What We Examine in Gilbert, AZ

The medical examiner notes anything unusual about your posture, limps, or tremors, along with your emotional state and overall appearance — anything that could affect safe driving.

If a driver is markedly overweight, the examiner weighs that together with all other findings. BMI is considered as part of the whole clinical picture, including whether sleep apnea may be present.

The examiner also looks for signs of current alcohol or drug abuse. If any are found, the driver must be referred to a Substance Abuse Professional for evaluation.

Conditions of the mouth and throat are evaluated to see whether they need long-term follow-up and monitoring, and whether any treatment is working and well tolerated.

Please don't have chewing tobacco in your mouth, and rinse your mouth before seeing the doctor.

The examiner listens for murmurs and extra sounds, and checks for an enlarged heart, a pacemaker, or an implantable cardioverter defibrillator. Your lower legs are checked for pitting edema and other signs of heart disease. Having a defibrillator is disqualifying.

If anything suggests current heart disease that could cause fainting, trouble breathing, collapse, or heart failure, you'll need clearance from a cardiologist.

Work restrictions aren't allowed. The DOT physical is all-or-nothing: you must be able to do every job-related task, including lifting, to be certified.

The examiner checks chest wall expansion, breathing rate, and breath sounds such as wheezes or rales, plus signs of impaired breathing and cyanosis (a bluish tint to the skin or nail beds). Clubbing of the fingers can be a sign of lung disease.

The examiner checks for an enlarged liver or spleen, masses, bruits, hernias, and significant weakness of the abdominal wall muscles, as well as tenderness and abnormal bowel sounds.

The examiner checks your pulse and its strength, listens for bruits in the carotid and other arteries, looks for varicose veins, and checks the pulses in your hands and feet.

The examiner checks for hernias. Any hernia that causes discomfort is evaluated to see how much it could affect your ability to drive a CMV safely, and further testing may be needed.

A driver who hasn't provided a urine sample cannot be certified.

The examiner checks for lasting loss, impairment, or deformity of an arm, hand, finger, leg, foot, or toe — making sure your grip is strong enough to hold the steering wheel and your legs have the mobility and strength to work the pedals.

Signs of progressive conditions such as muscle wasting, weakness, or loss of tone (for example, muscular dystrophy) are evaluated, along with clubbing or swelling that may point to a heart, lung, or vascular condition.

Your whole musculoskeletal system is checked for past surgery, deformities, limited motion, and tenderness. The examiner will ask about any condition linked to sudden episodes of muscle weakness, poor coordination, abnormal sensations, low muscle tone, or pain.

Drivers who use a wheelchair aren't automatically disqualified, but a Skill Performance Evaluation (SPE) will be needed.

The examiner checks your balance, coordination, and speech. There should be no loss of balance, reflexes should be even on both sides, and the Babinski (foot) reflex should not be present. You'll also be checked for loss of sensation and positional problems.

There are a lot of misleading rumors about which drivers need a sleep apnea test. Dr. Fern is up to date on the FMCSA guidelines and does not send everyone for one — every driver is evaluated individually.

If Dr. Fern decides a sleep study is needed, he works with two companies that let you take the test at home at a very reasonable cost.

What is sleep apnea? A condition where your body gets less oxygen during sleep because breathing slows or stops. It often causes daytime sleepiness.

Common symptoms:

• Waking up not feeling refreshed
• Unusual daytime sleepiness, including falling asleep at the wrong times
• Loud snoring or periods of not breathing
• Weight gain
• Memory loss, short attention span, or poor judgment
• Personality changes such as depression or irritability
• Erectile dysfunction

Learn more from the FMCSA: Driving When You Have Sleep Apnea.