Requirements for Passing the DOT Physical

Passing a DOT physical every 1-2 years is a requirement for any commercial driver. It’s important to make sure that drivers who haul hazardous materials, drive heavy vehicles, and transport large numbers of passengers are fit for the job and can do it safely, without posing a hazard to themselves or other drivers on the road.

There are a number of physical requirements that must be met, including vision, hearing, blood pressure, and overall health.

Requirements for Passing the DOT Physical


In order to pass the vision test, drivers must have 20/40 vision in each eye (with or without corrective lenses); peripheral vision of at least 70 degrees; and the ability to distinguish between red, green, and amber/yellow.


In order to pass the hearing test, drivers must be able to hear a “harsh whisper” from five feet away, with or without a hearing aid. With the driver’s ear turned toward the medical examiner and the other ear covered, the examiner will whisper words or random numbers. If the driver fails the whisper test, the examiner will administer an audiometric test.  

Blood Pressure

To pass the requirement for blood pressure without conditions, the driver’s reading needs to be 140/90 or below. If their blood pressure is higher than this, they will need to be re-assessed more frequently, and/or take measures to reduce their blood pressure to the passable range. If their blood pressure is too high — above 180/110 — the driver will not pass the DOT Physical. 


Drivers will need to submit a urine sample for analysis. (This is not a drug test, although some employers will request to have a drug screen done during the DOT physical.) The urine will be analyzed for levels of glucose, protein, or blood. The presence of any of these could indicate untreated medical conditions. In these cases, further testing may be required to rule out serious underlying disease before the driver is able to pass the DOT physical.

Physical Exam

The medical examiner will review the driver’s medical history and any ongoing treatment. They will conduct a physical examination that includes an assessment of the eyes, ears, mouth, skin, heart, spine, abdomen, and chest. They’ll check for hernias, muscle weakness, vascular abnormalities, and neurological issues.

Possible Reasons for Failing the DOT Physical

Any condition that interferes with the safe operation of a commercial vehicle is cause for failing the DOT physical. This can include sleep apnea, hernias, high blood pressure, and diabetes, if these conditions are left untreated. Being diagnosed with any of the following can also prevent passing the DOT physical:

  • Cardiovascular or respiratory disease
  • A nervous or psychiatric disease
  • Poor eyesight or hearing (that isn’t improved by corrective devices)
  • A missing appendage (leg, arm, foot, or hand)
  • Epilepsy
  • Alcoholism or drug use

The majority of the DOT physical is cut-and-dry. However, some aspects are subjective and could be interpreted differently by a different doctor. Additionally, some medical examiners could be behind on the current guidelines and may fail someone based on outdated information. If this is the case, drivers should not panic, but instead be clear on next steps they should take.

What Happens if a Driver Fails the DOT Physical

If a driver fails the DOT physical, it is important for them to understand why. They should ask the examiner to explain the issues that caused them to fail and recommendations on how to address these issues. This can help the driver to pass the exam in the future.

The driver may also qualify for a driver exemption program if they failed due to certain disabilities that can be corrected or managed. 

According to the Federal Motor Carrier Safety Administration (FMCSA), the agency that regulates DOT exams, drivers are allowed to get a second opinion if they fail their DOT physical. Since 2016, drivers are not allowed to “doctor shop” until they find an examiner willing to pass them. Only one second exam is allowed.

In getting a second exam, it’s important that the driver discloses all information about their health and medical history accurately. Since medical examiners are required to report each DOT physical to the FMCSA, the agency will be able to see how many doctors a driver has visited and the information provided to them. If a driver has attempted to see multiple doctors, or inconsistencies are discovered in the information provided, the driver will not receive a valid medical card. If they have already received their medical card, it will be revoked, the driver will lose their career, and they could be prosecuted.

Find a Trusted Certified Medical Examiner for Your DOT Physicals

As the leader in occupational medicine in Hampton Roads, I & O Medical Centers conducts DOT physicals every day. Our doctors remain up-to-date on the latest FMCSA standards and recommendations. Whether you are a driver seeking a second opinion, or you’re an employer searching for a trusted partner for all your workforce health needs, we are glad to provide our services at four convenient locations across Hampton Roads