Question on failed DOT physical

Your understanding is correct. Medical exams are to be transmitted to the FMCSA by midnight the day after completion and FMCSA updates their databases at midnight each night. This means there is at most a 48 hour delay before it is recorded on CDLIS, often quicker and in many states it is showing in near real time now. That said, not all states are meeting their obligations under this program. This means that a failed medical exam may be overlooked by some states, however should the driver be involved in a serious accident you can bet your sweet behind that someone will find that on discovery and make a big deal out of it.

I do agree that the ME should have issued a 3 month card to give the driver time to correct their issues so there likely is more to the story or it is just that, a story.

 

I'm surprised they failed him with a reading of 145 as they usually allow for what is known as "white coat syndrome", or simply put being nervous during the medical which does elevate your blood pressure, this brings back memories as I was going to a new job where they automatically require you to do a medical, and my blood pressure was 156/ 98 prior to this test the highest I'd ever been was about 130/ 90 so it was a huge surprise, needless to say I was told I needed to see a GP as the people testing my blood pressure were not doctors. In the mean time I thought I'd lose a little weight as I was about 12 kg over my average weight lost about 3 kg in 4 days before I saw another GP and my blood pressure was back down to about 143/ 95 still quite high though, out of all the doctors I saw, none said anything to me about watching what I eat, all they wanted to do was blood tests and prescribe me high blood pressure tablets. By fasting, and watching how many processed carbs I ate I was able to get my blood pressure back down to below 130/90 mark no medication required. As the saying goes "an apple a day will keep the doctor away"

 

Well I figured I owe those who responded hear an update. As it turns out the clinic did not send his exam in and they just put it in a file. So he got his self straight and went back in there and finish the exam and his blood pressure reading was normal and they gave him his two-year Medical card. So he’s GTG. I have no idea how it would’ve played out, had they have sent it in. He went to the same clinic, same doctor, explaining why his BP had been temporarily high.

 

This entire story doesn't make any sense to me. It is also why I hate getting into situations where the information is 2nd handed. Again @brian991219 can correct me if I am wrong. According to the BP reading, this person should have received a 3-month card. Then during those 3 months get treatment and come back to the same clinic. The 3 month physical still must be reported to the FMCSA. If I understand the FMCSA rules on this you don't get a 2-year card, you get a 1-year card. The only way I know of to get a 2-year card later is for a ME to certify you no longer have blood pressure problems. (good luck on that)

The only way this makes sense to me is the driver asked the ME to stop the exam explaining the problem and that ME agreed. In this case, it is really not a failed physical as much as it is a delayed physical.

I have been told the FMCSA medical dept has either deployed or is about to deploy algorithms that will look for these things in physicals. These algorithms will kick out physicals for a human to scan over if the algorithm finds something. I do know the amount of people that work in the FMCSA medical dept has increased every year since the 90s.

 

Per my understanding he cut the physical short and basically walked out and told him he would come back. So it got put in a file. The doctor was unable to finish the report because he left. This is where the system gets in the way of what’s practical. This person does not have high blood pressure. Anyone’s blood pressure can spike for a number of reasons temporarily. He knew what those reasons were so he chose to walk out. Realizing he shouldn’t have went in to be evaluated when he did. At that point in time it’s between him and his doctor. He’s paying for it. It’s like going into a private doctor across the street before you go get a DOT physical done. That’s between you and your doctor.
What if you went in for a physical while you had the flu. Everybody’s blood pressure spikes during a fever and having the flu. Does that mean you should be disqualified from driving when you can go back two or three days later and your blood pressure is normal?
I don’t know, I’m just going by what he told me. But he’s good to go now.

 

I can't stress enough that I am not attempting to pick a fight.
Do you see how these two quotes are different? When I read your post #23 I was a bit perplexed until I sort of figured it out. That was why I said this earlier! Now everything makes sense. THANK YOU for that last update!

"The only way this makes sense to me is the driver asked the ME to stop the exam explaining the problem and that ME agreed. In this case, it is really not a failed physical as much as it is a delayed physical."

Now with your last comment, it makes 100% sense. This happens a lot. I wrote about a driver that said the clinic was not going to report his failed physical in this THREAD. This is a good ME there are some fantastic people doing these exams and then there are some crooked and corrupt people doing them as well.

I have actually taken DOT physicals when I was not feeling well. What I tell drivers is to not wait until the last few days. Start looking to get a physical when you get within 60 days of the expiration date. This way you have some margin of safety.

Peace!

 

And most drivers that fail their physicals , fail on elevated blood pressure

buy one of the do it yourself blood pressure things and you can know what your BP is while you are still in the parking lot .

and as mentioned , renew your physical at least 60-90 days before the current one expires .

it’s not a two years card , it’s a 18 -20 month card.

same with the CDL , do NOT wait until the last minute to renew it at the DMV.
As soon as the state will allow you to renew it , go and get it done .

