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Guidance/Advisory Criteria — Tests

Exercise Tolerance Test

The exercise tolerance test is the most common test used to evaluate workload capacity and detect cardiac abnormalities.

Driver should be able to:

  • Exercise to a workload capacity greater than 6 Metabolic Equivalents (METs) (through Bruce protocol stage II or equivalent).
  • Attain a heart rate greater than or equal to 85% of predicted maximum (unless on beta blockers).
  • Have a rise in systolic blood pressure greater than or equal to 20 mm Hg without angina.
  • Have no significant ST segment depression.

NOTE: METs — Extensive literature exists on the energy requirements for many physical tasks.

  • Sedentary activity requires fewer than 2 METs. These activities include sitting, slow walking, and lifting light objects of no more than 10 pounds.
  • Light work requires 2 to 4 METs and includes carrying lightweight objects of no more than 20 pounds.
  • Medium work requires 4 to 6 METs and includes carrying moderate weight objects of up to 50 pounds.
  • Heavy and very heavy work requires greater than 6 METs and includes carrying heavy objects and climbing stairs rapidly.


Medical fitness for duty includes the ability to perform strenuous work. Overall requirements for commercial drivers along with the specific requirements in the job description should be deciding factors in the certification process.

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