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Potential Disqualifying Conditions

The DOT medical card may be denied or limited for various conditions that affect driving. These include uncontrolled hypertension (≥ 180/110 mmHg), insulin-treated diabetes without exemption, epilepsy or seizures (unless seizure-free for 8 years with exemption), narcole, untreated moderate-to-severe sleep apnea, active psychosis or severe mood disorders, substance dependence, vision worse than 20/40, and hearing loss (unable to perceive a forced whisper). Additionally, recent cardiovascular events such as heart attacks, angina, arrhythmia, or heart failure, as well as stroke, TIA, syncope with residual deficits, severe respiratory diseases, renal failure, and musculoskeletal disorders that restrict function can also disqualify a driver. However, certification may still be possible if the condition is managed and monitored, and it is essential for to disclose their complete medical history to avoid penalties.

Cardiovascular

- Uncontrolled hypertension 
- Recent MI (heart attack)
- Unstable angina 
- Severe arrhythmias 
- Severe heart failure

- pacemaker/ICD

Neurological

- Epilepsy 
- Narcolepsy 
- Recent stroke/TIA 
- Recurrent syncope

Endocrine

- Insulin-treated diabetes without exemption 
- Hypoglycemia unawareness

Psychiatric

- Active psychosis 
- Severe depression 
- Bipolar disorder 
- Substance dependence

Respiratory

- Untreated moderate-to-severe sleep apnea 
- Severe COPD

Vision/Hearing

- Vision worse than 20/40 
- Significant hearing loss

Musculoskeletal

- Severe arthritis 
- Amputations 
- Severe chronic pain

Renal

- End-stage renal disease without exemption

Gastrointestinal

- Severe IBD 
- History of severe GI bleeding

Hematological

- Severe anemia 
- Bleeding disorders

Medication

- Schedule II substances without clearance 
- Sedating medications

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