I’ve never had issues with BP,
But a while back when I was sick I bought a home BP tester .
It’s easy to use , wrap the thing around your arm and hit the button , it inflates and does all the work and displays the BP

I’m not OTR and my job no longer requires a CDL , but does require a med card , I gave up haz mat cause I got tired of taking the test every four years , submitting fingerprints etc , but kept the CDL .

i get my physicals done at a nearby CVS pharmacy clinic .
I I’d schedule my exam first thing in the morning , take my BP before I left home , since I was taking it several times a day for a chronic infection I was fighting , chug a bottle of water on the five minute drive over there to have some ammunition for the urine test , and was surprised to find my BP was noticeably higher at the clinic .

the next test I scheduled it early , got up ,took my BP at home , didn’t eat or drink anything . And my BP was the same at the clinic as at home .

for me, drinking water shortly before taking my BP will increase the BP

I’ve verified this at home checking my own BP .

 

I don't think this is true as it used to be anymore. To start with very few drivers actually fail a physical. What a lot of drivers consider a failure is getting < 2 year card. These days with so many carriers using places like Concentra the majority of < 2 year cards are because of sleep apnea. Even with a sleep study, all you get is a one-year card.

What has happened in the last 10 or so years is the FMCSA has moved away from setting standards and moved to a model that gives the ME discretionary authority based on an exam and history to make a decision. Below is a screenshot taken from the 2022 FMCSA medical examiners handbook. Take special notice of that 2nd paragraph. MEs are doing this with BP and OSA. The point is they don't really fail anymore but list the physical as pending waiting on more information.



On that BP device. Please don't skimp here. I use a Veterans Affairs-issued DEVICE much like the one in this link. I have taken readings from it that closely match having it taken the old-fashioned way. It is also critical to match the cuff size to your arm. Make sure you position the cuff correctly on the arm.

 

I don’t consider myself to have high blood pressure myself. I do have a blood pressure monitor that I keep it home and I check it periodically. As I’ve lost quite a bit of weight this last year I was monitoring it closely to see the results which were good. They really do need a more bulletproof way to monitor people’s blood pressure rather than walking into a sterile brightly lit clinic stressed out slap that thing on you after you just walked in, asking you questions and spiking your blood pressure probably by 20+ points on the bottom number. No joke!

here’s me for example. I say this based on years of monitoring my blood pressure. When I first wake up in the morning, I’m all relaxed, I stick the cuff on while laying down and take my blood pressure it is usually 110/65 to 118/70. That’s what it will be in those ranges every single morning that I take it. Unless I’ve been out drinking or something.

I get up, I move around a little bit, maybe take a shower I sit down on the edge of my bed put my feet on the floor and take it again. Guess what it is now? 130/90 ish. Then if I go eat breakfast have a cup of coffee do my usual morning tasks for an hour or so and sit down and take it again? It can be 135/95 sometimes even a bit more. I’ve taken random blood pressure readings after eating a big meal and loading up on caffeine and going about the stresses of the day and I’ve had even higher readings than that. But every single morning like clockwork when I get up and check it it’s always at that lowest number above. That means I do not have high blood pressure. High blood pressure is when your blood pressure is high and it stays high taxing your cardiovascular system. If it sets to a nice low point you’re usually good to go even if it spikes up during the day.

The problem with a lot of drivers they don’t go through this. They just walk into a clinic when they’re stressed out, worked up, probably ate at the buffet and they put that thing on their arm and next thing they know they’re on blood pressure medication‘s. And then they feel like crap.

Long story short these clinics need to start letting you relax for a bit. Maybe even let you lay down for a little bit. Isn’t the point to find out what your true resting blood pressure rate is?

 

I’m sorry if this was answered, but how did he fail with those readings? Was the medical examiner qualified?

I just took mine for a new employer. If it’s above 140/90 but below a certain level, and you DO NOT have a history of high blood pressure (no BP medication) then you get a 1 year card. If it’s higher than whatever that number is, you get a 6 month card. If it’s sky high, they’ll be nice and give you a 3 month card to give you time to get on medication and lower it to below 140/90 (only has to be this low if you’re on BP medication).

On the issue of when it gets reported, the examiner told me he has 30 days (or I think it was 45 days) to actually report any figures. It’s not sent the day you leave.

From what I read, it sounds like your friend panicked and ran out because they weren’t clear and/or he wasn’t understanding that he could get a shorter term medical card based on his readings. Every examiner I’ve dealt with so far or talked to would tell you to come back in a few days so I don’t know…