Exam for DOT Certification of CMV (Commercial Motor Vehicle) drivers:
What do you need to bring? Just bring a smiling face, a photo ID, your current DOT certificate, your DOT exam form (completed with your information) and any other supporting paperwork (e.g.: exemptions) if this is a recertification exam, a way to pay, and a need to pee. (A urinalysis test is required to certify.) The exam normally takes between 20-45 minutes.
DOT EXAM STEPS
STEP 1. Fill out the DOT exam form
STEP 2. Complete your DOT physical exam with Doc Charlie, D.C. who is certified as an ME (Medical Examiner) for the FMCSA (Federal Motor Carrier Safety Administration).
- Review of brief medical history
- Height, weight, blood pressure, pulse rate, range of motion, heart, lungs, eyes, ears
- Discuss any special medical conditions or concerns.
- Urine sample for a basic urinalysis test (NOT a drug test.)
STEP 3. Your paperwork will be completed immediately after the exam.
- You will receive the original DOT medical exam form. We will be happy to fax/e-mail a copy to your company if you wish. (You need to sign a release to allow us to do so.)
- You will receive your medical certificate for your wallet. Your employer also requires a copy, we will fax or email this for their records or provide it to you.
- We keep a scanned copy of your DOT physical exam form on file at our office. (In case you need a copy)
- We will schedule your next renewal exam appointment and send you a notification via e-mail (24 hours ahead) and text (1 hour ahead) so you do not miss your next exam.
What is a DOT Physical?
Federal rules have changed the way DOT physicals are performed. This physical is considered a “Medical Fitness for Duty” exam and is a comprehensive look at your current state of health, it is NOT a rubber-stamp and signature on a form.
DOT Medical Examiners exam two categories of conditions. Those two categories are referred to as “non-discretionary” and “discretionary” standards.
Non-Discretionary Standards
There are four “non-discretionary” standards. These are the standards which every single driver must meet to pass the federal minimum standards for fitness for duty. These are:
- Vision
- Hearing
- No seizures or history of (epilepsy)
- Insulin Dependent Diabetes: Drivers with insulin dependent diabetes must have their treating clinician (your diabetes physician – not the ME) fill out the Insulin-Treated Diabetes Mellitus Assessment Form MCSA-5870 (available by CLICKING HERE.) THIS MUST BE DONE PRIOR TO YOUR DOT PHYSICAL EXAMINATION! You must also provide a record of (at least) 3 months of blood glucose monitoring as part of the ITDM form. If these monitoring records are not available, you will only be certified for 3 months, to allow you time to generate those records. After the records are available, return them to the ME and your certification can be extended to the full year allowed.
About the Insulin Treated Diabetes Mellitus (ITDM) Assessment Form, MCSA-5870
As a part of the medical certification process for insulin treated diabetes mellitus (ITDM) individuals, the Federal Motor Carrier Safety Administration requires that the Insulin Treated Diabetes Mellitus Assessment Form (ITDM), MCSA-5870, be completed by the ITDM individual’s Treating Clinician attesting that the individual has a stable insulin regimen and properly controlled diabetes. ITDM individuals are required to provide the ITDM Assessment Form, MCSA-5870, including 3 months of blood glucose monitoring records, to the Certified Medical Examiner within 45 days of form completion by the Treating Clinician.
Discretionary Standards
There are several “discretionary” standards. The following are minimum DOT Physical guidelines which are applied to the “discretionary” standards.
- Blood pressure and heart rate are checked.
- Vision and hearing tests must be administered.
- A urine specimen must be collected. The urine specimen is collected to check for glucose, protein, blood and specific gravity (concentration). These are indicators of how well your organs are functioning and may indicate diabetes, renal (kidney) pathologies or other visceral disorders.
What do we examine for your physical?
Physical Examination: The ME will perform the physical examination, see the individual items below:
Urinalysis: The mandatory urinalysis screens for protein, blood and sugar in the urine. This is NOT a drug test.
General Appearance
The Medical Examiner (ME) will note any abnormalities with posture, limps, or tremors, as well as making note of the driver’s emotional state and overall appearance. The medical examiner is looking for potential adverse impacts on safe driving.
If the driver is markedly overweight, the ME will consider the clinical and safety implications when integrated with all other findings. The driver’s BMI should be considered in the totality of the clinical picture to determine if sleep apnea is, or presents a high probability of being, present.
The DOT Medical Examiner looks for signs of current alcohol or drug abuse. If those are noted, the ME must refer the driver to a Substance Abuse Professional for evaluation.
Eyes
At a minimum, the DOT physician must check for pupillary equality, reaction to light and accommodation, ocular motility, ocular muscle imbalance, extraocular movement, nystagmus, and exophthalmos. These findings may indicate pathologies that require further evaluation.
Ears
The Medical Examiner will check for evidence of any disease or condition effecting the ear(s). At a minimum, the certifying physician must check for scarring of the tympanic membrane, occlusion of the external canal, and perforated eardrums. PLEASE CLEAN YOUR EARS PRIOR TO YOUR DOT PHYSICAL/MEDICAL EXAM. The ME must be able to see your tympanic membrane (ear drum).
