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What is a Department of Transportation (DOT) Exam?

A DOT is a physical medical exam required by the Federal Motor Carrier Safety Administration (FMCSA) so someone can operate a commercial motor vehicle. DOT physicals are required to drive something like a semi-truck, cargo van, and or school bus. Smart Pain Solutions in St. Louis offers Department of Transportation physicals at our Bridgeton location for those looking to apply or get re-certified. Our blog this month will provide you with an explanation of what to expect during an exam and some of the top reasons individuals fail an exam. This will hopefully better prepare you for the physical and get you on the roads safely in no time. 

DOT Physical

DOT exams are required to be performed by chiropractors and other licensed medical examiners to assess the overall health status of an individual. Through this exam, the medical professional will be able to determine if their candidate is stable enough to safely operate a commercial motor vehicle on the major roads and highways.

Scheduling a DOT Physical at Smart Pain Solutions 

Our Bridgeton location in St. Louis offers Department of Transportation physicals and drug screenings right in office. Give us a call @ 314-298-1400 to schedule an appointment. You can also text us to get scheduled @ 314-274-9422.

What to Bring to Your DOT Physical in St. Louis

The applicant should provide the medical examiner with a valid driver’s license, a current list of medications, glasses, contacts, or hearing aids, and any important paperwork provided from the future commercial vehicle employer. It is recommended to avoid caffeine, tobacco, or alcohol at least two hours before the physical as this could impact the driver’s blood pressure reading. Additionally, if you use a CPAP (continuous positive airway pressure) machine, we recommend bringing the usage report for your CPAP. Some health conditions may require a letter of health from your treating provider.

What to Expect

On the day of the exam, the medical professional will evaluate various aspects of the driver’s health. Listed below are a few examples of what to expect during the physical;

General Physical Examination & Vitals: The medical professional will usually begin the exam by getting the driver’s height, weight, heart rate, respiratory rate, and then taking their blood pressure. Upon initial consultation, the doctor will discuss with the driver their previous & current medical history. The examiner will also assess the driver’s overall physical condition, including the musculoskeletal system, neurological function, and other relevant factors. 

Blood Pressure:

  • This is a very important step of the DOT exam. The driver’s blood pressure should be below certain thresholds to ensure it does not pose a risk while driving. If the driver is taking blood pressure medication it is important to let the examiner know the list of medications prescribed. Below we have included a diagram from the American Heart Association regarding safe & unsafe blood pressure readings. The DOT requires blood pressure to be less than 140/90 to be certified. In some scenarios when blood pressure is over 140/90, the doctor may be able to certify. That is only if the driver is not taking any medications and their reading is less than 170/110.

Vision: A driver must have at least 20/40 acuity in each eye with or without corrective lenses and their ability to differentiate colors. If the driver needs to wear glasses when they are driving, they should bring their contact lenses or glasses with them to the exam. 

Hearing: The driver must be able to perceive a “forced whisper” at a distance of at least 5 feet. If the driver uses hearing aids, please inform the doctor performing the exam. 

Cardiovascular & Respiratory Health: The examiner reviews the driver’s medical history, looking for heart, lung, and other conditions that could impair the ability to operate a commercial vehicle safely. The driver should not have any lung or respiratory conditions that would significantly impair their breathing or physical activity. 

Diabetes: If the driver has diabetes, it must be under control through medication or diet, and they should be able to demonstrate stable blood sugar levels.

Drug and Alcohol Testing: The driver must undergo a urinalysis or blood test to check for the presence of drugs or alcohol in their system.

Following the DOT Physical

Once the exam is complete, If the driver meets all the requirements, they will receive a Medical Examiner’s Certificate. This is known as a DOT medical card, which is valid for a specified period of time. The duration of the certificate may vary depending on the driver’s health, medical conditions, and the state regulations for which they will be working. It’s important to note that the specific requirements for a DOT physical may change over time, so it’s essential to refer to the FMCSA regulations and consult a certified medical examiner for the most up-to-date information.

Reasons for Failing DOT Physicals

Now that we have explained what to expect during a Department of Transportation exam, let’s take a look at some of the reasons why candidates are disqualified from becoming commercial drivers. These are the most frequent reasons why driver’s fail the DOT physical, starting with the most common reason for failing. 

  1. High Blood Pressure & Cardiovascular Disease: If an individual has uncontrolled high blood pressure, a recent history of a heart attack, chest pain, or other cardiovascular related conditions, that could significantly impair their ability to safely operate a commercial vehicle.
  2. Vision or Hearing Impairments: Commercial drivers must meet certain vision and hearing standards to ensure their ability to perceive and respond to traffic signals, hazards, and communicate effectively. If an individual’s vision or hearing does not meet the required standards, they may fail the exam.
  3. Diabetes: Drivers with insulin-treated diabetes or diabetes requiring the use of certain medications may face additional requirements to demonstrate that their condition is adequately controlled.
  4. Sleep Apnea: Sleep apnea is a sleeping disorder that can cause excessive daytime sleepiness and fatigue, which may lead to failing a DOT physical if it is untreated or inadequately controlled. Drivers may be required to undergo sleep studies and comply with treatment recommendations to ensure safe driving.
  5. Substance Abuse: A history of drug or alcohol abuse may disqualify an individual from obtaining or maintaining a commercial driver’s license. DOT physicals typically include drug and alcohol testing, and positive results or a history of substance abuse can result in failure.
  6. Certain Medications: Some medications have side effects that can impair a driver’s ability to safely operate a commercial vehicle. If a medication interferes with a driver’s cognitive or motor functions, it may lead to failing the physical.
  7. History of Seizures: having seizures, even when on medication is disqualifying. Rarely under special circumstances will a driver with a history or seizures be eligible for certification.

    Dr. Bo


    Dr. Walker


To increase the chances of passing your Department of Transportation (DOT) physical, it is essential to take proactive steps and prioritize your health and well-being. It can all start with setting up an appointment at Smart Pain Solutions Chiropractic in St. Louis. For those getting their Department of Transportation certification, stay up-to-date with routine medical check-ups and address any health concerns promptly when they arise. Manage conditions such as hypertension, diabetes, or other cardiovascular issues through proper treatment and medication compliance. Take prescribed medications responsibly and inform the medical examiner about any medications you are currently taking. Last, and certainly not least, familiarize yourself with the specific national and state requirements of the DOT physical. Stay up to date with the FMCSA regulations in your region to ensure compliance. Consult the official DOT guidelines for more comprehensive information. By adopting these proactive measures, you can successfully pass a DOT physical and be driving in no time!

You can save some time at the office by filling fill out the paperwork which we send as a text link that will direct you to our online DOT portal!

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