Be prepared
If you come to your DOT physical appointment prepared, your examiner can better assist you and you can continue to help keep America running.
There are benefits to preparing, including reducing stress and anxiety.
Know When Your Medical Examiner’s Certificate Expires.
A DOT physical exam is valid for up to twenty-four months, but can be less. Do not rely on reminders from the state, your safety manager, or any third party. Note the expiration date in your smartphone and set reminders at least six weeks prior to the expiration date. If you need to schedule medical appointments, set the reminder even further in advance of your expiration date.
Planning before your card expires can also provide more flexibility in addressing issues that arise. For example, if you schedule your DOT physical well in advance of your card expiration date and the exam reveals that you need an updated eyeglass prescription, the medical examiner has the discretion to note that the exam is “Determination Pending” and schedule a follow-up visit. This allows you to run legally on your current card and come back after you obtain a new prescription. In the same situation, if your card is near expiration or expired, the examiner’s choices are limited. The examiner may even determine you do not meet standards to safely drive and deny your card until these items are fixed, costing you time and money.
Collect and Organize All Necessary Documentation
Drivers should educate themselves about the documentation required for any health condition. If your medical history requires you to see a physician or have medical tests before your DOT physical, do them and obtain the proper documentation.
For example, diabetics must monitor hemoglobin A1c and should get the necessary lab work and reports no more than ninety days before their physical. Drivers with a heart stent must have a stress test prior to the DOT physical, and drivers who use a machine for sleep apnea (CPAP) must have the machine read and obtain a usage letter and a compliance letter. Drivers using medication that requires an annual visit to the prescribing physician will need to request a compliance letter.
If you forget to bring your lab work or CPAP compliance letter, you may be out of commission until your doctor can send it to the medical examiner.
Know Where to Go
The Federal Motor Carrier Safety Administration (FMCSA requires a certified medical examiner to conduct the DOT physical exam. The examiner must be listed on the National Registry of Certified Medical Examiners (NRCME. The registry can be found on the FMCSA website. It is your responsibility to have your DOT physical performed by a certified examiner. Many clinics require an appointment in advance, while others may accept walk-in appointments. Call ahead to avoid delays.
Complete the Forms
While the transition to digital forms has made the DOT physical paperwork process faster, you can reduce stress by completing the required forms and paperwork correctly and honestly.
Report Accurate, Up-to-Date Personal Information
The name and address on the DOT physical form should match the name and address on your license. Do not use abbreviations or nicknames. The address on the form will be reported to the Department of Motor Vehicles (DMV) in your state. If you moved since obtaining your license, list your most current address on the form and be sure to report your new address to the DMV.
Double-check your license number
Even if you think you know it by heart, now is not the time to challenge your memory. Incorrect information on your DOT physical form may cause it to be rejected by the DMV or could result in an error requiring you to return to the medical examiner to present proof of the change or error and resubmitting the form to the DMV.
Always Provide Truthful and Complete Medical History and Information
Drivers might feel compelled to be less than forthcoming about medical issues; however, omitting important medical information can have severe consequences.
When you sign the Medical Examination Report Form, you certify that the information provided is accurate and complete. Your signature reflects your understanding that inaccurate, false, or missing information may invalidate the examination and your Medical Examiner’s Certificate.
Further, submitting fraudulent or intentionally false information is a violation of federal regulations and could result in civil or criminal penalties. Providing inaccurate or fraudulent information could result in more liability for you if you are in an accident and could invalidate insurance coverage in some situations. Think about this next time you think it would just be easier to not disclose that blood pressure medication. Telling the truth could save your life and your livelihood.
Consider the consequences of withholding medical information.
Debbie Diabetic controls her diabetes with prescription medication. She feels fine and doesn’t think she needs to disclose her condition to the medical examiner.
During the standard urinalysis, the medical examiner discovers high sugar levels in Debbie Diabetic’s urine sample. The medical examiner believes Debbie Diabetic has an undiagnosed diabetic condition and determines that she is not fit to drive until she is cleared by a doctor. In reality, Debbie Diabetic’s diabetes medication caused the elevated sugar levels in her urine, but without the correct medical information the medical examiner could not have known. Had Debbie been honest, her DOT physical could have been completely stress-free.
Sleepy Sam uses a CPAP machine for his sleep apnea, but he is too embarrassed to disclose this to the medical examiner.
Sleepy Sam receives a twenty-four-month medical certification. A few weeks later, Sleepy Sam receives a letter informing him that his license has been revoked due to inaccurately reporting medical information on his DOT physical paperwork. Sleepy Sam forgot that in a prior DOT medical exam he actually disclosed his sleep condition. Every time a medical examiner completes a DOT physical, the results are submitted to FMCSA. Sam previously reported that he used a CPAP machine and since there was no documentation stating he no longer needed this treatment, Sam’s license was revoked. Sam was unable to drive until he was retested and paid fines.
Collect documentation
Collecting documentation and records is an important piece of a stress-free DOT physical process.
Bring Your Identification into the Appointment.
Always have your ID on your person.
