BLOGOccupational Health

Federal Physical vs. DOT Physical: Which One Do You Need?

KH
By Kee Health·October 2026·5 min read
Desk with a toy semi truck, a model government building, a stethoscope, a clipboard and a blood pressure cuff, comparing DOT and federal physicals
Quick answer

A DOT physical is the federal medical exam for commercial drivers. It must be done by a medical examiner on the FMCSA National Registry, and it can be good for up to 24 months. A "federal physical" usually means an exam a federal agency requires for a job with medical standards, and the agency decides the form and who does it. Pilots need a separate FAA medical from an FAA Aviation Medical Examiner. If you drive a commercial vehicle and need a DOT physical in the Madison, WI area, that is the one to book.

"Physical required" can mean different exams. Here is a plain side-by-side for drivers, federal workers, and pilots in Dane County, so you book the right one.

The short difference

The name tells you who sets the rules. A DOT physical follows the Federal Motor Carrier Safety Administration (FMCSA). A federal job physical follows the hiring agency. A pilot medical follows the Federal Aviation Administration (FAA).

  • Different rules. Each exam checks against its own standards.
  • Different examiners. Each one requires a certain kind of examiner, so not every clinic can do every exam.
  • Not interchangeable. One exam does not count for another unless the agency or employer says so in writing.

Side by side: drivers, federal workers, and pilots

Exam 1

DOT physical (drivers)

  1. Who: Commercial drivers, such as interstate drivers of vehicles rated at 10,001 pounds or more, vehicles that carry 9 or more people for pay, or placarded hazmat loads. Many Wisconsin in-state CDL drivers need one too.
  2. Examiner: A certified medical examiner on the National Registry.
  3. Good for: Up to 24 months, or less if a condition needs a closer look.
Exam 2

Federal job physical

  1. Who: Applicants and employees in federal positions with set medical standards or physical requirements.
  2. Examiner: Whoever the agency names. Many agencies use their own medical staff or contractor, and some send a form such as the OF-178.
  3. Good for: Whatever the agency sets.
Exam 3

FAA pilot medical

  1. Who: Pilots who need a first, second, or third class medical certificate.
  2. Examiner: Only an FAA-designated Aviation Medical Examiner (AME). Find one with the FAA's AME locator.
  3. Good for: Depends on the class and your age.

Flying under BasicMed? That uses FAA Form 8700-2 and an exam by a state-licensed physician.

What happens at a DOT physical

The examiner reviews your health history and medications, then checks the standards set in federal rules:

  • Vision. At least 20/40 in each eye, with or without glasses, plus side vision and the ability to tell signal colors apart.
  • Hearing. Hearing a forced whisper at 5 feet in your better ear, or a hearing test, with or without a hearing aid.
  • Blood pressure, heart, and lungs. High blood pressure can mean a shorter certificate.
  • Urine test. This screens for health issues such as sugar or protein. It is not a drug test.

Results go to the FMCSA electronically. Wisconsin's DMV now gets them within about 48 hours, and since October 12, 2026, a paper medical card no longer counts as proof in most states. Bring the items on our DOT physical checklist.

Federal workers who drive

Driving for the federal government is excepted from FMCSA's medical rules, so a federal job with driving duties follows your agency's rules instead. Ask your agency which exam, form, and examiner it wants before you book anywhere. Wisconsin CDL holders also self-certify a tier on DMV form MV3230, and that tier decides whether you need a DOT medical card on file.

When to book or renew, and red flags

  • New job or new CDL. Book once you know which exam is required.
  • Renewal. Book a few weeks before your certificate expires. Check the date, since it may be shorter than two years.
  • Health changes. A new diagnosis, surgery, or medication can affect whether you are qualified.
Bring records from your doctor or call ahead if you have:
  • High blood pressure or a heart condition
  • Diabetes treated with insulin
  • Sleep apnea, seizures, or vision or hearing loss
  • A recent surgery, injury, or new medication

See DOT physicals with medical conditions for what to bring. Chest pain, trouble breathing, or stroke signs need 911, not a physical.

How Kee Health helps

We do DOT physicals in Waunakee with Dr. Bret Toftness, DC, NRCME, RN (Dr. B), a nationally registered medical examiner.

Text or call us at (608) 207-8212. We are at 5939 State Road 113 in Waunakee. Appointments are preferred, and same-day visits may be available.

Book your DOT physical→

Need drug, alcohol, or other occupational health services? Book occupational health.

Frequently asked questions

Is a DOT physical the same as a federal physical?

No. A DOT physical follows FMCSA rules for commercial drivers. A federal job physical follows the hiring agency's rules. Ask the agency.

How long is a DOT physical good for?

Up to 24 months. The examiner can certify you for less time, such as one year, to keep an eye on a condition like high blood pressure.

Can a chiropractor do a DOT physical?

Yes, if they are a certified medical examiner on the FMCSA National Registry. Doctors of chiropractic are among the professions allowed. Dr. B at Kee Health is on the Registry.

Does a DOT physical include a drug test?

No. The urine test checks for health issues. A DOT drug test is a separate test that employers order. Kee Health offers both.

This article is for general education and is not medical or legal advice. Rules change, so confirm requirements with FMCSA, the Wisconsin DMV, your agency, or the FAA. Passing an exam is never guaranteed.