A lot of my patients who come in for their initial certification or recertification CDL physical exam have several questions regarding high blood pressure and CDL requirements. The basic regulations according to the FMCSA are as follows:

Stage 1 Hypertension: Medically certified to drive for a one-year period. Annual exams are needed.


Corresponds to a BP of 140-159/90-99

A driver with a blood pressure in this range is at low risk for hypertension-related acute incapacitation and may get their DOT medical card to drive for a one-year period. A DOT physical exam should be done annually thereafter and blood pressure should be at or less than 140/90. If at time of recertification it is 141-159/91-99 a one time certificate for three months will be issued. This will give the driver time to see their family doctor to get their blood pressure under control.



Stage 2 Hypertension: One-time medical certification of three months

Corresponds to a BP of 160-179/100-109.

The driver is given a one-time certificate for three months. At their recertification they will be issued a one year certificate from the date of the initial exam as long as their blood pressure is ≤ 140/90. The initial three months allow the driver to see their family doctor to help control their blood pressure.

A driver with a blood pressure in this range is a candidate for antihypertensive drug therapy. Provided treatment is well tolerated and the driver demonstrates a blood pressure is 140/90 or less, they may get their medical card for one year from the date of the initial exam. The driver should do a DOT physical exam annually thereafter.



Stage 3 Hypertension: Disqualified

Corresponds to a BP of ≥ 180/110. No medical certificate will be issued.

A driver with a blood pressure in this range is considered a high risk for an acute BP-related event, and is disqualified.

The driver may not be qualified for a DOT medical card, even temporarily, until blood pressure is reduced to equal to or less than 140/90 and treatment is well tolerated. The driver may be certified for 6 months and a recertification will be needed every six months thereafter if at recheck their blood pressure is ≤ 140/90.

If you have any questions regarding the CDL physical requirements or if you would like to schedule an appointment for the exam call Alexandria Chiropractic Center at 859-635-6666.


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