A step-by-step walkthrough of every component the medical examiner checks — and exactly what you need to bring, know, and do to walk out with your CDL medical card.
A DOT physical — also called a CDL physical, DOT medical exam, or FMCSA physical — is a medical examination required by 49 CFR Part 391.41 for all commercial motor vehicle (CMV) drivers. The exam must be performed by a certified Federal Medical Examiner (CME) listed on the FMCSA National Registry. You leave with a Medical Examiner's Certificate (MEC), commonly called your CDL medical card, which must be renewed every 24 months (or more often for drivers with certain conditions).
The exam covers 13 body systems and typically takes 30–60 minutes. There is no appointment required when you order through WorkOccMed — visit any of 15,000+ certified sites the same day.
You'll complete MCSA-5875 — the Medical Examination Report. It asks about past and current medical conditions, surgeries, medications, sleep disorders, and substance use. Answer honestly; falsifying federal forms is a federal violation. The examiner will review your answers before the physical portion begins.
You need at least 20/40 acuity in each eye, with or without correction. The examiner tests distant visual acuity, field of vision (70° peripheral in horizontal meridian), and the ability to distinguish traffic signal colors (red, green, amber). Drivers who can only meet standards with glasses or contacts receive a "must wear corrective lenses" restriction on their certificate.
You must perceive a forced whispered voice in the better ear at not less than 5 feet with or without the use of a hearing aid. Alternatively, the audiometric test requires a hearing loss not greater than 40 dB in the better ear. If you use a hearing aid, you may need to wear it during the exam and will receive a restriction notation.
Blood pressure is measured in both arms. The certificate duration depends on your reading:
| Stage | Reading | Certificate | Follow-Up |
|---|---|---|---|
| Normal | Below 140/90 | 24 months | None |
| Stage 1 | 140–159 / 90–99 | 12 months | Treat & recheck |
| Stage 2 | 160–179 / 100–109 | 12 months | Treat to <140/90 within 3 months |
| Stage 3 | 180/110 or above | Disqualified | Treat, then reapply |
You'll provide a urine sample. This is NOT a drug screen — the examiner tests for protein, blood, and glucose to screen for diabetes and kidney disease. A separate DOT 5-panel drug test (ordered by your employer or C/TPA) is a distinct requirement covered by 49 CFR Part 40.
The examiner performs a head-to-toe physical covering all 13 systems required by FMCSA:
Pupils, eye movement, peripheral vision, color recognition
Ear canals, whisper test, hearing aid use
Auscultation for wheezing, crackles, or reduced breath sounds
Rhythm, murmurs, rate, EKG history review
Organomegaly, masses, hernia
Reflexes, coordination, tremors, seizure history
Limb function, grip strength, range of motion
Peripheral pulses, varicosities
Scoliosis, disc disease, flexibility
Hernia check, urinalysis findings
Jaundice, rashes, needle marks
Thyroid, lymph nodes, airway
Overall impression, alertness, signs of substance use
Missing documents can delay or prevent certification. Bring all of the following:
The following conditions disqualify a driver unless they hold a specific FMCSA exemption or meet exception criteria:
Temporary disqualification; treat and return with controlled BP
Both eyes tested; corrective lenses allowed; monocular drivers need a federal vision exemption
Disqualifying unless seizure-free for 8 years off medication (FMCSA exemption available)
No longer automatically disqualifying — federal insulin exemption program exists; requires annual review
Requires SAP evaluation and DOT return-to-duty process before recertification
Not automatically disqualifying, but severe untreated OSA may be; CPAP compliance typically required
30 to 60 minutes for most drivers. If additional testing is required (EKG, specialist letter, or lab work), you may need to return or wait for results before the examiner can certify you.
Photo ID, medication list with dosages, eyeglasses or contacts if worn, hearing aid if worn, and any specialist letters for chronic conditions. Missing documentation is the most common reason drivers leave without their certificate.
Yes. The most common reasons are blood pressure above 180/110, vision below 20/40, positive drug/alcohol results, uncontrolled diabetes, and severe untreated sleep apnea. Many disqualifying conditions are treatable — if you fail today, you can treat and return.
No. The urinalysis during the physical checks for protein, glucose, and blood — it screens for kidney disease and diabetes, not drugs. The DOT 5-panel drug test is a separate test ordered by your employer or C/TPA under 49 CFR Part 40.
180/110 or above (Stage 3) results in disqualification. Stage 1 (140–159/90–99) and Stage 2 (160–179/100–109) earn a 12-month certificate with a recommendation to treat. Get your BP under control before your exam if possible.
24 months for most drivers. Drivers with blood pressure Stage 1–2, insulin exemptions, or other monitored conditions may receive a 12-month, 3-month, or even shorter certificate depending on what the examiner determines is appropriate.
They are all the same exam — the FMCSA-required medical examination under 49 CFR Part 391. "DOT physical," "CDL physical," "DOT medical exam," "FMCSA physical," and "CDL medical exam" are used interchangeably. The result is the same: MCSA-5876, your Medical Examiner's Certificate.
No. The examiner must be listed on the FMCSA National Registry of Certified Medical Examiners. WorkOccMed works exclusively with FMCSA-certified examiners at 15,000+ sites nationwide.