Commercial Driving and Mental Illness: What Are the Rules?

Commercial driving plays a vital role in keeping our economy moving, but it also comes with significant responsibility. To protect both drivers and the public, it’s essential that anyone operating a commercial vehicle is physically and mentally prepared for the demands of the job. Truck drivers must be able to make quick decisions, stay focused for long periods, and remain calm under pressure. When mental, psychiatric, or behavioral traits interfere with these abilities, the risk to roadway safety increases.

For this reason, the Federal Motor Carrier Safety Administration (FMCSA) pays close attention to behaviors such as anger, aggression, impulsiveness, and hostility. These traits can sometimes accompany certain mental health conditions and are known to put drivers at a significantly higher risk of causing an accident.

However, having a mental health diagnosis does not automatically disqualify you from obtaining or keeping a commercial driver’s license. Conditions like depression, ADHD, and others are often manageable with proper care. During your DOT medical exam, a certified medical examiner will review your health history, current treatment plan, and overall stability to determine whether it is safe for you to operate a commercial motor vehicle. In many cases, drivers who are effectively managing their condition can be fully certified.

FMCSA Regulations Regarding Mental Health

There are three categories of risk the medical examiner must consider when making a physical qualification determination.

• The mental disorder itself, including symptoms that may pose a risk when driving

• Residual or lasting symptoms that occur after a single episode or initial presentation
• Medications to treat the disorder, as many psychotropic medications could interfere with safe driving

FMCSA guidelines require that a medical examiner assess any mental health condition on a case-by-case basis. The examiner will consider the specific disorder and symptoms, the effectiveness of treatment, the medications prescribed, and any interactions between medications. For most mental health conditions, the consensus among medical examiners is to limit a driver’s certification interval to 1 year.

Disqualifying Mental Health Conditions

While medical examiners can make exemptions and accommodations, below is a list of DOT-disqualifying mental conditions:

• Dementia
• Personality disorder
• Active Psychosis/Schizophrenia

The more serious a disorder, the more likely it is that the driver will not be physically qualified.

Getting a CDL Medical Card with a Mental Health Diagnosis

If you have received a diagnosis of a mental disorder, you might be worried about obtaining or renewing your commercial driver’s license. With support, you can get an accurate diagnosis, find ways to manage your illness, pass a DOT medical exam, and obtain your CDL.

Meet With Your Treating Provider

You can prepare for your exam by bringing documentation detailing your medical history and prescription drugs. Obtain a letter from your treating provider describing your condition and treatment plan and a statement that you can perform your duties safely will speed up the process.

Follow-Up

For your safety and long-term health, it is important that you continue to follow up with your doctor to stay on top of your treatment and medication.

Learn how commercial drivers can navigate through depression.

Mental Health Stigmas

Mental health issues are on the rise. Both men and women experience mental health challenges, but men are less likely to receive treatment due to the negative stigma surrounding mental disorders.

If you are experiencing symptoms of depression or ADHD, you might be tempted to ignore them rather than risk your CDL. This is dangerous for you and the public. Ignored mental health issues can lead to anger and aggression, an inability to concentrate, drug and alcohol use, insomnia or excessive tiredness, or even an increase in risky behavior or thoughts of suicide.

It is possible to continue your career as a commercial driver with a mental disorder diagnosis, but only if you seek treatment to manage your challenges. Choose to prioritize your well-being and safety by consulting with your doctor and taking charge of your mental health.