What is a DOT physical? 

What will make you fail a DOT physical? 

Get the answers to these and other popular DOT physical questions so you can prepare for yours.


If you want to drive large commercial vehicles for a living you’ll need a CDL (commercial driver’s license) and a valid DOT medical card. This card can only be obtained once you have successfully passed a DOT physical, which you’ll need to have again every 1-2 years for the duration of your career.

Finally, A Better Way to Manage DOT Physicals 
While the process of getting your DOT physical and medical card is straightforward, many people feel confused about the requirements they have to meet to pass. Below, we’ll talk you through each aspect of the physical, what standard you need to meet to pass, and links to further resources where you can find out more about the requirements for each element of the DOT medical exam.


What is a DOT physical?
The DOT (Department of Transportation) physical is a medical examination you must undergo before being permitted to drive commercial vehicles for a living. This physical ensures you are fit enough to meet the demands of your job and can operate large vehicles or vehicles with passengers without putting yourself or anyone else at risk.


Do I need a DOT physical?
You are required to have a DOT physical exam if:

You transport hazardous materials You operate a vehicle that carries more than 15 people You are paid to operate a vehicle that carries more than 8 people You operate a vehicle with a gross combined weight of more than 10,000lbs


What does the physical exam consist of?


The DOT exam will include the following:

Physical examination - The doctor will check your eyes, ears, mouth, throat, heart, lungs, abdomen, spine, extremities, and neurological system for signs of any potential problems, impairments, or injuries. Vision test - While you don't need perfect 20/20 vision to pass a DOT physical, you will need to have a minimum 20/40 visual acuity in both of your eyes, even with contact lenses or glasses. You will also need a minimum peripheral vision of 70" in both of your eyes. Hearing test - You must be able to hear a "forced whisper" from five feet away, with or without hearing aids. Blood pressure check - Many people wonder, "Can you pass a DOT physical with high blood pressure?" The answer is yes, but only if it is below a certain limit. You can find out the current limitations in this Foley blog article. Urine test - While many assume the urine test in a DOT physical is a drug test, it doesn't check for drug use. The DOT physical urine test is simply to look for underlying conditions, such as diabetes. Sleep apnea test - If you report having symptoms such as drowsiness during the day, headaches in the morning, gasping while sleeping, or heavy snoring, you may need to undergo a sleep apnea test.
As well as a range of other health indicators that can indicate that there is a problem that may put you at risk while operating a commercial vehicle.

How do I prepare for a DOT physical?
If you’re fit and in good health, there’s very little you need to do to prepare. The DOT exam is simply a check-up by a doctor to ensure you are fit enough to operate such a large vehicle.

If you’re overweight, are recovering from a bigger health issue, or are having a serious health issue managed by a doctor, you may want to make additional preparations. Whether or not you need to make any changes before your CDL DOT physical or bring anything with you will depend on your circumstances and current level of health.

If you are currently managing any health issues, make sure your prescriptions and medications are up to date, you’ve recently had a vision test and have the right corrective eyewear, and the same for your hearing if you suffer from hearing loss.

It’s good practice for anyone getting ready for their DOT physical to cut back on processed foods, alcohol, and smoking to ensure they’re in good health at the time of their physical.NEW CSA Score Webinar - Reserve Your Spot Now!


What do I need to bring?
You need to bring:

Your medical records, if your exam is being carried out by a new doctor Medical records from any specialists you see, such as a sleep apnea specialist Your most recent laboratory reports if you have diabetes or a similar condition Your glasses, contact lenses, or hearing aids if you require them to drive A list of any prescription medication you take, including what dose you take and when
You may also want to bring the DOT physical medical examination report form with you so you can fill it out ahead of time at home. You can find that form here and in the forms section at the end of this article.


What are the DOT physical requirements?
Vision Requirements
To pass the vision test, you need to have 20/40 vision in each eye either with or without glasses, a field of vision of 70 degrees or more in each eye, and be able to differentiate between red, green, and amber.

If you do not meet these standards but meet all other standards of the DOT Physical, you may be able to apply for an exemption.

To find out more about the DOT physical eye exam, see our guide here. 


