With some warnings, they are fairly accurate. Federal Highway Admin design standards require that they be within 2 inches at time of construction.
However....
1. States have uniformly adopted FHWA standards. Cities and Counties are on their own. Nobody deliberately miss-marks a clearance, but some may not be marked at all.
2. Maintenance agencies tend to leave old signs in place when they repave (except on Interstates) and paving can raise the road surface as much as 1.5", reducing clearance.
3. 13'- 6" is minimum for federal and state roads without advanced warning signs. Minimum is measured at the closest point between the road surface and the bottom of the overhead structure; usually at the right edge line of the right lane.
4. Confirm your actual highest point. (RV manufacturers frequently forget air conditioners or sat dishes) Measure with the unit loaded for travel and the air suspension (if equipped) pumped up. My trailer is 12' - 9" over the front AC. I approach anything less than 13' - 3" (six inches clear) with extreme caution. My height in English and Metric units us written in large letters on a card taped to the driver's sun visor.
A