Massachusetts DOT Physical Requirements


[Updated for 2024]

Overview

A Department of Transportation (DOT) physical is a medical exam required by the Federal Motor Carrier Safety Association (FMSCA) and confirms that one is healthy enough to safely drive a commercial vehicle.

A DOT medical card is required for any commercial driver who operates a vehicle with a gross weight of 10,000 pounds or more. This applies to all commercial driver's license (CDL) holders as well as non-CDL holders including hoisting/hydraulic operators, box truck drivers, commercial bus drivers, limousine drivers, and others.

A DOT physical can only be provided by a licensed provider listed on the FMSCA National Registry of Certified Medical Examiners (NRCME). In Massachusetts, an MD, DO, DC, PA or ANP is eligible to become an NRCME. 

The physical itself consists of a review of one's medical history, medications as well as a physical exam.

The exam portion includes a hands-on check of the following:

  • Vital Signs (including blood pressure and pulse)

  • Eyes (including a vision test) 

  • Ears (including a standardized hearing test)

  • Heart

  • Lungs (breathing) 

  • Back/Spine

  • Arm/Legs (range-of-motion, strength and reflexes)

  • Overall Wellbeing

A routine urinalysis is also part of the exam. Note, this urinalysis is NOT a drug test. Instead, it indicates the presence of any blood, sugar or protein in one’s urine.

Upon a successful examination, one is issued a DOT medical card (effective immediately) that can be valid for up to two years.

Can one fail a DOT physical?

Some medical conditions can disqualify someone from obtaining a DOT card. Common reasons for disqualification include:

  • Marijuana (both recreational and medical). While both uses of marijuana are legal within Massachusetts, the DOT physical is a federal exam and thereby follows federal laws.

  • Unstable heart conditions. 

  • Uncontrolled diabetes. 

  • Uncontrolled high blood pressure. 

  • Sleep Apnea without CPAP compliance. 

  • Some neurological conditions including seizures/epilepsy, myasthenia gravis, and Meniere's disease. 

  • Schedule 1 drugs. 

  • Uncorrected hearing loss. 

  • Uncorrected impaired vision. 

  • Some pulmonary conditions including any that require the use of supplemental oxygen. 

  • Some psychological conditions including narcolepsy and schizophrenia

Some conditions are left to the discretion of the provider. If a disqualifying condition is resolved (ie: one gets glasses or a medication is adjusted), one may be eligible to receive a DOT medical card in the future. 

If a driver cannot resolve a disqualifying condition, he/she may qualify for an exemption waiver through either the federal government or the Mass RMV. 

Federal & State Exemption Programs

Exemption waiver options are dependent on the type of commerce one operates.

There are two types of commerce: interstate and intrastate. Interstate drivers operate across state lines and may qualify for an interstate exemption. Intrastate drivers operate only within the state of Massachusetts and may qualify for an intrastate waiver.

Federal Interstate Driver Exemption Programs

There are currently three federal driver exemption programs

  • Vision

  • Hearing

  • Seizures

Those who apply and qualify for a federal exemption are required to keep a copy of the documentation with them while driving commercially (along with a valid medical card). 

Update: As of 2018, there is no longer a federal exemption program for insulin-dependent diabetics. Instead, affected individuals must complete form MCSA-5870 prior to their appointment. 

Note: MA intrastate waivers tend to be easier to obtain and are more quickly processed than federal waivers. If you do not conduct any business outside of the Commonwealth you may want to consider operating only intrastate. 

Massachusetts Intrastate Medical Waivers

There are five conditions by which one can apply for a MA intrastate waiver.

  • Vision

  • Hearing Impairment

  • Insulin-Dependent Diabetes Mellitus (IDDM)

  • Cardiovascular

  • Loss of Limb

The waiver form must be completed by the supervising physician of the condition requiring a waiver. 

Both federal and state waivers are designated as such on a driver’s DOT card. A medical card with such designation is not valid without the accompanying waiver/documentation from the FMSCA (interstate) or MA RMV (intrastate). 

 CDL Self Certification

In Massachusetts, all CDL drivers are required to inform the RMV what type of commerce they engage in (ie: intrastate or interstate) and whether or not they are required to retain a valid DOT medical card. This process is known as self-certification. 

There are two ways that a driver can self-certify: online or via mail.

Online

Online is simple and convenient and is the preferred method of the RMV. The entire process should take less than 5 minutes. 

To submit online, go to this RMV web page and click the big blue button titled, “Complete your commercial driver’s license self-certification online.” 

You’ll then be taken through a series of web pages where you’ll be asked to verify your identity and upload your new medical card information. At the end you will be required to upload an image of your new medical card. If completing the self-certification on a mobile device, you can use the camera app to take a picture. If completing from a computer you will need to scan the medical card in (or email yourself an image).

Upon successfully submitting your self-certification, you will receive a confirmation PDF to print for your records. You’ll also receive a confirmation email from the MA RMV. For whatever reason these emails tend to land in the spam folder, so if you don’t see the confirmation email in your main inbox, be sure to check there.

By Mail:

If you choose to submit your self-certification via mail, you’ll first need to download and print the corresponding RMV form.

You’ll then mail the completed form AND a copy of your medical certificate to the following address:

Registry of Motor Vehicles
Driver Licensing Department
PO Box 55889
Boston, MA 02205

While not required, we do recommend sending your paperwork via certified mail. 

For those who complete their physicals with us, we offer a supplemental service to submit your information to the MA RMV on your behalf (we charge a $10 admin fee for this and provide in-office confirmation of it’s completion. 

Medical Card Renewal Process

How long is a DOT card good for?

A DOT medical card can be issued for up to 2 years. In some cases, the issue length may be less due to one's medical history. For example, the following diagnoses are commonly restricted to a one-year certification:

Regardless of your certification length, you’ll want to be sure to renew your card before the expiration date so that you can continue to be compliant with the FMSCA guidelines. 

What happens if my medical card expires?

If your medical card expires, you are restricted from operating. If you are a CDL holder, your license will be downgraded to a Class D license within a few weeks. If a full year passes, and you do not reinstate your CDL, you will be required to retake the CDL permit and road tests (and pay the necessary fees). 

Need a DOT Medical Card?

Rapid DOT Physicals serving Massachusetts provides DOT exams to drivers and operators across the Commonwealth and from the rest of New England. Our office is located in downtown Salem, MA (approximately 30 minutes north of Boston). To set up an appointment one can either call our office at 978-502-8303 or self-schedule using our easy and safe online system.

We are open Monday through Friday 7am - 7pm and Saturdays 9am - 12pm. If you have any questions regarding your specific health situation and what you may need for your appointment, please don’t hesitate to call our office during normal business hours.