Hearing Requirements
To pass your hearing test, you must be able to hear a harsh whisper in your best ear, at no less than 5 feet, with or without a hearing aid. If you fail this basic hearing test, you’ll be referred for an audiometry test which will further determine if you are safe to drive.

In most cases, you’ll be able to get a hearing correction device and then pass your DOT physical. If you need a hearing aid, you must wear it at all times while driving.

You’ll only fail the hearing test if you are completely deaf and cannot pass the whisper test even with hearing aids.


Blood Pressure Requirements
High blood pressure is an extremely common health problem, and the DOT medical exam uses it as a key health indicator.

If your blood pressure is 140/90 or below, you’ll pass the DOT physical blood pressure requirements with flying colors. Between 140/90 and 179/109, you may need to have a medical exam more frequently or be given a temporary medical card and be asked to reduce your blood pressure within a 3-month period.


What medical conditions can impact your ability to pass a DOT physical?
There are a handful of health issues that are DOT physical disqualifying conditions, meaning that if they are out of control or too severe for you to operate a large commercial vehicle safely, you will not be able to pass the DOT physical.

These conditions are:

Diabetes Hernias High BMI (Obesity) Sleep Apnea
Find out more about how to pass the DOT physical with a medical condition here, or click the links above to learn more about the individual conditions and their physical requirements.


What do they do in a DOT physical?
Your medical examiner will first talk through your medical history with you and any ongoing treatment you have. They’ll then take your height and weight, so they can calculate your BMI, and check your blood pressure, vision, and hearing.

They’ll do a general assessment of your physical health, look at your skin, check your reflexes, and examine you for hernias.

You’ll also submit a urine sample that will be analyzed to calculate your blood sugar levels and a few other health markers.

In most cases, the DOT exam will end there and you’ll get your medical certificate. However, if your medical examiner found something they believe warrants further testing, or if the requirements of the physical demand it, you may be referred on for another test before you can get your certificate.


How much does a DOT physical cost?
The DOT physical price varies depending on where you get it, and if you are fronting the cost, or if the company you work for will cover part or all of the cost. 

We value our hard working CDL drivers and have set our fee lower than our local competitors at $100


Do DOT physicals include a drug test?
The DOT physical does not specifically test for drugs. The urine sample you give as a part of your DOT physical checks your blood sugar levels. Some employers will require you to submit a urine sample for a DOT drug test, but the DOT physical itself will not look for legal or illegal substances.


What will make you fail a DOT physical?
If you have extremely high blood pressure, high blood sugar, an untreated hernia, or uncorrected vision or hearing, you may fail the DOT physical.

What happens if you fail the DOT physical?
Failing your medical exam is never good news, but it’s also rarely the end of your driving career. In most cases, failing your physical simply means you need to make some lifestyle changes and improve your health so you can safely get back on the open road.

Remember that the DOT physical isn’t trying to catch you out – it looks at your overall well-being and considers if you may have a major health episode in the near future that would jeopardize the safety of yourself and others. If you fail a DOT physical, work with your doctor to get your health back on track so you can get back on the road.


Where can I find the DOT physical forms?
You need to fill out a medical examination report before or when you start your physical.


Generally, the DOT physical is straightforward and nothing to worry about. The medical examiner merely needs to ensure you are fit and healthy enough to operate a large commercial vehicle. We have plenty of information for each medical condition and how they affect your ability to pass the DOT physical, so if you have any concerns, make sure you read those guides to put your mind at ease. 

Headaches

image of thumb and pointer finger stretching rubber bands while grasping multiple rubber bands

Headaches affect just about everyone at some point and they can present themselves in many different ways. Some people only experience pain in one part of their head or behind their eyes, some people experience a pounding sensation inside their whole head, and some people even experience nausea, while others do not. The pain itself may be dull or sharp and may last for anywhere from a few minutes to a few days. Fortunately, very few headaches have serious underlying causes, but those that do require urgent medical attention.

Although headaches can be due to a wide variety of causes, such as drug reactions, temporomandibular joint dysfunction (TMJ), tightness in the neck muscles, low blood sugar, high blood pressure, stress and fatigue, the majority of recurrent headaches are of two types: tension headaches (also called cervicogenic headaches) and migraine headaches. There is a third, less common, type of headaches called a cluster headache that is a cousin to the migraine.

