DOT Physical
Posted: Wednesday, November 24, 2010
by John Laurusonis
Doctors Medical Center
Commercial drivers are required by 49CFR391.43 to have on their person at all times a valid medical certificate which is obtained by a standardized physical examination. This means when the D.O.T. the officer asks to see your license, he will want to see your medical certificate. If no disqualifying health problems are found on the examination, the certificate is good for two years. Some certificates are good for only three months or six months depending if there is a medical problem such as high blood pressure which needs regular follow-up. Some certificates require a waiver from a certifying agency if there are certain conditions which may or may not represent hazards to the safe operation of a commercial vehicle. An example would be if you had high tech lower leg prosthesis. It would be up to the waiver authority to decide if you could perform all the duties required of a commercial driver.
The second part of your exam is eye and vision testing. Your vision must be corrected to no more than 20/40 if you wear glasses, or 20/40 if you don't. Field of vision must be at least 70 degrees for each eye in the horizontal plane. You must be able to distinguish colors you will take a color vision test.
The next area of testing is your hearing. It can be tested by whether you can hear a forced whisper over 5 feet, or you might be tested with the headphone standard tone hearing exam or audiogram. This measures the exact sound frequency of hearing loss. A primary care physician will perform the exam may or may not have an audiometer.
The fourth area of testing is the blood pressure and pulse. If you have blood pressure less than 140/90, it is considered normal by the DOT. Blood pressure of 140 to 149/90 to 99, it is considered Stage I hypertension, and your medical certificate is good for one year. If it is 160 to 179/100 to 109, it is considered Stage II hypertension, you are given a certificate for three months at which time you must return to the doctor for recheck. If it has come down to less than or equal to 140/90, the certificate is good for one year. Blood pressure over 180/110 is considered to be disqualifying, and must be brought down to less than 140/90 for a six month certificate. When the diagnosis of hypertension is being considered it is a good idea to come in for several readings, and then average them to see the actual Stage. New medical criteria consider 135/85 the normal target in most medical patients. If you are above this you must see your doctor.
The next area of testing is the urinalysis. It looks for abnormalities such as protein, white cells, red cells, nitrates, ketones, urobilinogen, bilirubin or blood. Sugar if there might be some diabetes in the offing. As stated before, you will not be drug tested unless it is required and you should be aware of it.
The final part of your appointment is the actual physical exam itself. Your height and weight will be measured to see if you are obese or underweight. The physician will note your general appearance as to whether you look healthy. The physician will examine your head, eyes, ears, nose, throat, lungs, heart, and abdomen, look for hernias, palpate pulses to look for abnormal vascular pulses, examine the spine and extremities, and perform a neurological exam including reflexes, equilibrium and coordination. Always truthfully tell any problems or past medical history and place it on paper work before physician sees you i.e glass eye prosthetic or past appendicitis surgery. These findings will all be entered on your report.
The doctor must then consider all the rules of physical fitness, and decide whether to issue you a medical certificate and for how long. He may need to call the D.O.T. for clarification of some issues. The purpose of the exam is not to interfere with your career of driving, but to ensure that you are physically safe when you are out on the road driving.
John Drew Laurusonis M.D.
Doctors Medical Center
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