Medical Affairs Policy > Medical Standards for Driver's Licenses
Policy explanation:
In order to operate a Commercial Motor Vehicle in Massachusetts with a gross vehicle rating in excess of 10,000 pounds in interstate commerce, a medical examiner's certificate may also be required, even if the customer does not have a Commercial Driver's License.
Who needs a DOT medical exam?
Any of the following license holders or drivers:
If you are scheduling a DOT Medical Examination specifically for SCHOOL BUS drivers; Be aware that the Mass Regulations specify that Non-MD/DO CME's CANNOT sign the bus driver form. We apologize for the inconvenience but, we do not make the rules! If you'd like to see this changed contact your congressman/woman.
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The DOT Physical Exam:
The fee for the DOT physical exam with med card issued upon successful completion is – $125.00
Cash or credit card payments are accepted.
There is ample parking at our office for large vehicles and tractor-trailers.
What to bring with you:
Appointments are generally scheduled within 24 hours and same-day exams can be provided.
FMCSA National Registry—Certified Medical Examiners Beginning in 2014, the Federal Motor Carrier Safety Administration (FMCSA) requires all medical examiners to be trained and certified in FMCSA physical qualification standards.
In compliance with this requirement, all Commercial Motor Vehicle (CMV) drivers must be examined by Medical Examiners who have completed the training/testing and are listed on the FMCSA National Registry of Certified Medical Examiners website.
All drivers regulated by DOT/Commercial Motor Vehicle (CMV) standards are required to have a valid medical certificate signed by a Certified Medical Examiner (CMA).
GCOHC is listed on the FMCSA National Registry and all of our Medical Examiners have completed the required training and testing.
For additional information, please refer to the FMCSA website.
Disclaimer In compliance with FMCSA guidelines, some health conditions require supportive medical documentation. In these cases, a limited certification may be issued. If a driver is given a limited card in order to obtain this documentation, the information must meet the FMCSA standards and be received by GCOHC in the requested time frame. An additional fee will apply based on time spent to review the documentation and issue a new card. If a driver has a medical condition requiring more frequent monitoring or the driver is temporarily disqualified and eligible for a repeat exam, full exam fees apply. Please contact us for specific pricing.
Policy explanation:
In order to operate a Commercial Motor Vehicle in Massachusetts with a gross vehicle rating in excess of 10,000 pounds in interstate commerce, a medical examiner's certificate may also be required, even if the customer does not have a Commercial Driver's License.
Who needs a DOT medical exam?
Any of the following license holders or drivers:
- Commercial driver’s license (CDL)
- Fork Truck Drivers
- Hoisting license
- Hydraulic license
- Limousine drivers
- Box truck drivers
- Tow truck drivers
- Landscapers
If you are scheduling a DOT Medical Examination specifically for SCHOOL BUS drivers; Be aware that the Mass Regulations specify that Non-MD/DO CME's CANNOT sign the bus driver form. We apologize for the inconvenience but, we do not make the rules! If you'd like to see this changed contact your congressman/woman.
________________________________________________________________________________________________
The DOT Physical Exam:
The fee for the DOT physical exam with med card issued upon successful completion is – $125.00
Cash or credit card payments are accepted.
There is ample parking at our office for large vehicles and tractor-trailers.
What to bring with you:
- Valid driver’s license
- Medication list
- Glasses, contact lenses, hearing aids
- Federal Vision or Diabetes Waiver
- Skills Performance Evaluation Certificate
- Medical records from your treating provider
- If you have conditions such as cardiac disease, diabetes, sleep disorders, neurologic disease
- If you take prescribed medication for pain, anxiety, depression, seizures, sleep disorders, muscle psychiatric disorders, or ADD/ADHD, spasms, or smoking cessation
- If you have conditions such as cardiac disease, diabetes, sleep disorders, neurologic disease
Appointments are generally scheduled within 24 hours and same-day exams can be provided.
FMCSA National Registry—Certified Medical Examiners Beginning in 2014, the Federal Motor Carrier Safety Administration (FMCSA) requires all medical examiners to be trained and certified in FMCSA physical qualification standards.
In compliance with this requirement, all Commercial Motor Vehicle (CMV) drivers must be examined by Medical Examiners who have completed the training/testing and are listed on the FMCSA National Registry of Certified Medical Examiners website.
All drivers regulated by DOT/Commercial Motor Vehicle (CMV) standards are required to have a valid medical certificate signed by a Certified Medical Examiner (CMA).
