FMCSA Streamlines Process Allowing Individuals with Properly Managed Diabetes to Operate Commercial Motor Vehicles

The Federal Motor Carrier Safety Administration (FMCSA) announced a final rule that streamlines the process for some diabetic drivers to be qualified to operate commercial motor vehicles (CMVs) interstate.

A Final Rule  published Wednesday 9/19/18 in the Federal Register allows a diabetic driver’s medical examiner to give the driver a Medical Examiner’s Certificate good for up to one year provided that the driver’s diabetes is well-controlled. The rule will take effect Nov. 19. Before the ruling, individuals with insulin-treated diabetes mellitus (ITDM) were not allowed to operate CMVs interstate unless they received an exemption from the FMCSA.

“The rule enables a certified medical examiner (ME) to grant an individual with ITDM a Medical Examiner’s Certificate, MCSA-5876, for up to 12 months. To do so, the treating clinician – the healthcare professional who manages, and prescribes insulin for, the treatment of the individual’s diabetes – provides the ITDM Assessment Form, MCSA-5870, to the certified ME indicating that the individual maintains a stable insulin regimen and proper control of his or her diabetes. The certified ME is then responsible for determining if the individual meets FMCSA’s physical qualification standards and can operate CMVs in interstate commerce.”

In order to grant the med cert, examiners must receive an ITDM Assessment Form from the driver’s treating clinician – the healthcare professional who manages and prescribes insulin to the driver – stating the driver maintains a stable insulin regimen and proper control of his or her diabetes. The CME then decides if the driver meets FMCSA’s physical qualification standards to operate commercial vehicles in interstate commerce.

Drivers with ITDM will be required to provide their treating clinician with at least three months of blood glucose self-monitoring records to be able to receive the one-year med cert. If three months are not available, the driver can receive up to a three-month certificate until the driver has three months of records.

If a diabetic trucker has a severe hypoglycemic episode, he or she is not allowed to drive a truck and must report the episode and be evaluated by their treating clinician as soon as possible. The driving prohibition lasts until the clinician determines that the episode has been addressed and the driver again has a stable insulin regimen and properly controlled ITDM. The Final Rule defines a “severe hypoglycemic episode” as one requiring the assistance of others or resulting in loss of consciousness, seizure or coma.

Drivers diagnosed with severe non-proliferative diabetic retinopathy or proliferative diabetic retinopathy — both conditions when diabetes affects eyesight — are permanently disqualified from driving a commercial vehicle.

The FMCSA says that the new rule will save approximately 5000 drivers with ITDM about $5 million per year in costs involved with obtaining an FMCSA exemption. The new rule is also expected to save the FMCSA about $1 million over the next three years.

Click on the following link to learn more about FMCSA’s Medical Program Division:



Updated: Tuesday, September 18, 2018

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