What Is the Long Form DOT Physical Examination?

A long form DOT physical is the medical examination commercial motor vehicle drivers must pass to be certified fit to drive, documented on Form MCSA-5875, the multi-page Medical Examination Report that a certified examiner completes.¹ The “long form” nickname comes from the form itself, which runs through a detailed health history and the examiner’s clinical findings. If you qualify, you leave the appointment with a separate one-page Medical Examiner’s Certificate (Form MCSA-5876), commonly called a medical card, which is what proves your qualification to drive.²

There is no shorter version. MCSA-5875 is the only medical examination report the FMCSA accepts.³

Who Has to Take One

Federal rules define commercial motor vehicles broadly, so this requirement reaches well beyond tractor-trailer drivers. You need the exam if you operate any vehicle that meets one of these criteria:⁴

Gross vehicle weight rating or gross combination weight rating of 10,001 pounds or more.
Designed or used to carry nine or more people, including the driver, for compensation.
Designed or used to carry 16 or more people, including the driver, without compensation.
Hauls hazardous materials in quantities that require placarding.

The 10,001-pound line catches many box trucks and delivery vehicles drivers don’t think of as commercial. If your vehicle fits any single category, the qualification standards apply to you.

What the Exam Tests

The DOT physical is narrower than a general checkup. The examiner is looking for anything that could cause you to lose control of a vehicle: sudden loss of consciousness, impaired vision, cardiovascular events, or physical limits that prevent safe operation.

Vision

You need at least 20/40 distant visual acuity in each eye, corrected or uncorrected, a horizontal field of at least 70 degrees in each eye, and the ability to recognize red, green, and amber traffic signals.⁵⁶⁷

Hearing

You must be able to hear a forced whisper at five feet in your better ear, or pass an audiometric test showing average hearing loss in the better ear of no more than 40 decibels at 500, 1,000, and 2,000 Hz. Hearing aids are permitted for both tests.⁵

Blood Pressure

Blood pressure trips up more drivers than any other part of the exam, and it decides how long your certificate lasts. FMCSA medical advisory criteria set the tiers:⁸

Below 140/90: full two-year certification.
Stage 1 (140–159 / 90–99): one-year certification, renewed at one-year intervals as long as readings stay at or below 140/90.
Stage 2 (160–179 / 100–109): one-time three-month certificate to start or adjust treatment; if you drop to 140/90 or below within those three months, a one-year certificate follows.
Stage 3 (180/110 or higher): disqualified until blood pressure comes down to 140/90 or below, then certification runs in six-month intervals.⁹

A reading of 141/91 versus 139/89 is the difference between a one-year and a two-year card, which is why exam-day preparation matters.

Urinalysis

A urine sample screens for underlying issues like diabetes or kidney disease. This is not the DOT drug test, which is a separate process. Glucose or protein in the sample can trigger follow-up questions and additional testing before you can be certified.

General Physical Assessment

The examiner evaluates neurological function, heart and lungs, abdomen, spine, musculoskeletal system, and your ability to grip, reach, and move normally, looking for anything that would impair steering, braking, shifting, or reaction to road hazards.⁵

Conditions That Can Disqualify You

Some conditions are firm barriers to certification unless you qualify under an alternative standard or hold an FMCSA exemption:⁵

Epilepsy or any seizure disorder likely to cause loss of consciousness. Interstate drivers can apply for a seizure exemption, but the FMCSA takes up to 180 days to decide.¹⁰
Hearing loss beyond the standard, which can be addressed through a hearing exemption.¹⁰
Current cardiovascular disease with fainting, shortness of breath, collapse, or heart failure.
Loss of a hand, arm, foot, or leg, or an impairment affecting the ability to operate vehicle controls. These drivers need a Skill Performance Evaluation certificate, which requires on-road and off-road driving tests.¹¹

