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Medical Variance of DOT Physicals

Written by Nick Webster

Published on Dec. 11, 2023, 3:07 p.m.

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What Does Medical Variance Mean? Medical Variance of DOT Physicals





It is essential for U.S. trucking professionals to understand the medical variance of DOT physicals. After all, getting a Department of Transportation (DOT) physical is essential for those who operate in commercial driving. If you’re a commercial truck driver, you know the importance of keeping up with all the regulations from the Federal Motor Carrier Safety Administration (FMCSA). But did you know that specific medical variances can help keep you on the road if you don't meet all of FMCSA's standards for your health?







That’s right! These medical variances could be that lifeline you need to stay in business. Below is what you should know about getting an FMCSA and DOT medical variance. If you have questions, do not hesitate to contact our third-party organization.



What Does Medical Variance Mean?



Drivers with certain medical conditions can get a variance from the FMCSA, allowing them to continue driving commercially. The driver must keep their variance up-to-date and have a copy of it on them whenever they're on duty. Additionally, the variance must be included in their driver qualification file alongside their medical certificate. Keeping your FMCSA variance current ensures you can continue to drive safely and legally. DOT disqualifying medical conditions.

For more information about FMCSA variances, you might need to contact your local FMCSA office for assistance. They'll be able to provide details regarding which medical conditions qualify for a variance and how you can apply for one. Or, you can save time by giving our organization a Phone Call right now.



What Forms of Medical Variances Exist?



If you have a medical condition that affects your ability to safely drive, you may be eligible for a medical variance. Variances provide accommodations and requirements tailored to the individual’s specific needs, ensuring they can continue driving safely despite their disability or impairment. Common medical conditions that qualify for this type of accommodation include:

  • vision issues
  • hearing issues
  • diabetes
  • epilepsy
  • missing limbs
  • impaired limbs

In general, those seeking a medical variance must provide information about their professional driving experience and details on their current driving record and diagnosis. Depending on the specific situation, an applicant may also need to submit additional documentation or complete further steps. Contact your state licensing agency or local DMV office to ensure you have relevant variance information for your location. Visit the DOT Authority Package, which contains tips to prepare for 2023 DOT Week filings in minutes. How do you get an Oregon Trip And Fuel Permit?




What Is the SPE: Skill Performance Evaluation?



If you're an individual with a missing or impaired limb and wish to drive a commercial motor vehicle, you must submit a Skill Performance Evaluation (SPE) variance application. To do so, simply compose a letter and include documentation of the necessary criteria. This includes demonstrating that your disability won't affect your ability to operate the motor vehicle safely and providing proof of medical fitness.

You must also be able to pass all required knowledge tests and a skills test conducted by a certified FMCSA examiner qualified to assess SPEs. After submitting all these documents, the FMCSA will review them and decide on your variance request. With the proper preparation, chances are high that you'll be approved as an SPE. Say that you're applying for a variance. Here is what you must provide the FMCSA:

  • results from your DOT physical
  • copy of your medical certificate
  • medical evaluation summary
  • copy of driver's road test
  • application for employment
  • three year history of your State Motor Vehicle Driver Record



If you are applying for a special permit from the FMCSA, it's essential to ensure that all the relevant information is included in your application letter. The FMCSA has provided a comprehensive instruction document outlining precisely what must be included in the application and which accompanying documents must be submitted along with it. What are the Top 3 DOT Violations?

You can easily download the more information from the FMCSA right now to start your application process! Remember to take your time and ensure that all of your documentation is up-to-date, complete, and accurate – this will help ensure that your application is accepted quickly and without any issues. Good luck! Also, take a look at the Drug and Alcohol Program policy. What is DOT Clearinghouse Enforcement?


What Makes You Fail a DOT Physical?



  • Being overweight or obese
  • Having a high BMI
  • High Blood Pressure
  • Heart Problems/Conditions like Arrhythmias, Angina etc.
  • Poor vision (failure to meet the vision requirements for certain classes of commercial motor vehicle drivers)
  • Diabetes Mellitus and other metabolic conditions
  • Sleep Apnea
  • Neurological Disorders like Seizures, Epilepsy, Stroke etc.
  • Certain Types of Mental or Emotional Diseases or Disorders such as Psychosis, Depression, or Anxiety
  • Drug use: current illegal drug use or abuse of prescription drugs can prevent you from passing a DOT physical
  • Alcoholism: anyone with an unresolved drinking problem will not be able to drive commercial vehicles.




The State of Texas as an Example of Medical Variance



DOT and FMCSA policies concerning medical variances will vary from state to state. So, let’s use Texas as an example of how a medical variance works. In Texas, long-haul truck drivers with Commercial Driver's Licenses (CDLs) must pass a medical examination to do specific jobs. The certification of this exam must remain up-to-date with the Texas Department of Public Safety, as failure to keep this record current could result in a downgrade or loss of CDL privileges. Must Visit Medical Examiners (MEs).

CDL holders who are exempt from displaying FMCSA medical certification must still pass a Texas medical examination before driving in the state. In the event of a downgrade, they will then be required to retake both the knowledge and skills tests before operating their vehicle. Also, visit the link.

Drivers with physical impairments that limit their ability to operate large trucks can still receive an exemption from the State, enabling them to drive commercially. This medical variance will be noted on the driver's CDL and may impose restrictions on what tasks they are allowed to perform. Those applicants with missing or impaired limbs must complete a Skill Performance Evaluation (SPE) from the Texas Department of Public Safety to qualify for this exemption. Ultimately, these guidelines provide drivers with physical impairments a chance to remain active and safe behind the wheel of a commercial truck. Visit BOC-3 to know more.


Drivers who pass the SPE are required to keep their certification on them while they're on duty. Even drivers with health issues such as diabetes, vision impairments, hearing impairment, and seizures may be given special permission to drive a commercial truck in some states. However, the trend of poor overall health among truckers is causing more difficulties for them. Regardless of your health, truckers must take care of themselves and ensure they're in good condition before hitting the road. It's not just necessary for their own safety, but also helps ensure safe travels for everyone else sharing the roads with them. Read about Texas DOT Numbers and USDOT Numbers. Learn here How to Prepare for a Compliance DOT Audit.





Key Takeaways: FMCSA Medical Variance for DOT Physicals


  • Drivers with certain medical conditions may be eligible for an FMCSA variance.
  • This variance allows them to continue driving commercially.
  • To remain valid, the driver must keep their clash up-to-date and have a copy of it on them when on duty.
  • It's essential to ensure the FMCSA variance is included in their driver qualification file and medical certificate.
  • Staying current with your FMCSA variance guarantees that you can drive safely and legally!
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