If you’re a commercial vehicle driver, fleet safety manager, or owner of a trucking company, then you know the drill: At least once every two years, drivers need to have a DOT physical exam to renew their DOT medical card. These exams, which are sometimes called DOT medical exams[RB1.1], are conducted by certified medical examiners whose job it is to evaluate drivers for a wide range of medical conditions and ensure they're healthy enough to operate a motor vehicle safely.
In addition to a general physical examination, your DOT physical will include a urinalysis. But unless the examiner requests a second sample be given for a DOT drug test (sometimes requested during the pre-employment process), the urine sample you provide during the exam isn’t used to detect drug use. Instead, the urinalysis helps screen for medical conditions, such as diabetes.
It’s important to note that if your employer does require a pre-employment drug test at the same time, the examiner will be very clear with you about the testing procedures during your appointment.
Related: Learn What to Expect at Your DOT Physical Here
Although a standard DOT drug test isn't conducted during DOT physicals, the medical examiner will review your current medications with you, — including those you take for diabetes, heart disease, neurological conditions, mental health conditions, and recent surgeries.
Some of these medications may automatically disqualify you from driving a commercial motor vehicle (at least temporarily), but that decision is left up to the medical examiner’s discretion, as well as the advice of your doctor. In these cases, your medical examiner will want to see a note from your doctor that describes your condition, the medications you take, and the impact it will have on your ability to safely operate a motor vehicle.
If you're wondering what specific drugs are prohibited by the DOT, check out this Foley article for more information: What Drugs Will Disqualify Drivers from Operating Commercial Vehicles?
If the medical examiner deems that the medications you’re on cannot be used while driving a commercial motor vehicle, you may receive a temporary disqualification. Once you’ve been off the medication for a certain period of time, you can then be reevaluated for a medical card. In other cases, you may be granted a medical card, but you’ll need to have another DOT physical exam in the next 6–12 months instead of the normal two-year timeframe.
Here's the thing: The DOT does NOT remind drivers when they're due for a DOT physical. It's the driver's responsibility to know when their medical card expires, and therein lies the challenge. Self-management is always tricky. What happens if the driver forgets?
If you think this doesn't happen much, think again. In 2025, violations related to medical certification included:
1,147 violations for operating a CMV with an expired medical certificate
2,025 violations for operating a CMV without a valid medical certificate
Thousands of additional violations when drivers couldn’t produce a certificate or had a history of expired medical certification
These numbers show how easily medical card expirations can slip through the cracks without a reliable reminder system.
Luckily, Foley’s DOT physical software helps prevent these types of violations by taking the guesswork out of medical certificate tracking.
Instead of relying on drivers or safety managers to manually monitor expiration dates, the system automatically alerts you when a medical card is nearing expiration and can even auto-order DOT physicals 60 days in advance. Once a preferred collection site is set for a driver, Foley handles the rest.
Request a demo today and see how easy our all-in-one compliance software is to use.