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Regulatory Guide

5 Reasons Drivers Fail the DOT Exam

Dr. Robert J. Evans, DC4 min read

Learn about the primary medical reasons commercial drivers can fail their DOT examinations, and steps you can take to stay legally compliant.

Failing your DOT exam can suspend your livelihood. The good news is that most failures are highly preventable and result from simple preparation oversights.

1. Elevated Blood Pressure: This is the #1 reason drivers encounter delays. Often, stress ("white coat syndrome") or caffeine consumption drives readings over 140/90. To counter this, drink plenty of water, arrive 15 minutes early to sit quietly, and take your regular blood pressure medications on schedule.

2. Missing Prescription Documentation: If you take medications for high blood pressure, diabetes, depression, or sleep apnea, the examiner is required to see a clearance letter or logs. Bring CPAP compliance logs showing at least 70% usage over the past 90 days if you have sleep apnea.

3. High Sugar Levels in Urinalysis: High glucose in the urine is an indicator of uncontrolled diabetes. If you are diabetic, ensure your blood sugar is well-managed and bring your latest HbA1c test results (which must be under 10.0%).

4. Vision Deficiencies: If your vision has deteriorated, your current glasses may no longer correct you to the federally-required 20/40. We suggest having an eye exam prior to your DOT check if you suspect your vision has slipped.

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