ANSWERS TO Texas DOT Physicals QUESTIONS

What Does a Texas DOT Physicals DOT Consist Of?

If your employees are designated as "safety-sensitive" for the Department of Transportation (DOT) - meaning their job can impact both their own safety and the safety of the public - they are required to have a regular physical to be compliant and keep working. 

A DOT physical follows strict guidelines mandated by the Federal Motor Carrier Safety Administration (FMCSA), ensuring that commercial drivers and other safety-sensitive employees are in good health to work safely.

With these strict guidelines, DOT physicals can sometimes seem overwhelming. To help simplify the process, here is a brief overview* of what your employees should bring to the exam, and what to expect once they get there.

Commercial drivers need to bring a complete list of their medications, including the dosage regimen, dosages, and their doctors’ names and addresses. To save time, it’s also recommended that drivers fill out the health history questionnaire before coming to the clinic. 

To make sure the exam runs as smoothly as possible, drivers with certain medical issues need to bring the appropriate documents or items. For example:

• Drivers with vision or hearing problems must bring their eyeglasses, contacts, or hearing aids
• Drivers with diabetes must bring the most recent lab results from their Hemoglobin A1C (HgAIC) and their blood sugar logs
• Drivers with heart-related issues must, at minimum, bring a letter from their cardiologist that outlines their medical history and current medications, and indicates that they are safe to work

Drivers must be able to perceive what is known as a “forced whisper” at a distance of 5ft or less, with or without a hearing aid. This standard equates to an average hearing loss in the better ear of less than 40 dB.

2. Vision

Drivers are required to have at least 20/40 acuity in each eye with or without correction. They are also required to have at least 70” peripheral in the horizontal meridian, measured in each eye.

The certified medical examiner will check the driver's blood pressure and pulse to look for high blood pressure and irregular heartbeats.

49 CFR 391.43(f)

An individual whose BP is less than 140/90 and it’s on antihypertensive medications may be certified for one year. An individual diagnosed with Stage 1 hypertension (BP is 140/90 - 159/99) may be certified for one year. At recertification, an individual with a BP less than or equal to 140/90 may be certified for one year; however, if his or her blood pressure is greater than 140/90 but less than 160/100, a one-time certificate for three months can be issued. An individual diagnosed with Stage 2 hypertension (BP is 160/100 - 179/109) should be treated and a one-time certification for 3-month can be issued. Once the driver has reduced his or her BP to less than or equal to 140/90, he or she may be recertified annually thereafter. An individual diagnosed with Stage 3 hypertension (BP greater than 180/110) should not be certified until his or her BP is reduced to less than or equal to 140/90, and may be recertify every six months.

A urinalysis is required. The test looks for indications of underlying medical conditions such as diabetes.

The physical exam will cover a dozen different categories:

• General appearance
• Eyes (cataracts, glaucoma, macular degeneration, etc.)
• Ears (scarring of tympanic membrane, perforated ear drums, etc.)
• Mouth and throat (to look for problems breathing or swallowing)
• Heart (murmurs, extra sounds, pacemaker, etc.)
• Lungs and chest, not including breast examination (abnormal breathing, impaired respiratory functions, cyanosis, etc.)
• Abdomen and Viscera (enlarged liver, viscera, muscle weakness)
• Vascular (abnormal pulse, carotid, varicose veins)
• Genito-urinary (hernias)
• Extremities (limb impaired)
• Spine, other musculoskeletal (previous surgery, limitation of motion, tenderness, etc.)
• Neurological (impaired equilibrium, coordination or speech pattern, ataxia, asymmetric deep tendon reflexes)

A DOT physical can only be completed by a qualified medical examiner certified by the FMCSA. It is up to the Medical Examiner to determine if a candidate meets all the requirements, and to mark the report to the best of their knowledge.

There are several forms associated with DOT physicals. These forms are available online, so that drivers and employers can review them before a visit -- they include:

Medical Examination Report (MER) Form, MCSA-5875

The MER contains the driver’s information and health history, as well as the findings of the medical examiner during the DOT exam.  

Certified drivers will receive this certificate after passing a DOT exam. 

Commercial drivers with insulin-treated diabetes must have this form completed by their treating clinicians no more than 45 days prior to examination by a certified medical examiner (CME). A Medical Examiner’s Certificate can’t be issued to the driver without this form.

An individual with Non-Insulin-Treated Diabetes Mellitus can be

certified for 2 years maximum, if they are WITHOUT a history of

hypoglycemia episodes for the past 12 months or a history of

seizure, loss of consciousness, coma or need of assistance from

another person in the last 5 years.

The process for the certification of the driver with Insulin-Treated

Diabetes Mellitus starts with The Treating Clinician, defined as

the healthcare professional who manages, and prescribes insulin

for, the treatment of the driver’s diabetes. Drivers with Insulin-

treated diabetes mellitus must provide to the treating

clinician at least the preceding 3 months of electronic blood

glucose self-monitoring records while being treated with insulin

to be eligible for the maximum 12-month certification. The

treating clinician must complete the Insulin-Treated Diabetes

Mellitus Assessment Form, MCSA- 5870, Insulin-Treated

Diabetes Mellitus Assessment Form MCSA-5870.pdf (283.65 KB)

attesting that the driver maintains a stable insulin regimen and

proper control of diabetes. Upon completion of this form, the

treating clinician must sign and date the Form and provide

his or her full name, office address, and telephone number

on the Form. The certified medical examiner must receive the

form and begin the medical examination no later than 45 days

after the date on the signed form; however, the medical

certification determination does not need to be completed within

45 days. The Medical Examiner must retain this form as part of

the Medical Examination Report Form.

The medical examiner, utilizing his or her independent medical

judgment, determines whether the driver meets the physical

qualification standards in 49CFR391.41 to operate a commercial

motor vehicle. The driver is not physically qualified to operate a

commercial motor vehicle if he or she is not maintaining a stable

insulin regimen and not properly controlling his or her diabetes.

The driver with Insulin-treated diabetes mellitus may be

certified for up to a maximum of 12 months, meaning an

annual or more frequent exam by a certified medical examiner.

If a driver does not provide the 3 months of records, the

medical examiner has discretion to grant the driver up to but

not more than a 3-month certification, to allow time for the

individual to collect the necessary records. Once the

individual has 3 months of blood glucose self-monitoring records,

the individual is treated the same as an ITDM driver with 3

months of records. 

For additional information, please visit www.fmcsa.dot.gov.

Talk to Dr. Davis' office to learn more about Texasdotphysicals.com, or call  

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*This document is an overview and does not constitute legal or medical advice. Examination may differ.