The Federal Motor Carrier Safety Administration (FMCSA) requires all drivers of commercial motor vehicles (CMVs) to pass an FMCSA physical to obtain a DOT medical card (the medical exam). https://youtu.be/sE5VDiRwIos

1. WEBINAR SERIES
503-479-6082 | www.cleanfleet.org

2. DOT Medical Exams
The Process, Disqualifications, Red Flags, and What to do
After Obtaining a Med Card
by Luke Kibby, CleanFleet
503-479-6082 | www.cleanfleet.org

3. 503-479-6082 | www.cleanfleet.org
Who needs a DOT Medical Exam
• It is required for all licensed commercial drivers in the US
• The Federal Motor Carrier Safety Administration (FMCSA) requires all
drivers of CMVs to pass a FMCSA physical to obtain a DOT Medical Card.

4. 503-479-6082 | www.cleanfleet.org
What Is Considered A Commercial Motor Vehicle?
• Part 390.5 of the FMCSRs:
• Is designed or used to transport more than 8 passengers (including the driver) for compensation; or
• Is designed or used to transport more than 15 passengers, including the driver, and is not used to
transport passengers for compensation; or
• If you operate a vehicle for interstate commerce purposes.
• If you drive a vehicle that weighs over 10,001 pounds.
• If you are responsible for transporting hazardous materials.

5. 503-479-6082 | www.cleanfleet.org
What is checked at your DOT Exam?
1. The driver’s health history
• When your driver arrives at the exam, they will be asked to fill out a form
that details their health history and current health, including all
medications they are taking.

6. 503-479-6082 | www.cleanfleet.org
What is checked at your DOT Exam?
2. The Health Basics
• Vision, Hearing, Blood Pressure, general appearance and demeanor, eyes,
ears, throat/mouth, heart, lungs, chest, abdomen, liver, vascular system,
spine, neurological and extremities–noting any loss of limbs or physical
debilities

7. 503-479-6082 | www.cleanfleet.org
DOT Automatic Disqualification
By regulation, Specific Medically Disqualifying Conditions Found
Under 49 CFR 391.41 are:
• Hearing Loss
• Vision Loss
• Epilepsy
• Insulin Use to treat diabetes
• If you take any habit-forming drugs

8. 503-479-6082 | www.cleanfleet.org
Federal Vision Exemption Program
The FMCSA Vision Exemption Program is for monocular vision. The vision
exemption is issued for a maximum of 2 years and is renewable.
Provisions of the vision exemption include an annual medical examination and
an eye examination by an ophthalmologist or an optometrist.
At the annual recertification examination, the driver should present the
current vision exemption and a copy of the specialist eye examination report.

9. 503-479-6082 | www.cleanfleet.org
Red Flags for Temporary Disqualification
• Cardiovascular: Disqualification requires that the CMV driver exhibit a higher than
acceptable likelihood of acute incapacitation from a cardiac event, resulting in an
increased risk to the safety and health of the driver and the public.
• Psychological Disorders: Some psychological or personality disorders can directly
affect memory, reasoning, attention, and judgment. Disorders of a periodically
incapacitating nature, even in the early stages of development, may warrant
disqualification.

10. 503-479-6082 | www.cleanfleet.org
Non-CDL Drivers Of CMVs Are Being
Denied Medical Cards
The culprit: Marijuana… but why?
One specific question: Can drivers operating CMVs that do not require CDLs
(commercial driver’s license) legally use marijuana where it is legal?
These Companies asking this often fall into these industries:
• Construction
• Landscapers
• Local Delivery
• Moving Companies
• Transporters of people/passengers
• Distribution companies

11. 503-479-6082 | www.cleanfleet.org
When Can This Happen?
Since drivers who operate CMVs that do not require CDLs are not subject to
DOT drug testing, some employers believe it is legal for these employees to
use marijuana in states that allow it.
The first way is when a driver admits use on the “federal” form s/he fills out
before the physical. The form the driver fills out for the medical examiner asks
two questions about illegal substances.
• “Have you used an illegal substance within the past two years?”
• “Have you ever failed a drug test or been dependent on an illegal
substance?”

12. 503-479-6082 | www.cleanfleet.org
What Happens If A Non-CDL Driver Fails A
Drug Test Ordered By A CME?
• Failing a drug test ordered by a CME automatically disqualifies the driver
from obtaining a medical card, and thus, prohibits the driver from
operating a CMV.
• However, failing a drug test under the authority of the DOT, the driver does
not have to see a Substance Abuse Professional (SAP) or be a part of a
follow-up program, unless individual company policy requires them to do
so.
• If the driver has a CDL and is operating a CMV that requires a CDL, you as
the employer have “actual knowledge” of drug use and will need to
perform a DOT reasonable suspicion drug test on the driver.

13. 503-479-6082 | www.cleanfleet.org
Choosing a Certified Medical Examiner
The National Registry of Certified Medical Examiners was implemented in 2014.
Before you choose a medical examiner, ask yourself these three questions:
1. Am I OK with a physician telling me that one of my drivers or potential
drivers is not fit to drive?
2. Am I willing to either work with that driver to get him fit or to part ways
with the driver?
3. Is ensuring the safety of the driver and other drivers on the road more
important than just certification and approval?

14. 503-479-6082 | www.cleanfleet.org
New Research Quantifies Impacts of
National Registry of CMEs
ATRI's research focused on commercial driver and motor carrier impacts and
identified the following:
1. A majority of drivers (63.3%) reported increased exam costs while only 6.2% of drivers
reported improved exam quality post-NRCME implementation.
2. 6 % of drivers reported spending 20 min or less with their CME, with 6.5% of those drivers
spending 10 min or less, an insufficient time to complete all required processes of a DOT
physical.
3. Among the 5.9% of drivers who were not issued a medical certificate on the day of their
physical exam, 22.6% cited having a medical condition that required treatment before
certificate issuance as the reason.
4. Nearly 50% of motor carriers reported that they specify which CME their drivers see to
ensure medical exam quality.

15. 503-479-6082 | www.cleanfleet.org
Are You Ready For Your Medical Exam?
Basic information needed at a physical exam:
• Medication list
• Corrective lenses
• Hearing Aids
• Recent lab results for Diabetes maintenance, at a minimum HgA1C within the last year.
• Cardiovascular testing results for heart conditions of any kind
• With use of CPAP machines a compliance printout is necessary, must be for 30 days
• Letters of Release after an injury from the treating physician.

16. How long is a DOT Exam Valid?
• A DOT exam is considered relevant and valid for up to a total of 24 months.
• If your examiner thinks you are overall fit and healthy but has some concerns they
may issue a certificate that is valid for three months, six months, or however long
they see fit.
503-479-6082 | www.cleanfleet.org

17. 503-479-6082 | www.cleanfleet.org
After Receiving a Medical Card
The list below is the basic information that is needed at a physical exam.
1. Driver needs to take the certified document to the DMV
2. Employer needs to pull an MVR 15 days after the certified driver exam

18. 503-479-6082 | www.cleanfleet.org
Common Questions when getting a
Medical Card
• Does A Driver Need A New Physical After Returning From A Medical Leave
Of Absence?
• Do We Need A Non-CDL Driver’s Motor Vehicle Record (MVR) As Proof Of
A Physical?
• Do We Need A New MVR After Each Driver Physical?
• Do We Need To Retain A Copy Of The Federal Medical Card In The Driver’s
Qualification (DQ) File?

19. Questions?
Luke Kibby
lucask@glostone.com
www.CleanFleet.org
503-479-6082

20. Thank You!
503-479-6082 | www.cleanfleet.org