What Happens If You Fail Your DOT Physical? Next Steps for Drivers

For commercial drivers, passing your DOT physical is a non-negotiable requirement for keeping your CDL valid and staying on the road. But what happens if you don’t pass? It can be nerve-wracking, especially if driving is your livelihood.

At Harmony Health Clinic in Naples, FL, we’ve helped hundreds of drivers navigate this process. Let’s break down what it means to fail a DOT physical, what your options are, and how to get back on track.

What Is Considered a "Failure" on a DOT Physical?

The Department of Transportation (DOT) physical is designed to ensure that drivers are medically fit to safely operate a commercial motor vehicle (CMV). To pass, you must meet minimum physical and mental health standards established by the Federal Motor Carrier Safety Administration (FMCSA).

You may “fail” your DOT physical if:

• You do not meet the minimum vision or hearing requirements

• You have untreated high blood pressure or diabetes

• You recently had a medical condition like epilepsy or heart attack

• Your medical history or medications disqualify you from safe driving

• You fail to provide required documentation (e.g., CPAP usage for sleep apnea)

It’s important to note that failing doesn’t always mean you're permanently disqualified—it often means you need to take further steps before re-qualifying.

What Happens Immediately After You Fail?

If the examiner determines you are not medically qualified, here’s what you can expect:

1. No Medical Certificate Issued - Without a valid DOT medical card, your CDL may be downgraded if you don’t take action within 60 days in Florida.

2. You’ll Receive a Summary of Findings - This form explains why you were disqualified and what additional information, treatment, or testing is required.

3. You Can Dispute or Clarify the Decision - If there’s missing information or documentation (e.g., a sleep apnea report or cardiologist clearance), you may be allowed up to 45 days to submit supporting documents without retaking the exam.

Common Reasons Drivers Fail a DOT Physical

Here are some of the most frequent causes we see at our clinic in Naples, FL:

1. Uncontrolled High Blood Pressure

If your BP is above 140/90, you may only qualify for a short-term certificate—or none at all—depending on how high it is. Readings above 180/110 are an automatic disqualification.

2. Diabetes with Poor Blood Sugar Control

Drivers using insulin must show their condition is under control

3. Vision or Hearing Deficits

Corrective lenses or hearing aids may allow you to pass, but severe impairment without aids will disqualify you.

4. Sleep Apnea or Daytime Drowsiness

If suspected, you may be referred for a sleep study. If you're already diagnosed, you must show CPAP compliance data.

5. Medication or Mental Health Concerns

Certain psychiatric medications, substance use history, or untreated mental health conditions can lead to disqualification. Bring a letter from your doctor confirming that your medications are stable and will not interfere with your driving.

Your Next Steps: How to Get Back on the Road

Failing your physical isn’t the end. Here’s how to get back in the driver’s seat:

Step 1: Understand Why You Failed

Review your summary carefully and clarify anything you don’t understand with your medical examiner.

Step 2: Take Corrective Action

Work with a primary care doctor or specialist to address the disqualifying issue—whether it’s managing blood pressure, submitting sleep apnea reports, or completing a drug treatment program.

Step 3: Gather Documentation

You’ll likely need:

• Clearance letters from specialists

• Lab results

• Medication adjustments

• CPAP data printouts

• Form MCSA-5870 (for diabetes) or MCSA-5871 (for seizure history), if applicable

Step 4: Return for Re-Evaluation

Once you’ve addressed the issue, you may retake the DOT exam—often with the same examiner for continuity, especially if they asked you to follow up.

Can You Get a Second Opinion?

Yes. If you believe the examiner was unfair or made a mistake, you're allowed to get a second opinion from another certified medical examiner. However, withholding information or “doctor shopping” for a different outcome without addressing the real problem is a red flag—and could jeopardize your CDL if discovered.

Preventing Future Issues: Tips from a DOT Examiner

As a DOT doctor here in Naples, I always recommend the following to drivers:

• Get a physical at least 2 months before your card expires, giving yourself time to address any problems.

• Keep records of medical conditions and bring them with you to the exam.

• Take medications as prescribed and avoid running out before your appointment.

• Ask questions ahead of time—we’re here to help, not disqualify you.

Want to prepare before your next exam? Read our blog: How to Pass Your CDL Medical Exam in Florida: A Driver’s Checklist

We Help Drivers Get Certified and Stay Road-Ready

At Harmony Health Clinic, we’ve built our reputation on fast, fair, and friendly DOT physicals. If you’ve failed your exam or just want to avoid surprises, we offer:

• Pre-exam consultations

• Same-day retests (if appropriate)

• Guidance on required follow-up steps

• Functional medicine support to optimize your long-term health

We’re conveniently located in Naples, FL and serve drivers from all over Collier County.

Book Your DOT Physical or Follow-Up Visit Today

Ready to get back behind the wheel? Schedule your next visit with us today.

Call Now or Book Online

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a licensed healthcare professional.