GCOHC is listed on the FMCSA National Registry and all of our Medical Examiners have completed the required training and testing.
For additional information, please refer to the FMCSA website.
Disclaimer In compliance with FMCSA guidelines, some health conditions require supportive medical documentation. In these cases, a limited certification may be issued. If a driver is given a limited card in order to obtain this documentation, the information must meet the FMCSA standards and be received by GCOHC in the requested time frame. An additional fee will apply based on time spent to review the documentation and issue a new card. If a driver has a medical condition requiring more frequent monitoring or the driver is temporarily disqualified and eligible for a repeat exam, full exam fees apply. Please contact us for specific pricing.
Your DOT exam will include the following components:
The basic requirements for passing a DOT physical exam under the new standards are:
Before you arrive at our office for your DOT exam, please do the following:
Passing or Failing your DOT exam:
- Past or recent illnesses or injuries.
- Review of current medications, including controlled substances.
- Review of any current or past medical conditions such as heart disorders, high blood pressure, diabetes, etc.
- Physical exam.
- Blood pressure & pulse.
- Vision acuity test.
- Hearing test.
- Urine dip screen (urinalysis, NOT A DRUG SCREEN).
- If needed, additional tests for cardiac, pulmonary and/or respiratory conditions.
The basic requirements for passing a DOT physical exam under the new standards are:
- At least 20/40 correctable vision in each eye as well as both combined. Glasses or contacts are allowed.
- Needs to be able to distinguish colors found on traffic signals.
- Forced whisper test to detect adequate hearing.
- Controlled blood pressure under 140/90. Prescription medication may be used to control blood pressure.
- Cannot have diabetes that requires insulin injections.
- Maximum blood sugar level allowed is 200.
- No use of a schedule I drug (controlled substance), amphetamine, narcotic or habit forming drug.
- For any exemptions for vision, diabetes, etc. , please bring the exemption to your physical exam.
Before you arrive at our office for your DOT exam, please do the following:
- Arrive about 10 minutes early to complete necessary paperwork.
- Bring your completed DOT Form to your visit along with your driver’s license and pocket certificate. You can download the form and complete your portion by clicking HERE.
- Bring your glasses, contacts or anything you routinely use for vision.
- Bring a list of all of the prescription medication that you take including over the counter medications.
- Bring a list of doctors that you see and their phone numbers.
- Take any required medications prior to your visit, including blood pressure meds.
- Drink plenty of water. You’ll be required to give a urine sample to screen for kidney problems.
- If you have any of the conditions below, bring the requested items.
- Diabetes – Bring a list of medications and the name of your prescribing doctor. Bring copies of your blood sugar results or hemoglobin A1C results from the past 3 months.
- High blood pressure – Bring a list of medications and the name of your prescribing doctor.
- Heart condition – If you’ve had a heart attack or cardiovascular disease, bring a copy of your last stress test or release from your cardiologist.
- Sleep apnea – Bring a copy of your latest sleep study results along with a print out of your CPAP usage for the preceding month.
Passing or Failing your DOT exam:
- The most common reasons for failing a DOT physical are high blood pressure and uncontrolled sugar in your urine. Both conditions can commonly be controlled and managed.
- Another reason for failing a DOT exam would be having any condition that would cause a loss of the ability to operate a commercial vehicle safely, including the loss or impairment of limbs, poor vision, insulin controlled diabetes, high blood pressure, heart disease, epilepsy, mental disorders or use of certain drugs.
- DOT medical cards are typically issued for 2 years. However, your medical examiner may issue a card for one year or less, if you have a medical condition that requires monitoring, such as hypertension.
- If you fail your medical exam, your medical examiner may issue you a 3 month medical card and have you return for further follow-up, to be sure that your medical issue is now controlled.
- Drug testing is not a typical part of the DOT exam but may be required by your employer.
Waiver VS Exemption
A waiver is temporary regulatory relief from one or more of the FMCSRs given to a person subject to the regulations, or a person who intends to engage in an activity that would be subject to the regulations. A waiver provides the person with relief from the regulation for up to three months. 49 CFR 391.64 provides waivers to CMV drivers who were in the initial vision and insulin programs in the early 1990's.
An exemption is a temporary regulatory relief from one of more of the FMCSRs given to a person or class of persons subject to the regulations, or who intend to engage in an activity that would make them subject to the regulation. An exemption provides the person or class of persons with relief from the regulations for up to two years, but may be renewed.
