Driver requirements
Updated October 22, 2026
A DOT physical is the medical exam federal rules require before you drive a commercial truck in interstate commerce. A medical examiner listed on FMCSA’s National Registry gives it.
If you pass, you are certified for up to 24 months. The examiner can certify you for less time to keep an eye on a condition, such as high blood pressure.
This guide is for drivers getting their first medical card or renewing one. It covers who gives the exam, what the rules check, how long the card lasts, and how the card ties to your CDL.
What Is a DOT Physical?
It is the physical exam behind your medical examiner’s certificate, the paper most drivers call the DOT medical card. Federal rules say you must be examined and certified if:
- You have never been certified before.
- You have not been certified in the past 24 months.
- An injury or illness has hurt your ability to do your job.
Only a medical examiner listed on the National Registry of Certified Medical Examiners can give the exam. FMCSA says that list can include medical doctors, doctors of osteopathy, physician assistants, advanced practice nurses, and chiropractors.
You can search the registry by city, state, or ZIP code on FMCSA’s National Registry site. An eye doctor may do the vision part of the exam.
DOT Physical Requirements
The standards are set in federal rule 49 CFR 391.41. Here is what they cover, in plain words.
Vision
- At least 20/40 in each eye, with or without glasses or contacts
- At least 20/40 with both eyes together
- A field of vision of at least 70 degrees to the side in each eye
- The ability to tell the red, green, and amber colors of traffic signals
A driver who misses the one-eye vision standard may still qualify under a separate rule, 49 CFR 391.44.
Hearing
You must hear a forced whisper at 5 feet or more in your better ear, with or without a hearing aid. The examiner may use a hearing test machine instead. Then the average loss in your better ear cannot be more than 40 decibels at the tested tones.
Blood pressure
The rule does not print a number. It says you may not have a current diagnosis of high blood pressure that is likely to get in the way of safe driving. FMCSA says the examiner can issue a shorter certificate to monitor it.
Other health conditions
The rule also looks at conditions that could affect control of a truck. These include:
- Heart disease that can cause fainting, shortness of breath, or collapse
- Breathing problems that could affect safe driving
- Epilepsy, or any condition likely to cause a loss of consciousness
- Diabetes treated with insulin, which has its own standard in 49 CFR 391.46
- Loss of a hand, arm, foot, or leg, or a limb problem that affects driving tasks
- Mental or nervous conditions likely to affect safe driving
Drugs and alcohol
You may not use a Schedule I drug, an amphetamine, a narcotic, or another habit-forming drug. Other controlled drugs are allowed only with a prescription from a licensed doctor who knows your history. That doctor must tell you the drug will not affect safe driving. The rule also bars a current diagnosis of alcoholism.
This is a summary of the rule, not medical advice. Your medical examiner makes the call on every standard.
Before Your Exam
A few steps make exam day go smoother:
- Pick a listed examiner. Check the National Registry first. An exam from someone not on it does not count.
- Bring what you drive with. The vision and hearing standards allow glasses, contacts, and hearing aids, so bring the ones you use on the road.
- Bring any FMCSA exemption or skill certificate. Some drivers qualify through an FMCSA exemption letter or a skill performance evaluation certificate. The rule says you must carry a copy when on duty.
- Ask about records. Call the examiner’s office and ask which medical records to bring for any condition you are treated for.
The examiner records the exam on FMCSA’s Medical Examination Report Form, MCSA-5875.
How Long Is a DOT Physical Good For?
The longest a certification lasts is 24 months. Some drivers get a shorter one. FMCSA lists these cases for a one-year card:
- High blood pressure that is stable on treatment
- Heart disease
- Drivers in FMCSA’s insulin or vision programs
- Any condition the examiner decides needs closer watching, such as diabetes or a sleep disorder
If the examiner needs more information before deciding, you have 45 days to get it to them. If the examiner finds you are not qualified, they must tell you, and the result is reported to FMCSA. Any earlier certificate you hold is then no longer valid.
