DOT physical requirements
The standards are federal, so they're the same in every state. Here's each requirement in plain English — and what happens when a reading is out of range, because most of the time the answer is a shorter card, not a failed exam.
The core standards
- Vision: at least 20/40 in each eye and both together — glasses or contacts count — plus a 70° field of vision to each side. Drivers who can't meet it in one eye may qualify under FMCSA's alternative vision standard.
- Hearing: hear a forced whisper from 5 feet in at least one ear, or pass an audiometry test. Hearing aids count.
- Blood pressure: the full table is below — it decides how long your card lasts more often than whether you pass.
- Urinalysis: checks protein, blood, and sugar in your urine for signs of underlying conditions. It is not a drug test — more on that here.
- Physical exam and history: heart, lungs, spine, neurological function, plus your medication list and health history.
Blood pressure chart
High blood pressure is the single most common issue at DOT physicals. The examiner's guidance works like this:
| Your reading | What it means |
|---|---|
| Below 140 / 90 | Pass — full certificate (up to 2 years) |
| 140–159 / 90–99 | Pass — 1-year certificate |
| 160–179 / 100–109 | One-time 3-month certificate to get treatment going |
| 180 / 110 or higher | Not certified until your pressure is brought down |
Examiner guidance based on FMCSA medical standards; the examiner makes the final call.
If your pressure runs high: take your medication as usual that morning, skip caffeine and nicotine right before the exam, and if the first reading is borderline, ask the examiner to re-check after you've sat quietly for a few minutes — that's allowed and routine.
Conditions that need paperwork, not panic
- Diabetes: managed with diet or pills — certify as normal. Insulin-treated — bring FMCSA's assessment form completed by your treating clinician; certificates typically run up to 12 months.
- Sleep apnea: a diagnosis doesn't disqualify you. Bring your CPAP compliance report showing regular use.
- Heart conditions: after events like a heart attack or surgery, certification usually needs a waiting period and a cardiologist's clearance.
- Medications: most are fine. Expect questions about anything sedating, and note that marijuana is federally disqualifying regardless of state law.
Frequently asked
- What blood pressure do I need to pass a DOT physical?
- Under 140/90 gets you a full two-year certificate. Readings of 140–159 over 90–99 typically mean a one-year card, 160–179 over 100–109 a one-time three-month card to get treatment started, and 180/110 or higher means you must bring it down before you can be certified.
- Can I pass a DOT physical with diabetes?
- Yes. Drivers managing diabetes with diet or oral medication can be certified normally. Insulin-treated drivers can also be certified — your treating clinician completes an FMCSA assessment form (ITDM process), and certificates are typically issued for up to 12 months.
- Can I wear glasses or hearing aids at the exam?
- Yes. The vision and hearing standards can be met with correction — glasses, contacts, or hearing aids all count. Just bring them to the exam.
- What medical conditions disqualify you from a DOT physical?
- Very few are automatic. Unmanaged epilepsy, current use of Schedule I drugs (including marijuana, regardless of state law), and severe uncontrolled conditions are the main ones. Most everything else — high blood pressure, diabetes, sleep apnea — is certifiable once it is managed and documented.