Do Truck Drivers Have to Pass a Medical Exam?

Do Semi Drivers Have to Pass a Medical Exam?

Yes, they do. And many big rig truck drivers have medical conditions that may impact their ability to drive.

One reason for this is the fact that commercial truck drivers who have at least three health issues can have up to four times the risk of a road accident than healthier drivers, according to a study from the University of Utah School of Medicine. Tractor-trailer drivers with a number of health issues—commonly obesity, diabetes, heart disease, and high blood pressure—are more likely to be involved in a crash than those truckers with only a single condition or those who are in good health.

A big factor in the problem with semi drivers staying healthy is the fact that they’re usually sitting for extended periods of time behind the wheel, they don’t get enough quality sleep, and truck stops and greasy spoons are known for health-conscious menus.

Because of the rigors of this physically and mentally demanding job, and an environment that isn’t conducive to a healthy lifestyle, the U.S. Department of Transportation (DOT) requires regular physical examinations to ensure drivers maintain a certain level of fitness. There are many rules that truck drivers must follow; having a knowledgeable Atlanta truck accident lawyer explain those rules is crucial to winning any truck accident case.

What Type of Physical Exam is Required?

A DOT physical examination must be performed by a licensed “medical examiner”—a doctor of medicine (MD), doctor of osteopathy (DO), physician assistant (PA), advanced practice nurse (APN), or a doctor of chiropractic (DC) who’s listed on the Federal Motor Carrier Safety Administration (FMCSA) National Registry.

A semi driver’s DOT physical exam is good for up to 24 months. However, the medical examiner may also issue a certificate for less than two years if the driver has a condition that requires monitoring, like high blood pressure.

At a DOT exam, the truck driver must fill out a personal health history. If the semi driver falsifies any personal information, or withhold information, it may invalidate his or her certification and be used as evidence of negligence in a trucking accident.

Are There Any Disqualifying Medical Conditions?

Yes. FMCSA regulations state that a medical examiner may not certify a driver who has a DOT disqualifying medical condition or uses a medication/substance that compromises his or her ability to drive safely.

The Department of Transportation disqualifying medical conditions include those that may lead to loss of consciousness or involve poor hearing or vision, a compromised nervous system, or physical limitations that interfere with his or her driving ability.

Drivers who can remedy a DOT disqualifying medical condition can ask for re-certification.

The list of DOT disqualifying medical conditions is too long to list here, but the most common conditions that can disqualify a truck drive include the following:

  • Some Heart Conditions. There are certain heart conditions that will disqualify a driver until they’re resolved. They include a current clinical diagnosis of heart attack, chest pain or discomfort due to heart disease (angina pectoris), reduced blood flow through one or more coronary arteries (coronary insufficiency), or the risk of forming a blood clot (thrombosis). To be reinstated, this usually requires the additional step of obtaining medical clearance from a cardiologist. The FMCSA regulations state the fact that a driver is taking nitroglycerine for angina isn’t by itself medically disqualifying if the driver’s angina is stable.
  • Epilepsy (and other conditions that can cause loss of consciousness). FMCSA rules prohibit anyone with epilepsy or another seizure disorder from operating a commercial vehicle in interstate commerce. However, a driver who can show that their seizures are under control may be able to submit an application to the FMCSA for a seizure exemption.
  • Inner Ear Diseases, Disorders that Cause Vertigo (Spinning/Dizziness) or Other Balance Issues. An inner ear issue, such as Meniere’s disease is a DOT disqualifying medical condition. For example, Meniere’s disease is unpredictable, and it can be brought on by overwork, fatigue, smoking, and too much salt in the diet—all present in a truck driver’s work. Moreover, some prescription medications for vertigo also may be disqualifying if the medical examiner finds that there are possible sleep-inducing effects that may compromise safety. Some drivers with certain balance disorders van seek re-certification after being symptom-free for a period of time.
  • Vision Loss. Any driver who isn’t at least 20/40 vision in each eye and both eyes together (with or without corrective lenses) is disqualified. But for a vision exemption, a driver must be able to meet peripheral vision requirements and also able to recognize the colors of traffic signals and devices showing the standard colors.
  • Hearing Loss. A driver with hearing loss can take a “forced whisper” test, and if he or she passes this, a follow-up audiometry test isn’t required. If a semi driver fails both of these tests, his or her hearing loss is a DOT disqualifying medical condition.
  • Marijuana Use. Despite the fact that a licensed doctor has prescribed or recommended marijuana, its use is a DOT disqualifying medical condition. This includes smoking or consuming marijuana, CBD oil, or the use of any product or preparation derived from hemp or cannabis. Further, even though marijuana is legal in many states, the federal Drug Enforcement Agency (DEA) prohibits the use of Schedule I substances, which include marijuana, as well as illegal substances like LSD, heroin, and ecstasy (MDMA).

With some of these conditions, such as vision and seizure, a driver may apply for an exemption.

Is There Any Gray Area?

Yes. There are some medical conditions that are left to the medical examiner’s discretion. Here are a few of the more common conditions:

  • Truck drivers with insulin-treated diabetes don’t need to apply for an exemption to obtain DOT certification. The medical examiner will review the driver’s glucose level information and, if everything looks okay, will certify the driver for up to one year (rather than the standard two years).
  • High Blood Pressure. Although the FMCSA medical examiners are given guidelines, they can use their discretion in deciding whether to grant certification.
  • Respiratory Conditions. Some respiratory diseases may be DOT disqualifying medical conditions, especially where the driver requires oxygen therapy because of the risk of an oxygen equipment malfunction or explosion.

A tractor-trailer driver may be able to obtain a waiver or exemption for a DOT disqualifying medical conditions, but a driver’s medical condition and behavior may be contributing cause in an accident.

Medical Conditions Lead to Accidents

Again, studies show that 18-wheeler drivers who have at least three health issues can be as much as quadruple the crash risk of healthier drivers. The University of Utah study is the first to look at multiple conditions in the same subject.

Researchers reviewed nearly 38,000 drivers’ medical and crash records. They found that those with three or more ailments had a crash frequency of 93 incidents per million miles compared to only 29 per million miles for all drivers.

If a truck driver has one condition—no matter the type—it increases his or her risk of an accident. However, the research showed that when a driver suffers from three or four, it’s much worse. The director of the study commented that “People with four conditions, shouldn’t even be driving.”

The cost of truck accidents is high. FMCSA statistics show that roughly 60,000 truck crashes were reported to law enforcement in the past five years with an average cost per crash of between $331,000 and $533,000. Plus, the average cost per accident involving a fatality was between $7.2 million and $11.7 million.


Semi drivers must pass a physical examination, and those with disqualifying conditions should not be on the road. In some cases, a driver’s medical condition is ignored or isn’t monitored by his or her employer, the trucking company, and this may be a factor in a serious accident.  Hiring a knowledgeable Atlanta truck accident lawyer Atlanta residents trust and turn to can make the difference in any case.

If you or a loved one has been injured in a semi accident, you should work with an experienced Atlanta truck accident attorney like those of Tobin Injury Law. We understand state and federal commercial carrier laws and have represented hundreds of auto drivers and motorcyclists who have been hurt because of the negligence of a truck driver. We will investigate the driver’s condition to determine if he or she had a serious health issue that contributed to your accident.

Before you speak with a claims adjuster from an insurance company, contact an experienced Atlanta personal injury lawyer at Tobin Injury Law.