Example:
Dear Dr. _______,
The above driver came to our clinic for a DOT medical certificate to drive a commercial motor vehicle. Before qualifying the driver, the DOT medical guidelines require that we obtain your assistance in determining if they have met the necessary medical criteria.
Although we must obtain and consider the opinions of the treating physician, it is our responsibility to make the final driving status determination.
For drivers with a history of angina, the following requirements must be met before being qualified operate a commercial motor vehicle:
- Minimum of 3 months with no angina at rest, change in angina pattern, or decreased response to medication
- Angina is stable
- Driver tolerates medications
- Has a satisfactory ETT every two years, achieving > 6 METS (Bruce Protocol Stage II or equivalent), > 85% target heart rate (unless on beta blockers), 20mm or greater rise in systolic bp without angina, no significant ST segment depression (>1mm); OR
- If ETT is inconclusive, an imaging stress test may be indicated
If the driver meets the above requirements, please sign and date below.
__________________________________________ ___________
Signature Date
If the driver does not meet the above requirements but it is your opinion that the driver should be allowed to drive a commercial vehicle, please identify in the area below which guideline is not met and the medical reason the driver is safe to drive. Then sign in the area provided.
______________________________________________________________________
______________________________________________________________________
__________________________________________ ____________
Signature Date
