DOT Physical and Medical Card
What the DOT physical checks, who can do it, how long your medical card lasts and what changed in 2025, with the federal rule for each.
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What does a DOT physical check?
A medical examiner checks you against the federal standards. These are the main ones.
| Check | To pass |
|---|---|
| Vision | 20/40 in each eye and both together, with glasses or contacts if you need them; 70° of side vision in each eye; tell red, green and amber apart |
| Hearing | Hear a forced whisper at 5 feet with your better ear, or lose no more than 40 dB on average in a hearing test, hearing aid allowed |
| Heart and blood pressure | No heart condition likely to cause fainting, breathlessness or collapse, and no high blood pressure likely to affect your driving |
| Diabetes | Insulin-treated diabetes is allowed when the clinician who treats it fills in FMCSA’s assessment form |
| Seizures | No epilepsy, or other condition likely to make you lose consciousness or control |
| Drugs and alcohol | No Schedule I drugs; other controlled drugs only as prescribed, by someone who knows your history and says they won’t affect your driving; no current alcoholism |
| Arms and legs | No missing foot, leg, hand or arm, and no limb problem that gets in the way of driving, unless FMCSA grants a skill performance evaluation certificate |
49 CFR 391.41(b) and 391.46.
Who can do my DOT physical?
A medical examiner listed on FMCSA’s National Registry of Certified Medical Examiners. Your own doctor can do it only if they’re on the Registry. An ophthalmologist or optometrist may do the vision part.
49 CFR 391.43(a) and (b).
How long is a DOT medical card good for?
Up to 24 months. The examiner can certify you for less.
With insulin-treated diabetes, or under the alternative vision standard, you need an exam at least once a year.
49 CFR 391.45(b), 391.44(c) and 391.46(c).
Do I need to carry my medical card?
Not with a CDL or a permit, since June 23, 2025. The examiner sends your result to FMCSA by midnight the next day, and FMCSA sends it to your state for your driving record. You no longer carry the certificate or take it to your state.
If you drive under an FMCSA exemption or a skill performance evaluation certificate, keep that with you.
49 CFR 391.41(a)(2), 391.43(g) and 383.71(h).
What if I fail the DOT physical?
The examiner tells you and reports it to FMCSA, and any medical certificate you had stops being valid. If the examiner needs more information first, you have 45 days to provide it.
For some conditions FMCSA can grant an exemption, and for a missing or impaired limb, a skill performance evaluation certificate.
49 CFR 391.43(g)(3) and (4), and 391.49.
Which medical self-certification do I choose?
When you apply for a permit or CDL you tell your state which kind of driving you’ll do. Only non-excepted interstate drivers need the federal medical card; the intrastate kinds follow your state’s rules.
| Kind | What it means |
|---|---|
| Non-excepted interstate | You drive across state lines, or on a trip that crosses them, and need a medical card |
| Excepted interstate | You drive across state lines, but only in work the medical rules exempt |
| Non-excepted intrastate | You drive in one state only, under its rules |
| Excepted intrastate | You drive in one state only, in work its rules exempt |
49 CFR 383.71(b)(1).
Is there a drug test?
It’s separate from the physical. Before you first drive for an employer, they must have a negative drug test result from you and check the Drug and Alcohol Clearinghouse.
49 CFR 382.301(a) and 382.701(a).
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