Often, drivers leave their ID in their truck and make a mad dash to the parking lot to retrieve it. When they return, their blood pressure is heightened and it takes time to bring it back down.
Although not required, it is helpful to bring your last DOT physical form with you
The examiner can review what was said and done in your last physical, which will streamline the process and save you time. This can also help avoid errors in the paperwork.
Your medication list is a very important part of this process.
Your list should include all prescription and over-the-counter medications that you are taking. Coming to your appointment with this information in hand saves a lot of time. If you don’t have this information readily available, you’ll waste time calling doctors or pharmacists to obtain this information. Many smartphones can store medication information for you. But the list is only as good as the information on it. Keep your medication list up-to-date. If your doctor changes medications, your list should reflect those changes.
It is a good idea to keep a medication list on you at all times in case of an emergency.
Bring your eyeglasses and hearing aids to your appointment
Your exam will include vision and hearing tests, so your equipment should be in working order. Don’t show up to the exam with broken eyewear or dead hearing aid batteries.
If you have any health conditions that require lab work, bring it
Include your most current records and documentation. For example, diabetics must have hemoglobin A1c labs completed. If you are unsure about whether you need lab work completed, contact the medical examiner’s office in advance of your appointment.
If you use a sleep apnea machine (CPAP), bring your compliance documentation
Sleep apnea machine compliance documentation is required, so plan in advance.
Know What To Expect
While every medical examiner has his or her own way of conducting the exam (and some companies may impose higher standards or require additional fitness testing) the FMCSA has set minimum guidelines and rules for the DOT physical to ensure that all drivers undergo the same basic evaluation. The examination customarily includes the following components.
The Examiner Reviews Your History, Your Answers on the Forms, and Any Documents You Brought (Such as Your Medication List).
The examiner may ask follow-up questions or ask you to explain your answers.
The Examiner Calculates Body Mass Index (BMI) By Recording Height and Weight Measurements
The examiner will use the BMI along with neck measurements to assess whether sleep apnea may be an issue for you.
It is better to work with your examiner as your teammate in your health journey than to try to cover something up.
You Will be Asked to Read from an Eye Chart
This helps to determine whether your vision is 20/40 or better, using both eyes together and with each eye individually. This can be done with or without corrective lenses. Since drivers must be able to distinguish colors, color recognition will be checked. Also, peripheral vision is tested for adequacy. If you have any vision problems, you may be sent to an ophthalmologist or optometrist and need to come back.
The DOT Allows for Two Types of Hearing Tests: A Forced Whisper Test or Audiometric Device Testing
A forced whisper test requires the medical examiner to stand five feet from you and determine whether you can perceive a forced whisper voice. Audiometric testing utilizes an audiometric device to test hearing. Both tests can be performed with or without hearing aids. If you use hearing aids, tell the examiner. Also, check your hearing aids prior to ensure the batteries are fully functioning.
You Are Required to Give a Urine Sample for this Exam
The urine sample is used to check for protein, blood, and sugar to identify underlying health conditions. Abnormal results may result in further testing or referral to another physician. Make sure you are hydrated and prepared to give a urine sample.
The Examiner will Physically Examine and Discuss with You the Following Body Systems
- General
- Skin
- Eyes
- Ears
- Mouth/Throat
- Cardiovascular
- Lungs/Chest
- Abdomen
- Genito-urinary system, including hernias
- Back/Spine
- Extremities/Joints
- Neurological systems, including reflexes
- Gait
- Vascular system
Having a physical issue does not necessarily disqualify a driver from driving, particularly if the condition is controlled adequately, is not likely to worsen, or is readily responsive to treatment. So be honest with the examiner.
Even though all examiners are checking for the same things, understand that examiners may have different ways of doing things. Don’t get frustrated if one examiner asks you to do different things than another examiner.
Ultimately, all examiners are working to keep you safe and healthy on the road.
Get the results
Following the exam, you need to know whether you passed, and if so, when your new Medical Examiner’s Certificate expires.
If You Pass, the Longest any Medical Examiner’s Certificate can be Issued for is Two Years
However, there are many other possibilities, all of which can vary depending on your individual situation and are subject to many variables, including medical examiner discretion.
A Medical Examiner May Issue a Card for a Shorter Period if Further Testing is Required
One example is a requirement for a sleep apnea test. If you need to work on your blood sugar, the examiner has the discretion to issue a card for a shorter period and give you time to work on this. These situations are very personalized to each driver and each driver’s health conditions, so avoid comparing yourself with others.
Certain health conditions can result in shorter issuance periods.
If you are diabetic, use a sleep apnea machine, or have a cardiac condition, you will need to have a DOT physical at least annually. If you take medication to control blood pressure, you can expect your card to be issued for one year. Other diseases, disease states, disorders, and medications may require annual screening by your physician or healthcare provider, or more frequent monitoring. Having a one-year card is not a punishment. It is an opportunity to utilize your medical examiner to help keep you healthy and safe on the road.
If You Need to Get Lab Work or Have Something Checked, the Medical Examiner May Have the Option to Note that the Exam is “Determination Pending”
The medical examiner is not certifying anything at this point; he or she is simply allowing you to leave the exam to rectify certain things—usually minor issues like a CPAP machine reading or picking up lab work— and return by a specified date. This is only an option if your card is not expired.