Mouth and Throat
Conditions of the mouth and throat must be evaluated to determine whether the condition or treatment requires long-term follow-up and monitoring to ensure that the disease is stabilized, and whether the treatment is effective and well-tolerated. Please DO NOT have any chewing tobacco in your mouth and PLEASE rinse your month before seeing the doctor.
Heart
The DOT physician must examine the heart for murmurs, extra sounds, enlargement, and a pacemaker or implantable cardioverter defibrillator. The ME will also check the lower extremities for pitting edema and other signs of cardiac disease. A defibrillator is disqualifying.
If the ME finds any abnormalities indicating the driver may have a current cardiovascular disease accompanied by and/or likely to cause symptoms of loss of consciousness, difficulty breathing, collapse, or congestive cardiac failure, a cardiologist clearance will be required.
Work restrictions are not permitted. The DOT Physical/Fitness for Duty Examination is an all-or-none examination. The commercial driver must be able to perform all job-related tasks, including lifting, climbing into the cab or trailer, tying loads, etc. to be certified.
Lungs and Chest
The Medical Examiner must examine the lungs and chest for abnormal chest wall expansion, respiratory rate, and breath sounds including wheezes and other abnormal breath sounds. The ME will also check for impaired respiratory function and cyanosis or bluing of the skin and nail beds. Clubbing of the fingers is an indicator pulmonary (lung) disease.
Abdomen and Viscera
The DOT physician will check for enlarged liver and spleen, masses, bruits, hernias, and significant abdominal wall muscle weakness. The ME will check for tenderness and listen for abnormal bowel sounds.
Vascular System
The DOT physician will check for abnormal pulse and amplitude, carotid or arterial bruits, and varicose veins. The ME will also check for pulses in the abdomen and distal extremities.
Genitourinary System
The DOT physician must check for hernias. Specifically, the ME will evaluate any hernia that causes the driver discomfort to determine the extent to which the condition might interfere with the ability of the driver to operate a CMV safely. Further testing and evaluation may be required.
NOTE: A driver who does not provide a urine specimen CANNOT be certified.
Extremities-Limb Impaired
The ME will check for fixed deficits of the extremities caused by loss, impairment, or deformity of an arm, hand, finger, leg, foot, or toe. An SPE (Skill Performance Evaluation) may be required.
The ME will ensure that the driver has sufficient ability to grasp objects in the upper limbs to maintain steering wheel grip, as well as sufficient mobility and strength in the lower extremities to operate pedals properly.
Signs of progressive musculoskeletal conditions, such as atrophy, weakness, or loss of muscle tone consistent with Muscular Dystrophy and other conditions will be evaluated. The ME will also look for signs of clubbing (malformation of the fingers) or edema (swelling) that may indicate the presence of an underlying heart, lung, or vascular condition.
Spine, Other Musculoskeletal
The ME checks the musculoskeletal system for previous surgery, deformities, limitations of motion, and tenderness. The ME will want to know if the driver has a diagnosis or signs of a condition known to be associated with acute episodes of transient muscle weakness, poor muscular coordination, abnormal sensations, decreased muscle tone, and/or pain.
NOTE: Drivers confined to a wheelchair are not necessarily disqualified, but an SPE (Skill Performance Evaluation) is indicated.
Neurological
The ME examines the driver for impaired balance, coordination, and speech pattern. The driver must not have signs of loss of balance. Several reflexes are checked (they should be symmetrical, and the foot reflex, also known as Babinski’s reflex should not be present.) The driver will also be evaluated for loss of sensation (pins and needles) and positional abnormalities.
Sleep Apnea
Sleep apnea and sleep studies continue to be a hot topic with regard to DOT physicals and in the trucking industry. There are many misleading rumors about which drivers should get a sleep apnea test. Doc Charlie stays up to date on the FMCSA guidelines. Not everyone requires this exam. Every driver is examined on an individual basis.
If Doc Charlie determines a sleep study is needed, he will refer you to a local sleep study center for evaluation.
Click here for FMCSA information about sleep Apnea
What is Sleep Apnea? Sleep Apnea is a condition where oxygen to the body is reduced during sleep due to the slowing or stopping breathing. This often results in daytime sleepiness.
You may be at risk if:
- You are overweight or obese
- You have a tighter than normal throat
- Your neck size is > 17″ if male or > 16″ female
Symptoms of Sleep Apnea:
- Waking up not feeling refreshed
- Abnormal daytime sleepiness, including falling asleep at inappropriate times
- Erectile dysfunction for males
- Weight gain (Sleep decreases/inhibits cortisol production; sleep apnea disrupts sleep, higher cortisol levels produces belly fat);
- Cognitive issues including memory loss, short attention span, and poor judgment;
- Personality changes including depression, irritability.
- Loud snoring, periods of not breathing (apnea)