Your Medical Card and CDL Self-Certification
When you get or renew a CDL, you tell your state which of four types of driving you do. This is called self-certification.
| Category | What it means | Medical card? |
|---|---|---|
| Non-excepted interstate | You drive, or will drive, across state lines, and federal driver rules apply to your work. | Yes |
| Excepted interstate | You drive across state lines, but only in work the federal rules exempt. | No federal card |
| Non-excepted intrastate | You drive only inside one state, under that state’s driver rules. | Set by your state |
| Excepted intrastate | You drive only inside one state, in work the state exempts. | Set by your state |
If you haul freight across state lines and no exception in the rules fits your work, you certify non-excepted interstate. That is the category that needs a current medical card on file with your state.
Hauling across state lines with a current card? Apply in a few minutes from your phone.
How your card gets to your state
Since June 23, 2025, the examiner sends your results to FMCSA. FMCSA then sends them to your state, which posts them on your driving record. That electronic record is the official proof of your medical status.
The rule no longer requires CDL drivers to carry the paper card. Keep a copy anyway. FMCSA advises examiners to keep handing out paper certificates while states finish the switch. The paper helps you sort out any mix-up with your state.
Since October 12, 2026, FMCSA says drivers licensed in every state and the District of Columbia except Alaska, and their carriers, can no longer rely on a paper copy as proof of medical certification. Alaska is the only state that has not made the switch. For Alaska-licensed drivers only, FMCSA renewed a temporary exemption from October 12, 2026 to October 12, 2027. It lets them and their carriers rely on a paper copy for up to 60 days after the certificate is issued. Check with your state licensing agency if your record does not show your new card.
The DOT Physical and Car Hauling Jobs
Carriers check your medical status as part of hiring. Here is what Accelerated asks for:
- A current DOT medical certificate
- The ability to pass a DOT physical, a drug screen, and a background check
- A valid Class A CDL, an acceptable MVR, and a clean safety history
- 3 years of CDL-A driving and 1 year of verifiable 9-car experience
When you apply, have your CDL, your DOT medical certificate, and proof you can work in the US ready. We run your MVR, so you do not need it in hand. See the full list on our car hauler jobs page.
Haul Cars With Accelerated
We hire drivers with 3 years of CDL-A driving and 1 year of verifiable 9-car experience. All of our contract drivers keep 82% of the truck’s gross, with GPS tracking and Electronic Proof of Delivery on every truck. See car hauler jobs at Accelerated, or start your application now.
The application takes a few minutes from your phone.
DOT Physical FAQs
How long is a DOT physical good for?
Up to 24 months. The examiner can certify you for less time to watch a condition. FMCSA lists a one-year card for cases such as high blood pressure that is stable on treatment and heart disease.
What blood pressure do you need to pass a DOT physical?
The federal rule does not set a number. It says you may not have a current diagnosis of high blood pressure likely to get in the way of safe driving. The examiner decides, and may give you a shorter card to monitor it.
Can my own doctor do my DOT physical?
Only if your doctor is listed on FMCSA’s National Registry of Certified Medical Examiners. Search the registry by city, state, or ZIP code before you book.
What happens if I fail my DOT physical?
The examiner must tell you that you are not qualified, and the result is reported to FMCSA. Any earlier certificate you hold is no longer valid. If the examiner only needs more information, you have 45 days to provide it.
What does non-excepted interstate mean?
It is the CDL self-certification for drivers who drive across state lines and fall under the federal driver rules. Drivers in this category must keep a current medical certificate on file with their state.
Do I have to carry my DOT medical card?
Not if you hold a CDL. Since June 23, 2025, CDL drivers with a current certificate do not have to carry it. The result is sent to their state electronically. Keep a paper copy anyway while states finish the switch.
Sources
Last checked October 22, 2026. Federal rules change. Confirm the current rules with FMCSA or the eCFR before you rely on them. This guide is a plain-language summary, not medical or legal advice.
- 49 CFR 391.41, physical qualifications for drivers
- 49 CFR 391.43, medical examination and certificate
- 49 CFR 391.45, who must be examined and certified
- 49 CFR 383.71, CDL self-certification and medical certification
- FMCSA, DOT Medical Exam and Commercial Motor Vehicle Certification
- FMCSA, How long is my medical certificate valid?
- FMCSA National Registry, NRII Learning Center