What Doctors Check During a DOT Physical Exam

A Department of Transportation (DOT) physical exam is a mandatory medical evaluation for commercial drivers to ensure they are physically and mentally fit to operate commercial motor vehicles safely. Required by the Federal Motor Carrier Safety Administration (FMCSA), this exam focuses on identifying medical conditions that could increase the risk of accidents on the road. Understanding what doctors check during a DOT physical exam can help drivers prepare, reduce anxiety, and avoid unexpected delays in certification.

Purpose of a DOT Physical Exam

The main goal of a DOT physical is safety. Commercial drivers often work long hours, face demanding schedules, and operate heavy vehicles that can cause serious harm if a medical emergency occurs. The exam is designed to assess whether a driver can safely perform essential job duties without posing a risk to themselves or others.

While many people search online for DOT physicals explained, the most important takeaway is that this exam is not about diagnosing illness—it’s about determining medical fitness for duty under FMCSA guidelines.

Medical History Review

The exam begins with a detailed review of the driver’s medical history. Drivers must complete a health history form that includes information about past and current medical conditions, surgeries, hospitalizations, and medications.

Doctors pay close attention to conditions such as:

• Heart disease

• Diabetes

• High blood pressure

• Sleep disorders

• Neurological conditions

• Mental health conditions

Honesty is essential during this step. Providing inaccurate or incomplete information can lead to disqualification or issues later if discrepancies are discovered.

Vision Test

Vision is a critical part of safe driving, and DOT standards are specific. During the exam, the doctor checks:

• Visual acuity (distance vision)

• Peripheral vision

• Ability to distinguish traffic signal colors

Drivers must have at least 20/40 vision in each eye (with or without corrective lenses) and a field of vision of at least 70 degrees in each eye. If corrective lenses are required, this restriction will be noted on the medical certificate.

Hearing Test

Hearing is another key safety factor. Doctors assess whether the driver can hear a forced whisper from a specific distance or use an audiometric test if needed.

Drivers must be able to hear a forced whisper at five feet in at least one ear, with or without hearing aids. If hearing aids are required, this will also be documented as a restriction.

Blood Pressure and Pulse Rate

Blood pressure is carefully evaluated during a DOT physical exam. Elevated blood pressure can increase the risk of heart attack, stroke, or sudden incapacitation while driving.

Blood pressure readings fall into categories that determine certification length:

• Normal or controlled blood pressure may allow up to a two-year certification

• Elevated readings may result in a shorter certification period

• Severely high blood pressure may lead to temporary disqualification until controlled

Pulse rate is also checked to identify irregular heart rhythms or other cardiovascular concerns.

Urinalysis

A urine test is required for every DOT physical. This test does not screen for drugs but checks for indicators of underlying health conditions ,such as:

• Diabetes (glucose levels)

• Kidney disease (protein levels)

• Dehydration

Abnormal results may prompt further evaluation before certification is granted.

Physical Examination

The doctor conducts a head-to-toe physical exam to assess overall health and functional ability. This includes evaluation of:

• Heart and lungs

• Abdomen and organs

• Spine and posture

• Extremities, joints, and range of motion

The goal is to identify physical limitations that could interfere with driving tasks such as steering, braking, climbing into the cab, or performing emergency manoeuvres.

Neurological and Mental Health Screening

Doctors also evaluate neurological function, including reflexes, coordination, and balance. Conditions such as seizures, stroke history, or severe neurological disorders are carefully reviewed.

Mental health is another important component. The examiner assesses whether conditions like severe anxiety, depression, or other psychiatric disorders could impair judgment, concentration, or reaction time. Stable, well-managed mental health conditions do not automatically disqualify a driver, but uncontrolled symptoms may require additional documentation.

Respiratory Health and Sleep Disorders

Respiratory health is evaluated to ensure adequate oxygen intake during long driving hours. Doctors may ask about shortness of breath, chronic lung disease, or history of respiratory issues.

Sleep disorders, especially sleep apnea, are a major focus of DOT exams. Drivers may be asked about daytime sleepiness, loud snoring, or fatigue. If sleep apnea is suspected or diagnosed, proof of effective treatment and compliance may be required to maintain certification.

Medication Review

All current medications—prescription, over-the-counter, and supplements—must be disclosed. Doctors assess whether medications could cause side effects such as drowsiness, dizziness, slowed reaction time, or impaired judgment.

Some medications may be allowed with documentation from a treating provider, while others may require temporary or permanent disqualification depending on risk.

Certification Decision

After completing all evaluations, the examiner determines whether the driver:

• Meets DOT medical standards

• Qualifies for certification with restrictions

• Requires a shorter certification period

• Needs further medical documentation

• Is temporarily or permanently disqualified

Most drivers who meet requirements receive a medical certificate valid for up to two years, though shorter periods are common for certain medical conditions.

Final Thoughts

A DOT physical exam is thorough but manageable when drivers know what to expect. Doctors focus on vision, hearing, cardiovascular health, physical ability, neurological function, and overall medical fitness to ensure safety on the road.

Understanding what doctors check during a DOT physical exam allows drivers to prepare properly, address health concerns early, and avoid unnecessary delays. With preparation, honesty, and proper medical management, most drivers can successfully meet DOT requirements and stay certified to drive safely.