I know some examiners that have high volume practices and don’t require commercial drivers to disrobe for a DOT physical.
Here’s an interstate driver who popped into a truck stop restaurant to wolf down a burger and fries.
Some would argue that this condition is not likely to be the immediate cause of an accident.
Until the development of an acute deep vein thrombosis or a pulmonary embolus.
But it might prompt an examiner to consider other cardiovascular conditions, and consider risk factors of obesity, possible diabetes, sleep apnea, etc.
How would you certify such a driver?
If multiple conditions are uncovered during the DOT physical “teetering on the edge” one might submit a “determination pending” to allow a complete work up with the primary doctor. Or you could go anywhere from a few months to a year to monitor progression and see if any other conditions rear up. I doubt I’d feel comfortable giving a full 2 year certificate at any rate.
Similarly, many a chest or abdominal surgical scar is missed by not making a simple observation. Joint swelling, bruising, petechiae and rashes can all be missed. I’ve even heard of an examiner not knowing a driver had a prosthetic leg because he never looked!
Make the driver disrobe for their DOT physical. Unfortunately, they’re not all going to be completely forthcoming regarding recent or past surgery and so many other conditions you can pick up with simple observation.