Insulin-treated diabetes is no longer an automatic disqualifier for interstate driving. Since a final rule effective November 19, 2018, drivers with stable, properly controlled insulin-treated diabetes can qualify under 49 CFR 391.46 and receive a 12-month certificate, with annual re-examination.¹²⁷

Finding a Certified Examiner and What It Costs

The exam has to be performed by a medical examiner on the FMCSA’s National Registry of Certified Medical Examiners.¹³ A regular family doctor cannot do it unless they hold that certification. You can search by location at nationalregistry.fmcsa.dot.gov.¹⁴

Fees typically run from about $75 to $200. Insurance generally does not cover the exam because it’s regulatory rather than diagnostic, though some trucking companies reimburse the cost, so check with your employer first. The exam usually takes around 30 minutes; conditions that need additional evaluation can extend that.

How to Prepare

Blood pressure is where preparation pays off. Avoid caffeine and high-sodium foods for 24 hours before your appointment. If you take blood pressure medication, take it on your normal schedule. Skipping a dose to see how you do almost always backfires.

Bring the following:

Records for chronic conditions such as diabetes, sleep apnea, or heart disease. CPAP users should bring compliance data showing regular use.
A full medication list with dosages, including over-the-counter drugs and supplements.
Any glasses, contacts, or hearing aids you use while driving.
Specialist clearance letters if a prior examiner required them.

Be straightforward on the health history questionnaire. The examiner will ask follow-up questions about anything you check, and inconsistencies between your answers and the clinical findings create problems. Disclosing a well-controlled condition is far better than having the examiner discover it during the exam.

After the Exam

If you meet all the standards, the examiner issues your Medical Examiner’s Certificate.² A standard certificate is valid for up to 24 months. Conditions like Stage 1 hypertension, insulin-treated diabetes, or the alternative vision standard shorten that to 12 months or less.⁷

One rule changed on June 23, 2025. If you hold a CDL or commercial learner’s permit and your medical certificate is on file with your state licensing agency, you no longer have to carry the paper card while driving; your status is maintained electronically. Drivers who hold medical variance documents such as an exemption letter or SPE certificate must still carry a copy of that paperwork on duty. If you don’t hold a CDL, for example because you drive a non-CDL commercial vehicle over 10,001 pounds, you still need to carry your medical card whenever you’re driving.⁵

If You Don’t Pass

Not every exam ends with a certificate. The examiner may find you don’t currently meet the standards and issue a report explaining why. Besides full disqualification, common outcomes include a temporary certificate with conditions (such as the three-month Stage 2 hypertension window) or a requirement to obtain specialist clearance before certification can be issued. If the disqualifying condition is eligible for an FMCSA exemption, you can apply through the appropriate program, though review can take up to 180 days.¹⁰

1
Federal Motor Carrier Safety Administration. Medical Examination Report (MER) Form, MCSA-5875
2
Federal Motor Carrier Safety Administration. Medical Examiners Certificate (MEC), Form MCSA-5876
3
Federal Motor Carrier Safety Administration. Medical Examination Report Form MCSA-5875
4
eCFR. 49 CFR 390.5 – Definitions
5
eCFR. 49 CFR 391.41 – Physical Qualifications for Drivers
6
Federal Motor Carrier Safety Administration. Qualifications of Drivers; Vision Standard, 87 FR 3390 (Jan. 21, 2022)
7
eCFR. 49 CFR 391.45 – Persons Who Must Be Medically Examined and Certified
8
Federal Motor Carrier Safety Administration. What Is the Effect on Driver Certification Based on FMCSA Hypertension Stages
9
eCFR. Appendix A to Part 391 – Medical Advisory Criteria
10
Federal Motor Carrier Safety Administration. Driver Exemptions
11
Federal Motor Carrier Safety Administration. Skill Performance Evaluation Certificate Program
12
Federal Motor Carrier Safety Administration. Diabetes Standard, 83 FR 47486 (Sept. 19, 2018)
13
Federal Motor Carrier Safety Administration. National Registry of Certified Medical Examiners
14
FMCSA National Registry. Search Medical Examiners