Every interstate CDL holder in the United States must hold a current Medical Examiner's Certificate, commonly called a "DOT medical card" or "DOT physical card." The card certifies that you've passed a federally standardized physical exam administered by a Certified Medical Examiner listed on the FMCSA National Registry, and that you're physically and mentally fit to operate a commercial motor vehicle.
What the DOT physical covers
The exam itself takes 20 to 40 minutes and covers vision (20/40 in each eye, with or without correction; horizontal field of vision of at least 70 degrees), hearing (forced whisper at 5 feet or audiometric test ≤ 40 dB average loss), blood pressure (must be under 140/90 for a full 24-month card), urinalysis (sugar, protein, blood, specific gravity), a review of your past medical history, and a hands-on cardiopulmonary, neurological, and musculoskeletal exam.
How long the card is valid
A standard card is valid for 24 months. If your blood pressure is between 140/90 and 159/99, you'll get a 12-month conditional card. Insulin-treated diabetes, certain cardiovascular conditions, and sleep apnea on CPAP can each result in a 12-month or shorter cycle even when otherwise well-controlled. Track your renewal date — driving with an expired card is a federal violation that gets you placed out-of-service immediately.
Common disqualifications and waivers
Conditions that automatically disqualify you include uncorrected diabetes mellitus requiring insulin (waivable through the FMCSA Diabetes Exemption Program), epilepsy (rarely waivable), severe vision loss in one eye (waivable through the Vision Exemption Program), and any current substance abuse diagnosis. Many other conditions — high blood pressure, sleep apnea, controlled diabetes — only require ongoing monitoring rather than disqualification.
Cost and where to get one
A DOT physical typically costs $80 to $150 out of pocket. Some carriers reimburse the cost as part of orientation. Use the FMCSA National Registry of Certified Medical Examiners to find a certified provider near you — anyone not on the registry cannot legally issue a CDL medical card. Read our related vision, blood pressure, and sleep apnea guides for the details.