A “Determination Pending” status is not a temporary card. It is merely a period to allow you time to fix whatever the problem is. This puts your exam on hold until you bring back what is needed to finish the exam. If you fail to return by the designated date, the exam is logged in as incomplete and submitted to the FMCSA. If you return after the designated return date, you will need a new exam and must pay to do the entire exam over.
Under Certain Circumstances, a Driver Simply Cannot Safely Perform His or Her Duties as a Professional Truck Driver and will not Pass the DOT Physical
For example, having an internal defibrillator will make a driver ineligible for medical certification. If you have any concerns about your specific condition, contact your medical examiner’s office.
While You are Allowed to get a Second Opinion, This Doesn’t Mean You Can “Doctor Shop”
Scheduling multiple exams with different medical examiners or doctors and changing your health history answers is illegal. Medical examiners are required to submit exams daily, no later than midnight of the day they were completed. The results are put into a database, and if you change your health history questions to pass a previously failed test, you will likely be caught.
If You Discover That You Have a Health Condition That Prohibits You From Driving, it is Time to Stop Driving for Your Own Safety and the Safety of Others
Take time to work on yourself and your health. If your prohibitive condition changes for the better, contact a medical examiner about retesting. Then, and only then, should you consider driving.
In Some Situations, You May be able to Obtain a Waiver for Certain Conditions
Each situation is different, and you should consult a medical examiner to determine if you qualify for a waiver. Additionally, other rules may apply for certain health conditions if a driver is intrastate only. Consult https://www.fmcsa.dot.gov/ for questions regarding current regulations and waivers.
Reporting Results
The medical examiner will record your Medical Examiner’s Certificate with the FMCSA, but it is your responsibility to register with the state.
Each State Has Different Rules, So Check with Your State to Find Out What is Required
Some states require you to present your Medical Examiner’s Certificate in person, while others allow you to send it by fax or submit it online or on your mobile device. Some states require additional forms such as a self-certification form.
Importantly, confirm which form your state will accept: the “long form” Medical Examination Report Form (MCSA-5875, the Medical Certification form (MCSA-5876, or both.
Provide a Copy of Your Medical Examiner’s Certificate to Your Company (if Applicable)
Your company may request a copy of both the “long form” Medical Examination Report Form (MCSA-5875) and the Medical Certification form (MCSA-5876). It is always a good idea for you to keep a copy for yourself in your own records. If you are an owner-operator, you are required to have a DOT compliance folder on yourself, and this is part of the file for compliance.
If You Were Instructed to do Testing or Follow Up with a Physician, Make Those Appointments as Soon as Possible
Do not wait until your card is nearing expiration to complete the medical examiner’s request. Don’t count on an extension. You don’t want to end up without a medical certification because you forgot something.
Tips for Reducing Stress
Following the exam, you need to know whether you passed, and if so, when your new Medical Examiner’s Certificate expires.
Tip 1 – Get a Good Night’s Rest
Sleep is important to decreasing physical and mental stress. Your body uses this time to restore and replenish. Getting a good night’s rest on the nights leading up to your exam can make a difference.
Tip 2 – Hydrate
- Hydration is key to many organ systems.
- Adequate hydration can help with blood sugar and blood pressure.
- Dehydration can wreak havoc on a body, so hydrate coming into your exam.
- Hydration can also help you be prepared for the urinalysis portion of the exam.
Tip 3 – Refrain from Tobacco Use
Smoking and tobacco usage can cause blood pressure to elevate. Avoid smoking immediately prior to your DOT physical.
Tip 4 – Clean Your Ears
Earwax and buildup in the ears can decrease hearing. If needed, consider going to your family doctor to have them cleaned prior to your exam.
Tip 5 – Breathe
- Breathing can help with “Whitecoat Syndrome” and decrease stress.
- Count 1, 2, 3, 4 while inhaling slowly.
- Count 5, 6, 7, 8, 9, 10 while exhaling slowly.
- Breathing should be slow and controlled.
- Breathe with your belly, and see your belly move in and out, rather than your chest up and down.
- Repeat for 2 minutes.
- Make sure you are counting. If you are counting, you are concentrating on a single thing, which can decrease anxiety.
- Try this technique any time you are stressed. Someone pulls out in front of you and you are upset. Instead of yelling, start to count and breathe. If you are stuck in traffic and are not going to get your load delivered on time, take a few seconds and breathe.
Tip 6 – Shut Off Your Phone During Your DOT Physical
Telephone calls, alerts, and messages can be stressful and cause your blood pressure to elevate. You may need to bring your phone to access important information. But once you are in the exam room, shut it off.
Being in a familiar place with a medical examiner you like will help achieve the goal of a stress-free DOT physical.
Tip 7 – Find an Examiner You Like
People have different personalities, and medical examiners are not any different. If you find an examiner who listens to you and with whom you communicate well, return to that examiner. You may even try to find a load that will get you to the location of your favorite medical examiner. It is worth it to see an examiner your are comfortable with, even if it means doing your exam early.
