Medical Conditions or diseases

You will need to get letters from your doctor for:

1. Cardiovascular:  Angina (chest pain), Myocardial Infarction (MI or heart attack),    

    Percutaneous Coronary Intervention (PCI) or angioplasty with or without stents,

    Coronary Artery Bypass  Graft ( CABG), valvular heart disease, Permanent Pacemaker

    Placement (PPP).    

2. Endocrine:  diabetes mellitus.


3. Pulmonary: Sleep Apnea, Chronic obstructive pulmonary disease (COPD), 

4. Neurological:  Transient ischemic attack (TIA or "mimi-strokes), Cerebro-

     vascular accidents (stroke), Traumatic brain injury (TBI).

5.  Psychiatric:  Depresion, Anxiety disorder, Bipolar disease, Attention Deficit 

     Hyperactive Disesase

6.  Certain medications that you are taking:  prescribed opiods, muscle relaxants,

     anti-depressants, migraine and ADHD medications etc.


DOT Physical Examination Page

As discussed in the DOT CDL Physical examination page on this website, 49CFR part 391.41 and 391.43 ( provide the medical examination requirements for commercial drivers to detect physical and mental conditions that may affect their ability to operate a commercial motor vehicle.  

From FMCSA Medical Examiner's Handbook:  

"The general purpose of the history and physical examination is to detect the presence of physical, mental, or organic conditions of such character and extent as to affect the driver's ability to operate a CMV safely. This examination is for public safety determination and is considered by FMCSA to be a ―"medical fitness for duty" examination. "

What happens during the DOT physical?

Please note that the vast majority of drivers generally meet the standards and pass their DOT physical.  The purpose of this page and other pages on this web site that will go into more detail on specific guidelines and recommendations, is to list the most commonly seen medical conditions that will require an opinion letter from a treating physician.  We will need to review your doctor's opinion on your condition, or the safety of your medication as it relates to commercial driving, prior to making a final determination on certification.  

Also, keep in mind that other medical conditions not listed here may also affect certification, including those uncovered during the course of your physical examination.  Please consult the FMCSA Medical Guidelines for a complete listing of medical conditions or disease affecting the commercial driver.   

DOT Medical Examiner-DOT Physicals Commercial Driver CDL/DOT Medical Examinations and Physical Exams

For drivers with medical conditions or using medications

Effect on medical certification


Stop here if you have any of the medical conditions listed above, or diagnosed with other conditions, or currently taking prescribed or over the counter medications.  Please get a letter from your treating physician now before coming in for your DOT physical in order to save yourself time.  The medical guidelines that need to be addressed in the  letter can be found by clicking on the body system involved (i.e cardiovascular, endocrine, or neurological etc).  Have your doctor review the requirements and guidelines for your particular medical condition and Include any supporting diagnostic tests or lab work that may be required in their response letter to us.  Your treating doctor may also wish to consult the FMCSA Medical Examiner's Handbook for elaboration, or for further information  regarding any other medical conditions not covered here.  Have your doctor contact us with any questions.

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

Call: 718-701-5949


Call Us:  718-701-5949 /     


DOT Medical Examiner