Call: 718-701-5949

         718-205-9020

DOT Medical Examiner

DOT /CDL TRUCKER & TLC PHYSICALS, DRUG AND ALCOHOL TESTING


Call Us:  718-701-5949 /     

                718-939-9020

**The ​FMCSA Medical Examiner's Handbook defines a normal Exercise Tolerance Test (ETT) as:  

The ability to exceed 6 METS (beyond completion of Stage II, or 6 minutes) on a standard Bruce protocol without the presence of ischemic symptoms or signs, such as characteristic angina pain or 1mm ST depression or elevation in 2 or more leads or marked T wave abnormality.  There should be no inappropriate systolic blood pressure (SBP) and or heart rate responses ( SBP should rise 20mm or greater), with the ability to meet or exceed 85% of the age predicted maximal heart rate ( unless on Beta blockers), and no ventricular dysrhythmia.  


Please consult the FMCSA Medical Examiner's Handbook online for a comprehensive review of the cardiovascular and all other medical guidelines.

To book a DOT physical exam call 718-701-5949 or 718-939-9020.

Instructions to treating physician:  

Please review the FMCSA medical guidelines below for the medical condition(s) that apply to the driver .  If the driver meets these criteria and it is your opinion that he or she can operate a commercial vehicle safely, please respond accordingly on your letter head stating that all criteria for the particular diagnosis have been met.   Also, include with your letter any supporting documents such as diagnostic tests performed ( ETT, echocardiogram etc).  If more than one condition affects a driver and there is a waiting period for both conditions, the longer of the two waiting periods will apply (i.e.  driver with both PCI and MI, the 2 month waiting period for MI would apply instead of 1 week PCI).


Please note that the Medical Examiner is responsible for making the final determination  of driver status for the purpose of certification for commercial driving after considering the opinion of treating physician.

If the driver does not meet the guidelines and it is still your opinion that the driver is safe to operate a commercial vehicle, please identify the particular guidelines not met and state the reason why you feel the driver should continue to operate a commercial vehicle.  We will use our best discretion, keeping in mind public safety being paramount.  Feel free to contact us with any questions.



PPM (Permanent Pacemaker Insertion)

"Pacemaker"


  • Minimum 1 month post-pacemaker implantation if underlying disease is sinus node dysfunction or AV block
  • Minimum 3 month post-pacemaker implantation if underlying disease is Neurocardiogenic syncope or Hypersensitive carotid sinus with syncope.
  • Driver has a functioning pacemaker.
  • Driver has completed routine pacemaker checks.
  • No other underlying disease that could interfere with safe driving of a commercial motor vehicle.

Valvular heart Disease


  • Has no current diagnosis of CHD or CVD that exhibits syncope, dyspnea, collapse, or congestive heart disease that interferes with the safe operation of a CMV.
  • Is responding to medication and has been advised regarding safe use and side effects that may interfere with operation of a CMV.
  • Normal ETT.**
  • Has an LVEF equal to or greater than 40%
  • Generally, drivers classified as II, III, IV Class of New York Heart Association do not qualify for driving.
  • Pulmonary hypertension less than 50% of systemic systolic.
  • It is your recommendation is that he can safely operate a CMV.

Cardiovascular Medical Guidelines (Please refer to the FMCSA Cardiovascular Recommendation Tables for more information).


CABG (Coronary Artery Bypass graft)

"Cardiac Bypass"


  • Minimum waiting period of 3 months post CABG
  • Healed sternum.
  • LVEF greater than or equal to 40%.
  • Asymptomatic status with no angina
  • Tolerance to medications, no orthostatic symptoms.
  • Yearly exam and clearance by cardiologist.
  • Has no current diagnosis of CHD or CVD that exhibits syncope, dyspnea, collapse, or congestive heart disease that interferes with the safe operation of a commercial motor Vehicle (CMV).
  • The following is required yearly beginning 5 years post CABG:
  • Still with no current diagnosis of CHD or CVD that exhibits syncope,               dyspnea, collapse, or congestive heart disease that interferes with the safe operation of a CMV.
  • Is responding to medication and has been advised regarding use and side                    effects that may interfere with operation of a CMV
  •  Beginning 5 years post-surgery, he must have an satisfactory ETT yearly.** 
  •  Imaging stress test if indicated.
  •  Has an LVEF equal to or greater than 40%
  •  Your recommendation is that he can safely operate a CMV.


PCI (Percutaneous Coronary Intervention)

"Angioplasty/ stents"


  • Mandatory 1 week waiting period 
  • Is asymptomatic at examination.
  • Tolerates medications.
  • Has no injury to the vascular access site.
  • No incomplete healing or complication at vascular access site.
  • No Resting angina.
  • No Ischemic electrocardiogram (ECG) changes.
  • Following initial certification to drive, the driver should have a satisfactory ETT 3 to 6 months post-percutaneous coronary intervention and bring results to a 6-month follow-up examination.
  • Satisfactory ETT** 

Clearance from a cardiovascular specialist who understands the functions and demands of commercial driving.

Satisfactory ETT every two years**

If an ETT is inconclusive, an imaging stress test may be indicated.



Angina 

"Chest Pain"


  • Minimum of 3 months with no resting angina or change in angina pattern or decreased response to medication.
  • Has stable angina 
  • Is asymptomatic.
  • Tolerates medications.
  • Has a satisfactory ETT**

Evaluation and clearance from a cardiovascular specialist who understands the functions and demands of commercial driving.

Satisfactory ETT every two years.**

NOTE: If an ETT is inconclusive, an imaging stress test may be indicated.


MI (Myocardial Infarction)

"HEART ATTACK"


  • Minimum 2 month waiting period post MI
  • Is asymptomatic
  • Tolerates medications/cardiovascular therapy
  • Has a satisfactory ETT (post MI aprox.4-6 wks).**
  • LVEF greater than or equal to 40% 
  • No resting ECG ischemic changes
  • No Angina at rest, or change in angina pattern within 3 months of examination
  • Satisfactory ETT every 2 years.**

Clearance by cardiovascular specialist who understands the functions and demands of commercial driving such as load/unloading cargo, tarping trailers, inspecting brake lines and putting on tire chains.