What Can Cause a Failed DOT Physical Exam?

By Alana Smart / December 21, 2021 / Blog ,

What Can Cause a Failed DOT Physical Exam?

Anyone applying for or holding a Commercial Driver’s License (CDL) is required to undergo periodic DOT physical examinations. In order for a license to be issued or renewed a certified provider needs to ensure that drivers meet the Department of Transportation regulations. Typically, these exam results are valid for up to two years but based on the results of the exam one-year certifications, and month designations can be given.


Why would a driver fail a DOT Exam?


The driver is an insulin-dependent diabetic

Drivers with diabetes who require insulin for management may fail a DOT Physical. The Federal Motor Carrier Safety Administration (FMCSA) does offer a diabetic waiver application. The waiver requires that the individual’s Treating Clinician attests that the individual has a stable insulin regimen and properly controlled diabetes. This form must be presented to the medical examiner within 45 days of completion by the Treating Clinician.


The driver has hypertension

While the examining provider may use their own discretion, per the FMCSA guidelines, a normal blood pressure is less than 120/80. When a drivers’ blood pressure exceeds 120-129/<80 it enters hypertensive blood pressure stages.

  • Stage 1 is 130 to 139 systolic or 80 to 89 diastolic pressure. A Stage 1 blood pressure reading may limit certification to one year.
  • Stage 2 is 140 or higher systolic or 90 or higher diastolic pressure. A Stage 2 reading may result in a three-month certification. If blood pressure goes below 140/90 within that time and is maintained, a driver may receive certification for one year.
  • A stage 3 is considered hypertensive crisis. Stage 3 is a higher than 180 systolic and/or higher than 120 diastolic pressures. It is a disqualifying medical condition and requires immediate medical attention.


The driver has poor eyesight

The FMCSA has a visual acuity standard for 20/40 with or without corrective lenses. Drivers should always have corrective lenses with them at the time of their examination. For those who are unable to demonstrate the appropriate visual acuity, there is a vision exemption application available.


The driver has hearing loss

The DOT physical exam has two possible hearing tests. If the driver passes the first, a whisper test, then the second test is not necessary. However, if the driver is not able to hear a forced whisper in either ear at a five-foot distance, an audiogram is required. Passing the audiogram may allow certification. If the driver cannot pass both tests their hearing loss is considered a disqualifying medical condition.


The driver has a cardiac condition

Certain heart conditions can be disqualifying until they are resolved or clearance from a cardiac specialist is obtained. Examples of these heart conditions are:

  • Heart attack
  • Blood clots (Thrombosis)
  • Congestive heart failure
  • Irregular heartbeat (Arrhythmias)


The driver has active epilepsy or seizure disorders.

Drivers with a history of seizures within the past ten years will not be allowed to obtain a Commercial Driver’s License. Drivers with documentation stating that their seizures are well controlled may be able to submit a seizure exemption application to the FMCSA.


The driver has narcolepsy

Narcolepsy is a neurological disorder characterized by fatigue, excessive daytime sleepiness and sudden attacks of sleep. It is a disqualifying diagnosis, regardless of treatment due to likelihood of daytime sleepiness and sudden muscle weakness.


The driver tests positive for marijuana use

Drivers are held to a federal standard. Even if medical marijuana is prescribed, marijuana exemptions are not accepted by the FMCSA.


Medical follow-up

In some cases, such as those involving elevated blood pressure or exemption waivers, drivers will need to return to provide documentation to the medical examiner. Upon reviewing any additional results or changes it is up to the medical examiner’s discretion whether or not certification can be issued or updated. Medical examiners cannot approve a waiver. Waivers for exemptions for certain medical conditions must be issued directly by the FMCSA.


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