What Are the DOT Physical Requirements for 2026?

Commercial driving requires a sharp focus throughout long hours, so drivers must be able to meet these challenges. Department of Transportation (DOT) physicals are one of many regulations in the transportation industry that protect public safety. They ensure that commercial drivers are physically, mentally, and emotionally capable of handling commercial motor vehicles safely.

DOT physicals involve several health checks, and drivers who pass them all are issued a medical certificate allowing them to operate a commercial motor vehicle. However, some exceptions may apply for drivers with certain health conditions. Learn what DOT physicals consist of, the disqualifying factors, and new updates for 2026.

What Is a DOT Physical?

A U.S. Department of Transportation (DOT) physical is a comprehensive medical examination that commercial motor vehicle (CMV) drivers must take to maintain their commercial driver’s license (CDL). CMV drivers must take and pass the exam every two years to ensure they are physically, mentally, and emotionally fit to operate a CMV, protecting public safety.

DOT physicals are crucial to certain DOT-regulated employers, particularly those working under the Federal Motor Carrier Safety Administration (FMCSA). They are typically one aspect of DOT background checks, along with driving record checks and drug screenings.

Who Needs a DOT Physical?

An individual must take a DOT physical if they operate a CMV for interstate commerce, which includes the following:

• Drivers who operate a vehicle with a gross combination weight of 10,001 pounds or more.
• Drivers who transport hazardous material requiring their vehicle to have a placard.
• Drivers who operate a vehicle designed to carry more than 16 people (including the driver)
• Drivers who are paid to operate a vehicle carrying more than eight passengers.

What Does a DOT Physical Consist Of?

A DOT physical consists of a broad range of health checks. If a driver passes these checks, they will receive their medical certificate. However, they may need to undergo further testing if the medical examiner finds something concerning.

Medical History Review

DOT physicals typically begin with the medical examiner reviewing the driver’s medical history. They may ask questions regarding past surgeries, medications, health concerns, and use of drugs or alcohol.

Pulse and Blood Pressure Check

The medical examiner will take the driver’s pulse and blood pressure to check for irregular heartbeats and hypertension. A driver with a blood pressure under 140/90 mmHg is eligible for a two-year certification. A driver with a blood pressure of 140-159/90-99 mmHg is eligible for a one-year certification.

A driver with a blood pressure of 160-179/100-109 mmHg is eligible for a one-time three-month certification to allow time for treatment. If their blood pressure is regulated to less than 140/90 mmHg, they may receive a one-year certification.

A driver with a blood pressure above 180/110 mmHg is disqualified from receiving a certification until their blood pressure is controlled. If their blood pressure is controlled to less than 140/90 mmHg, they may receive a six-month certification.

Urinalysis

Drivers must undergo a urine test to check for any underlying health conditions, such as diabetes. This urinalysis is not a drug test, but employers may request a separate drug screening in addition to the DOT physical.

Vision Test

Drivers must have a minimum of 20/40 vision in each eye with or without eyeglasses or contact lenses. They must also have a minimum peripheral vision of 70 degrees in each eye and be able to distinguish red, green, and amber colors.

Drivers should take the vision exam while wearing the corrective lenses they typically wear while driving. If a driver passes the vision test wearing corrective lenses, they must wear those lenses while driving a CMV.

Hearing Test

Drivers must be able to hear a “forced whisper” from five feet away with or without a hearing aid. This test indicates whether a driver has hearing loss in their good ear of less than 40 decibels. If a driver passes the hearing test with a hearing aid, they will be required to wear it while driving a CMV.

If a driver fails the whisper test, they will undergo an audiometry test to evaluate potential hearing loss and receive guidance regarding a hearing correction device. A driver will only fail the hearing test if they are completely deaf and cannot pass the whisper test even while wearing hearing aids.

Sleep Apnea Test

Drivers experiencing symptoms such as daytime drowsiness, morning headaches, gasping while sleeping, or heavy snoring may need to undergo a sleep apnea test. Drivers with sleep apnea may still pass their DOT physical if their condition is under control.

Physical Examination

During the physical examination, the medical examiner will assess the driver’s eyes, ears, throat, mouth, heart, lungs, abdomen, vascular system, genitourinary system, extremities, spine, and neurological system for any signs of issues or worrying conditions.

What Are the New DOT Rules for 2026?

In 2026, the major changes to DOT rules focus on reporting and verification, rather than the DOT physical itself. 

Back in June 2025, the Federal Motor Carrier Safety Administration’s Medical Examiner’s Certification Integration Rule went into effect. This rule changed how DOT physical results are reported and connected to commercial driver’s licenses.

Under the revisions, drivers required to have a commercial driver’s license or a commercial learner’s permit, and who have an updated medical examiner’s certificate (MEC) highlighting that they meet the physical requirements of their job, no longer have to carry the medical examiner’s certificate in most cases.

However, because this reporting shift is still being implemented across states and systems, FMCSA has introduced additional guidance for 2026 to address transitional gaps.

It has issued a temporary waiver, effective January 11 through April 10, 2026, allowing CDL/CLP drivers and motor carriers to rely on a paper copy of their medical examiner’s certificate for up to 60 days after issuance in certain situations during the transition. Once the transition period is complete, electronic reporting is expected to be the “new normal”.

Under the electronic reporting process, certified medical examiners submit DOT physical results directly to the FMCSA’s National Registry, which then shares medical certification status with state driver licensing agencies for posting on the driver’s Motor Vehicle Record.

Non-CDL drivers who are still subject to DOT medical certification requirements may continue to carry physical MECs, depending on state and employer policies. 

Frequently Asked Questions

What Disqualifies You From a DOT Physical?

Drivers with certain physical or mental health conditions may be unable to drive a CMV without an approved exemption. Conditions include, but are not limited to, hernias, hypertension, vision loss, and hearing loss. Drivers may be eligible for an exemption for their disqualifying condition, provided they obtain a written statement from a medical examiner.

How Long Does a DOT Physical Take?

A DOT physical can take anywhere from 30 minutes to an hour. The process can take longer if a driver has underlying health conditions that require further examination. Applicants can save time by filling out the driver’s portion of the form in advance.

How Long Is a DOT Physical Good For?

A DOT physical is typically good for two years. However, if a driver has a medical condition that requires regular monitoring, they may be required to take a DOT physical at more regular intervals.