Chiropractic Care for Headaches

Numerous research studies have shown that chiropractic adjustments are very effective for treating tension headaches, especially headaches that originate in the neck.

A report released in 2001 by researchers at the Duke University Evidence-Based Practice Center in Durham, NC, found that "spinal manipulation resulted in almost immediate improvement for those headaches that originate in the neck, and had significantly fewer side effects and longer-lasting relief of tension-type headache than commonly prescribed medications." These findings support an earlier study published in the Journal of Manipulative and Physiological Therapeutics that found spinal manipulative therapy to be very effective for treating tension headaches. This study also found that those who stopped chiropractic treatment after four weeks continued to experience a sustained benefit in contrast to those patients who received pain medication.

Each individual's case is different and requires a thorough evaluation before a proper course of chiropractic care can be determined. However, in most cases of tension headaches, significant improvement is accomplished through manipulation of the upper two cervical vertebrae, coupled with adjustments to the junction between the cervical and thoracic spine. This is also helpful in most cases of migraine headaches, as long as food and lifestyle triggers are avoided as well.

Headache Trigger Points

Trigger point therapy for headaches tends to involve four muscles: the Splenius muscles, the Suboccipitals, the Sternocleidomastoid (SCM) and the Trapezius. The Splenius muscles are comprised of two individual muscles - the Splenius Capitis and the Splenius Cervicis. Both of these muscles run from the upper back to either the base of the skull (splenius capitis) or the upper cervical vertebrae (splenius cervicis). Trigger points in the Splenius muscles are a common cause of headache pain that travels through the head to the back of the eye, as well as to the top of the head.

The Suboccipitals are actually a group of four small muscles that are responsible for maintaining the proper movement and positioning between the first cervical vertebra and the base of the skull. Trigger points in these muscles will cause pain that feels like it's inside the head, extending from the back of the head to the eye and forehead. Often times it will feel like the whole side of the head hurts, a pain pattern similar to that experienced with a migraine.

The Sternocleidomastoid (SCM) muscle runs from the base of the skull, just behind the ear, down the side of the neck to attach to the top of the sternum (breastbone). Although most people are not aware of the SCM trigger points, their effects are widespread, including referred pain, balance problems and visual disturbances. Referred pain patterns tend to be deep eye pain, headaches over the eye and can even cause earaches. Another unusual characteristic of SCM trigger points is that they can cause dizziness, nausea and unbalance.

The trapezius muscle is the very large, flat muscle in the upper and mid back. A common trigger point located in the very top of the Trapezius muscle refers pain to the temple and back of the head and is sometimes responsible for headache pain. This trigger point is capable of producing satellite trigger points in the muscles in the temple or jaw, which can lead to jaw or tooth pain.

Avoid Headache Triggers

  • Stress may be a trigger, but certain foods, odors, menstrual periods, and changes in weather are among many factors that may also trigger headache.
  • Emotional factors such as depression, anxiety, frustration, letdown, and even pleasant excitement may be associated with developing a headache.
  • Keeping a headache diary will help you determine whether factors such as food, change in weather, and/or mood have any relationship to your headache pattern.
  • Repeated exposure to nitrite compounds can result in a dull, pounding headache that may be accompanied by a flushed face. Nitrite, which dilates blood vessels, is found in such products as heart medicine and dynamite, but is also used as a chemical to preserve meat. Hot dogs and other processed meats containing sodium nitrite can cause headaches.
  • Eating foods prepared with monosodium glutamate (MSG) can result in headache. Soy sauce, meat tenderizer, and a variety of packaged foods contain this chemical which is touted as a flavor enhancer.
  • Headache can also result from exposure to poisons, even common household varieties like insecticides, carbon tetrachloride, and lead. Children who ingest flakes of lead paint may develop headaches. So may anyone who has contact with lead batteries or lead-glazed pottery.
  • Foods that are high in the amino acid tyramine should also be avoided, such as ripened cheeses (cheddar, brie), chocolate, as well as any food pickled or fermented foods.

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