DOT physical exams, NRCME-certified.
Every CDL driver needs a current medical certificate (MCSA-5876) to perform safety-sensitive duty — 49 CFR 391.41. $129 at member prices with a National Registry of Certified Medical Examiners (NRCME) examiner in our network. The cert is valid up to 24 months, and the examiner reports the result to the FMCSA National Registry.
Members: schedule in the member portal · Hiring? See the hire workflow →
- NRCME-listed certified medical examiner — the only credential FMCSA recognizes
- Full 49 CFR 391.43 exam: vision, hearing, BP, urinalysis, cardiovascular, neurological
- Medical Examination Report Form (MCSA-5875) completed at the visit
- Medical Examiner's Certificate (MCSA-5876) issued when you qualify
- Result reported to the FMCSA National Registry by the examiner
- Keep your copy for state DMV self-certification
Three categories. One exam.
49 CFR 391.43 specifies exactly what the medical examiner evaluates. The exam takes 30–45 minutes for a healthy driver — longer if specialty records are reviewed for a qualifiable condition like sleep apnea or controlled diabetes.
Vision & hearing
Vision: at least 20/40 acuity in each eye, with or without correction; 70-degree peripheral; ability to recognize standard traffic signal colors. Hearing: ability to perceive a forced whisper at 5 feet, with or without hearing aid. 49 CFR 391.41(b)(10–11).
Cardiovascular & BP
Blood pressure, pulse, heart sounds, peripheral circulation. BP up to 140/90 qualifies for a 24-month cert; 140/90–159/99 typically gets a 12-month; 160/100–179/109 gets 3 months while it's brought under control. 49 CFR 391.41(b)(6) + FMCSA Medical Advisory Criteria.
Med history & neurological
Medication list reviewed against disqualifying-substance criteria. Urinalysis screens sugar, protein, and blood. Neurological exam covers reflexes, balance, mental status. Sleep apnea, diabetes, and cardiac history qualifiable with documented compliance. 49 CFR 391.41(b)(1–9).
Schedule. Exam. Card in hand.
A driver who qualifies leaves the visit with the medical certificate. Three steps from the moment of order to the National Registry record.
Routed to NRCME examiner
Order through the portal. We match you with an NRCME-listed examiner near your ZIP. You bring photo ID, your current medication list and any specialty records.
30–45 minute exam
Examiner runs the full 391.43 protocol — vision, hearing, BP, urinalysis, full body. Driver fills out the medical history portion of MCSA-5875 in the waiting room. Medication list and any specialty records reviewed at the visit.
MCSA-5876 issued + National Registry filed
Pass the exam and leave with the medical certificate. The examiner reports the result to the FMCSA National Registry. Keep your copy for state DMV self-certification.
Most drivers get the full 24. Some don't.
A short cert isn't a fail — it's the examiner saying "qualified, but with documented compliance." These are the four common situations. Bring the right paperwork up front and the cert length is usually as long as it can legally be.
Hypertension
BP up to 140/90 → 24 months. Up to 159/99 → 12 months. Up to 179/109 → 3 months while controlled. Bring your home BP log if recently started or adjusted on meds.
Sleep apnea
Diagnosed sleep apnea is qualifiable with a current CPAP compliance report (≥4 hours/night ≥70% of nights). Cert renews annually with the next compliance report. Bring the printout.
Insulin-treated diabetes
Insulin-treated diabetes has been qualifiable since 2018 with the FMCSA Insulin Exemption. Need recent A1C (under 10), blood-glucose log, and an ophthalmology evaluation within 12 months.
Stable conditions
Controlled hypertension, well-managed cholesterol, fully recovered from an isolated cardiac event with cardiologist clearance — all qualify for the full 24-month cert when documentation is current.
The fastest path to a 24-month cert is bringing the right paperwork on day one — sleep study + CPAP compliance for apnea, A1C + glucose log + eye exam for diabetes, BP log for new-on-meds hypertension.
How much does a DOT physical exam cost?
The member price is $129 for the full exam and certificate. Specialty referrals (sleep studies, cardiac exams, lab work), when a condition needs documentation, are billed by the facility that does them; we help coordinate the referral.
Carriers: the annual consortium membership is $85/year for the first driver and $25/year for each additional driver, or $295/year for unlimited drivers. It includes the drug and alcohol testing program and DQF Pro, which reminds you before medical cards lapse.
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Frequently Asked Questions
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How often do I need a DOT physical?
The standard DOT medical certificate is valid for up to 24 months. Certain conditions — controlled high blood pressure, sleep apnea on CPAP, insulin-treated diabetes — typically result in a shorter cert (3, 6, or 12 months) with documented compliance required at renewal. The medical examiner determines cert length based on 49 CFR 391.41 qualification standards.
What should I bring to my DOT physical appointment?
Valid photo ID, current eyeglasses or contacts, hearing aids if used, complete medication list with dosages, and any specialty records that affect qualification — sleep study + CPAP compliance report (if applicable), recent A1C and blood glucose log (if diabetic), cardiac stress test or echo (if you have a cardiac history). Bringing the records up front prevents a return visit.
Can I choose my own DOT physical location?
Yes. Every examiner in our network is listed on the FMCSA National Registry of Certified Medical Examiners (NRCME) — the only credential that makes a physical valid for DOT purposes. We route you by ZIP to the nearest NRCME-listed examiner. You can also search the National Registry yourself at nationalregistry.fmcsa.dot.gov if you prefer a specific clinic.
What conditions disqualify a CDL driver?
Per 49 CFR 391.41(b), absolute disqualifiers include uncorrected vision worse than 20/40, current alcoholism, current drug use including marijuana even where state-legal, and any condition that interferes with safe driving. Many conditions that look disqualifying on paper — diabetes, sleep apnea, hypertension, cardiac history — are qualifiable with documented treatment compliance and may receive shorter certs (3–12 months) instead of the full 24.
Can I drive while waiting for my new medical cert?
No. The cert must be in hand before any safety-sensitive duty after your prior cert expires — driving on an expired med card is a violation under 49 CFR 391.41(a). Schedule the physical at least 30 days before expiration. A driver who qualifies receives the MCSA-5876 from the examiner, and the examiner reports the result to the FMCSA National Registry.
Do I need to file the medical certificate with my state DMV?
Yes — most states require CDL holders to self-certify and submit the medical certificate (MCSA-5876) to the state licensing agency within a state-specific window (often 10–15 days). The examiner reports the result to the FMCSA National Registry; the DMV submission is a separate driver responsibility. Keep your copy of the MCSA-5876 for that submission.
Med card up for renewal? Book it now.
30 days out is the right window — it gives you room to handle any specialty referral without an expired-cert gap. Members' DQF Pro reminds them before medical cards lapse.