Commercial drivers are required by 49CFR391.43 to have on their person at all times a valid medical certificate which is obtained by a standardized physical examination. This means when the D.O.T. the officer asks to see your license, he will want to see your medical certificate. If no disqualifying health problems are found on the examination, the certificate is good for two years. Some certificates are good for only three months or six months depending if there is a medical problem such as high blood pressure which needs regular follow-up. Some certificates require a waiver from a certifying agency if there are certain conditions which may or may not represent hazards to the safe operation of a commercial vehicle. An example would be if you had high tech lower leg prosthesis. It would be up to the waiver authority to decide if you could perform all the duties required of a commercial driver.

Now, let’s go through the process of a physical examination for a medical certificate. The first part of the exam is your medical history. The basic information needed is whether you have had any medical illnesses, surgery, or injuries in the past five years. It would not be a good idea not to disclose that you were in the ICU with a heart attack last year. Not being truthful on your medical history could get you banned from driving for life. You will be asked whether you take any medicines especially for diabetes or seizures. The form will go through all the body systems asking for relevant information. This includes lung disease, heart disease, liver disease, and digestive disease. It is necessary to know if you have a nervous or psychiatric disease and what medicines you might take. Especially important is whether you have had fainting or loss of consciousness. It asks direct questions about frequent alcohol use, and the use of narcotics or habit forming drugs. If you are coming in on your own, you will usually not be drug tested. If your company is sending you for your physical, they may require drug testing. Please complete your form and all and any parts of the form well before seeing the doctor; this saves you time.

The second part of your exam is eye and vision testing. Your vision must be corrected to no more than 20/40 if you wear glasses, or 20/40 if you don’t. Field of vision must be at least 70 degrees for each eye in the horizontal plane. You must be able to distinguish colors you will take a color vision test.

The next area of testing is your hearing. It can be tested by whether you can hear a forced whisper over 5 feet, or you might be tested with the headphone standard tone hearing exam or audiogram. This measures the exact sound frequency of hearing loss. A primary care physician will perform the exam may or may not have an audiometer.

The fourth area of testing is the blood pressure and pulse. If you have blood pressure less than 140/90, it is considered normal by the DOT. Blood pressure of 140 to 149/90 to 99, it is considered Stage I hypertension, and your medical certificate is good for one year. If it is 160 to 179/100 to 109, it is considered Stage II hypertension, you are given a certificate for three months at which time you must return to the doctor for recheck. If it has come down to less than or equal to 140/90, the certificate is good for one year. Blood pressure over 180/110 is considered to be disqualifying, and must be brought down to less than 140/90 for a six month certificate. When the diagnosis of hypertension is being considered it is a good idea to come in for several readings, and then average them to see the actual Stage. New medical criteria consider 135/85 the normal target in most medical patients. If you are above this you must see your doctor.

The next area of testing is the urinalysis. It looks for abnormalities such as protein, white cells, red cells, nitrates, ketones, urobilinogen, bilirubin or blood. Sugar if there might be some diabetes in the offing. As stated before, you will not be drug tested unless it is required and you should be aware of it.

The final part of your appointment is the actual physical exam itself. Your height and weight will be measured to see if you are obese or underweight. The physician will note your general appearance as to whether you look healthy. The physician will examine your head, eyes, ears, nose, throat, lungs, heart, and abdomen, look for hernias, palpate pulses to look for abnormal vascular pulses, examine the spine and extremities, and perform a neurological exam including reflexes, equilibrium and coordination. Always truthfully tell any problems or past medical history and place it on paper work before physician sees you i.e glass eye prosthetic or past appendicitis surgery. These findings will all be entered on your report.

The doctor must then consider all the rules of physical fitness, and decide whether to issue you a medical certificate and for how long. He may need to call the D.O.T. for clarification of some issues. The purpose of the exam is not to interfere with your career of driving, but to ensure that you are physically safe when you are out on the road driving.

Author's Bio: 

Dr. Laurusonis was conferred his Doctor of Medicine degree in 1983 and has been actively taking care of patients since completing his Internal Medicine residency in 1987 in the Garden State of New Jersey. Dr. Laurusonis has been licensed in four states but ultimately chose to permanently relocate to Georgia with his family and begin a private practice. Through his extensive experience in Internal Medicine, as well as in Emergency Rooms throughout the United States, Dr. Laurusonis saw how traditional Emergency Rooms were often overwhelmed by patients suffering medical conditions that were urgent but may not need the traditional “Level I Trauma Center”. Patients often waited six to twelve hours to be seen by a physician, were riddled with thousands of dollars in medical bills, and were generally unhappy with the system.
Dr. Laurusonis decided to open an Urgent Care Center instead of a 9-5 doctor's office. Through the last fifteen years he has received accolades from the community and his patients. He has expanded his practice to include many cosmetic therapies that have previously been treated with painful and extensive plastic surgery. He has been invited to the White House numerous times, has been named Physician of the Year from GA, as seen in the Wall Street Journal, and has served as Honorary Co-Chairman on the Congressional Physicians Advisory Board
Dr. Laurusonis and his practice, Doctors Medical Center, is open 7 days a week from 7:30 am to 9:30 pm offering such services as lab, x-ray, EKGs, aesthetics (Botox, dermabrasion, sclerotheraby and veins etc.), cold/flu, sore throats, fractures, sprains, lacerations, GYN, Pediatrics, Phlebology Anxiety/Insomnia/Depression Treatment, skin tag/mole removal, veins, allergies, asthma, physicals--just to name a few. Dr. Laurusonis welcomes you to either make an appointment or just walk-in to see him. Dr. Laurusonis will take the time to speak with you about your concerns--no problem is too big or too small. If you need additional services we have specialist referrals available or we can refer you to the neighborhood hospital emergency room. Give Doctors Medical Center a call--Dr. Laurusonis will be happy to speak with you.

John Drew Laurusonis, MD
Doctors Medical Center
3455 Peachtree Industrial Blvd
Suite 110
Duluth, GA  30096