiner.
Following a DOT physical examination, you will be issued a DOT medical card or Medical Examiner’s Certificate (MEC). A DOT physical exam is valid for up to 24 months, and the medical examiner keeps the card/MEC on file for three years.
After receiving your card, make sure to follow your state’s guidelines for submitting proof of certification to the state’s DMV office within the specified timeframe. Any delay in submission can impact your medical certification status and ability to legally operate a CMV. The certification will then be added to your DMV record.
Finding a Certified Medical Examiner
DOT physicals are performed by FMCSA-certified medical examiners. Acuity has a network of more than 11,000 providers, including certified, reputable medical examiners who can perform DOT physicals and issue a DOT certification. You can also search for a certified medical examiner using the FMCSA National Registry.
Preparing for Your DOT Physical Exam
Preparation is key to ensuring a successful certification by a medical examiner. Before your DOT physical examination, gather as much information as possible, including:
- Current documents that outline your medical history and a list of any medications you’re taking, whether prescription or over the counter.
- A valid form of identification.
- Your commercial learner permit or license.
- Records of your recent medical visits.
- Contact information for your primary care provider and any specialists you see.
- Recent blood work or lab results.
- A signed letter from your physician stating that you can perform tasks, including driving, without restrictions.
- Plan on bringing any special equipment to your appointment, such as glasses or hearing aids.
To avoid potential missteps during the physical examination, avoid alcohol for at least 24 hours before the exam, and don’t take any drug (legal or prescription) that could interfere with exam results.
What to Expect During a DOT Physical
During a DOT physical examination, the examiner will perform several health checks and tests, including:
- Vision
- Hearing
- Blood pressure and heart rate
- Lung and chest functions
- Limb function
- Neurological indicators
- A DOT drug screen or test (urinalysis)
- DOT psychological, DOT physical ability, and sleep apnea tests may also be ordered
In addition, the examiner will review your general appearance, skin, medical history, tobacco use, and drug and alcohol use, and discuss any current health problems or medications.
Vision and Hearing Requirements
Safe driving requires a combination of good vision and hearing. Visual and hearing inputs are essential for driving a CMV.
DOT vision standards:
The vision requirements for a DOT physical are as follows:
- At least 20/40 vision in each eye with or without corrective lenses or glasses.
- A field of vision of at least 70 degrees in each eye.
- The ability to recognize the colors of traffic signals and devices showing standard red, green, and amber.
If you wear glasses, you must always wear them while driving. Your DOT medical card will show this as “Qualified only if wearing corrective lenses.” Contact lenses are also allowed if worn.
If you don’t meet DOT vision standards, you can apply for a vision exemption.
DOT hearing standards:
The hearing requirements for a DOT physical are as follows:
- The ability to hear a forced whispered voice in the better ear at a distance of at least five feet, with or without the use of a hearing aid. If you cannot hear the whisper, you will need to undergo an audiometry test.
- There should be no average hearing loss in the better ear greater than 40 decibels at 500Hz, 1000HZ and 2,000 Hz with or without a hearing aid.
If you fail these tests, you can still qualify for a DOT medical card if you obtain a hearing aid.
Medical Conditions and Disqualifications
Certain medical conditions can disqualify drivers from obtaining a DOT medical card. These include:
- Vision impairment
- Hearing loss
- Insulin-treated diabetes mellitus (disqualifying if uncontrolled)
- Heart disease (drivers must have no current diagnosis of cardiovascular disease or high blood pressure, which will likely interfere with the ability to operate a CMV).
- Seizures and epilepsy (Drivers with epilepsy or seizure disorder diagnosis must be seizure-free for eight years, on or off medication. If an examinee stops taking anti-seizure medication, he or she must be seizure-free for eight years from the date the medication was discontinued).
- Oxygen therapy (disqualifying)
- Meniere’s disease (disqualifying)
- Substance abuse (disqualifying)
- Sleep apnea (disqualifying if moderate to severe)
- Mental conditions including depression, attention deficit hyperactivity disorder (ADHD), bipolar mood disorder, anti-personality disorder, and post-traumatic stress disorder (PTSD). However, a medical examiner may consider any treatment routine when making a qualification determination.
Read more about DOT Disqualifying Mental Conditions and DOT Disqualifying Medications.
Maintaining Your DOT Medical Card
A DOT medical card is valid up to 24 months. However, if you present with health conditions during the DOT physical, you may need to renew every 12 months and undergo periodic health exams to ensure you are still fit for duty. Conditions that require ongoing monitoring include diabetes, high blood pressure, and sleep apnea.
Renewal Process
If your DOT medical card is expiring or has expired, you must undergo a new DOT physical examination and obtain a new DOT medical examiner’s certificate before your card can be renewed. The certificate must then be submitted to the DMV. Failure to renew on time can result in your CMV driving privileges being canceled.
FAQs About DOT Medical Cards
Who needs a DOT medical card?
A DOT medical card is required before a driver can legally operate a commercial motor vehicle (CMV). The card is issued following a physical examination by an FMCSA-approved medical examiner. The examination assesses a driver’s physical, emotional, and mental fitness to safely drive a CMV.
How long is DOT certification good for?
A DOT certification or DOT medical card is good for 48 months after it has been issued. However, if a driver is found to have health conditions during the DOT physical, they may need to renew every 12 months and undergo periodic health exams to ensure they are still fit for duty. Conditions that require ongoing monitoring include diabetes, high blood pressure, and sleep apnea.
What happens if your DOT medical card expires?
If your DOT medical card expires, you must undergo a new physical examination by a DOT-certified medical examiner and submit your DOT medical card or certificate to your state’s DMV.
How much does a DOT medical card cost?
Prices vary by clinic and region. Expect roughly $70–$200 for the exam; drug testing (if required by your employer) is usually billed separately. Some employers cover the cost; many clinics accept HSA/FSA.
What blood pressure do I need to pass a DOT physical?
• < 140/90: qualifies (often up to 24 months).
• 140–159 / 90–99: typically 1-year certificate.
• 160–179 / 100–109: one-time 3-month certificate to reduce BP; then up to 1 year if controlled.
Can I pass with high blood pressure
Yes—if you reduce and maintain BP under the required thresholds. Expect a shorter certification period and follow-up exams until readings are consistently controlled.
What happens if my DOT medical card expires?
You cannot legally operate a CMV. Your CDL may be downgraded by your state DMV. Schedule a new exam, obtain a current MEC, and submit it to the DMV before returning to duty.
How early should I renew my DOT medical card?
Renew 30–60 days before expiration to allow time for the exam and DMV processing—especially if you manage conditions like hypertension, diabetes, or sleep apnea.
Is a drug test part of the DOT physical?
The DOT physical includes a urinalysis for health indicators (e.g., protein, glucose). A DOT drug test is separate but often required by employers under FMCSA rules; many clinics can perform both at the same visit.
Does insurance cover the DOT physical?
Often no—it’s an employment/compliance exam. Coverage varies; check with your plan and employer. HSA/FSA funds are commonly accepted.
How long does the DOT physical take?
Most visits take 30–45 minutes, depending on your medical history and any additional testing or documents the examiner needs.
Ensuring Compliance and Safety with DOT Certification
A DOT medical card is an important certification for CMV drivers that ensures the safety of our nation’s roads and highways.
Issued following a DOT physical examination, a DOT medical card is a necessary step to obtaining and retaining a CMV license. Following this article’s steps and best practices can help you obtain a DOT medical card and maintain your certification.
Learn more about Acuity’s FMCSA-compliant DOT physicals. Our services are available whenever and wherever they are needed, 24/7.
Contact Acuity today to learn more.