One number runs this exam: 140/90. Everything about blood pressure at a DOT physical — the stages, the certificate lengths, the second-chance process — hangs off where your reading falls against it.
The checker reads your verdict. The Kit gets you through the exam: documentation packets for your condition, the two 45-day form clocks run as a calendar, the official medication form packet, waiting-period calendars, failure recovery, and the examiner phone script.
| Reading | Stage | What the standard does |
|---|---|---|
| Below 140/90 | Meets the standard | Full certificate length available (up to 2 years), unless medication or another condition shortens it |
| Below 140/90, on BP medication | Meets the standard, treated | 1-year certificate, annual recertification |
| 140–159 / 90–99 | Stage 1 | 1-year certificate, annual recertification |
| 160–179 / 100–109 | Stage 2 | One-time 3-month certificate to reach control; not qualified if control is not reached in the window |
| 180/110 or above | Stage 3 | Not qualified while the reading stands; once controlled to 140/90 or below, 6-month certificates |
Federal source: Appendix A to Part 391, §A; FMCSA Medical Examiner's Handbook 2024, §4.6 · Rules checked October 2026
The higher number governs. A reading of 150/105 is Stage 2 — the diastolic decides it. Staging uses whichever of your two numbers falls in the higher stage.
The 3-month certificate is one-time. Stage 2's short certificate exists to give treatment a window. It is not renewable as a lifestyle; if the window closes without control, certification waits until the reading is at or under 140/90.
There is no federal "borderline." 139/89 and 140/90 are different certificates. The line is the line — which is why the two weeks before the exam (treatment consistency, sleep, the home log) matter more than the two minutes in the cuff.
The examination process contemplates re-measurement during the same visit after rest. Ask for it, calmly — it is inside the published process. What is not inside the process: discarding readings, or visiting a second clinic the same day without disclosing the first (49 CFR 390.35 makes concealment falsification). The full published-process protocol — and the home-log template — is §5 of the Medical Card Kit.