A waiver is temporary regulatory relief from one or more of the FMCSRs given to a person subject to the regulations, or a person who intends to engage in an activity that would be subject to the regulations. A waiver provides the person with relief from the regulation for up to three months. 49 CFR 391.64 provides waivers to CMV drivers who were in the initial vision and insulin programs in the early 1990's.
An exemption is a temporary regulatory relief from one of more of the FMCSRs given to a person or class of persons subject to the regulations, or who intend to engage in an activity that would make them subject to the regulation. An exemption provides the person or class of persons with relief from the regulations for up to two years, but may be renewed.
Applying for A Medical Exemption
The Federal Diabetes and Vision Exemption Programs have specific requirements, as well as requests for hearing and seizure exemptions. These requests may include medical exams, employment history, driving experience and motor vehicle records which must be submitted with the application. The Agency will make a final decision within 180 days of receipt of the complete application.
Applying for an Exemption An individual may apply for an exemption from the diabetes, hearing, seizure and vision standard, section 391.41(b)(3) and 391.41(b)(11), 391.41(b)(8) or 391(b)(10) of the regulation, by utilizing these programs. If you do not currently meet the diabetes, hearing, seizure and/or vision standard and are unable to obtain a medical card, you may be an eligible candidate.
Please note that all exemption programs are for drivers who intend to operate commercial motor vehicles (CMVs) in interstate commerce. FMCSA does not have statutory authority to grant waivers/exemptions to drivers from states' intrastate requirements. Therefore, the FMCSA waivers/exemptions do not permit regulatory relief for drivers who plan to limit their operations to intrastate commerce.
Diabetes Package
Applying for an Exemption An individual may apply for an exemption from the diabetes, hearing, seizure and vision standard, section 391.41(b)(3) and 391.41(b)(11), 391.41(b)(8) or 391(b)(10) of the regulation, by utilizing these programs. If you do not currently meet the diabetes, hearing, seizure and/or vision standard and are unable to obtain a medical card, you may be an eligible candidate.
Please note that all exemption programs are for drivers who intend to operate commercial motor vehicles (CMVs) in interstate commerce. FMCSA does not have statutory authority to grant waivers/exemptions to drivers from states' intrastate requirements. Therefore, the FMCSA waivers/exemptions do not permit regulatory relief for drivers who plan to limit their operations to intrastate commerce.
Diabetes Package
- Diabetes Exemption Application
- Quarterly Endocrinologist Evaluation Form for Already Exempted Drivers
- Annual Diabetes Assessment Package for Already Exempted Drivers
- New Hearing Applicant Doc
- Renewal Hearing Document
- Medical Release of Info Hearing SAMPLE
- Medical Release of Info Hearing 12-2006
FMCSA/DOT additional Information
The Federal Motor Carrier Safety Administration (FMCSA), along with the Department of Transportation (DOT), requires that persons subject to the commercial driver’s license (CDL) requirements and their employers follow alcohol and drug testing rules. These rules include procedures for testing, frequency of tests, and substances tested for.
Who's Impacted?
The Federal Motor Carrier Safety Administration (FMCSA), along with the Department of Transportation (DOT), requires that persons subject to the commercial driver’s license (CDL) requirements and their employers follow alcohol and drug testing rules. These rules include procedures for testing, frequency of tests, and substances tested for.
Who's Impacted?
- Anyone employing CDL drivers to operate commercial motor vehicles (CMVs) on public roads
- CDL drivers who operate CMVs on public roads
- Interstate motor carriers
- Intrastate motor carriers
- Federal, State, and local governments
- Civic organizations (disabled veteran transport, boy/girl scouts, etc.)
- Faith-based organizations
Resources for Drivers*
While it is the responsibility of your employer to provide you with information on drug and alcohol testing programs, it is still ultimately your responsibility to obey all rules and regulations in order to keep our roadways safe. Drivers of CMVs can learn about drug and alcohol rules, types of tests required and their rights, responsibilities and requirements here.
Resources for Employers*
As an employer, you have a responsibility to implement and conduct drug and alcohol testing programs. Learn about drug and alcohol rules and how they affect your business here.
*An employer who employs himself/herself as a driver must comply with requirements of 49 CFR Part 382 that apply to both employers and drivers.
Resources for Service Agents
Service agents that administer drug and alcohol tests can find general information and other resources here.
Guidance on Drug and Alcohol Supervisor Training All persons designated to supervise drivers of commercial motor vehicles that require a commercial drivers license can find information and resources here on who is required to take Drug and Alcohol Supervisor Training.