ANALYSIS: FMCSA finally loosens regulatory grip on insulin-dependent diabetics

September 18, 2018

Jami Jones


It’s taken more than a decade, but the Federal Motor Carrier Safety Administration cut the last bit of regulatory red tape that stood between insulin-dependent diabetics and a life on the road behind the wheel of a truck.

FMCSA announced Tuesday it will no longer require insulin-dependent truckers to acquire an exemption from the agency to operate in interstate commerce.

Rather, the agency will now allow a treating clinician who manages and prescribes insulin for the treatment of diabetes to decide if the driver meets the physical standards to drive a truck. The driver will have to maintain a stable insulin regime and proper control of his or her diabetes, according to the pending Federal Register notice.

The Owner-Operator Independent Drivers Association has long fought against the initial prohibition against drivers with insulin-treated diabetes and more recently the exemption process they had to complete just to drive.

“We are pleased and heartened that the agency has made the decision to do this. The reality has always been that these drivers have demonstrated their commitment to highway safety and to maintaining their health,” said OOIDA President Todd Spencer. “All the research shows that individuals with diabetes, under stable control with insulin, are no less safe of a driver, and we are pleased that the agency has finally recognized it.

“We hope that this will start a trend. Drivers who have demonstrated their skills and exceptionalism should realistically expect to be treated better, as opposed to continuously having to jump through new, time consuming and expensive hoops.”

The journey toward a physician signing off on an insulin-dependent driver to operate in interstate commerce started more than 15 years ago.

Before 2003 drivers diagnosed with insulin-dependent diabetes were prohibited from operating a truck in interstate commerce, period. But in 2003, FMCSA officials decided that if a driver had three years of driving experience while maintaining proper control of their diabetes, they could apply for and receive an exemption to operate in interstate commerce.

Let that sink in.

The regulations had – with the three-year requirement – made it impossible for individuals to get an exemption to run interstate if they had insulin-treated diabetes.

Finally in October 2005, FMCSA eliminated the three-year driving requirement. The agency made it official in November 2005.

“FMCSA will immediately discontinue use of the three-year criterion for drivers with (insulin-treated diabetes mellitus),” the notice stated. “Applications from drivers with ITDM will no longer be denied because the drivers do not have three years of experience operating (commercial motor vehicles), while using insulin.

“FMCSA will also no longer require submission of a driving record in order to determine exemption eligibility.”

That move wasn’t purely out of the goodness of FMCSA’s heart. Rather, Congress, at the behest of the Owner-Operator Independent Drivers Association, directed the agency to do just that.

Section 4129 of the highway bill, which was signed into law in August 2005, clearly instructed FMCSA to eliminate the requirement of commercial driving either 90 days after the bill was enacted or upon the issuance of the revised final rule, whichever was earlier.

The legislation mandates that insulin-dependent truckers face an individual assessment and prove a period of control before being released to drive interstate. Type 1 diabetics will be subject to a period of no more than 60 days of control and Type 2 diabetics will be subject to a period of no more than 30 days.

On a side note, the first ever exemptions were granted to four individuals a month before the agency announced it would be lifting the driving requirement, and just less than a month before the statutory deadline Congress set.

And, the agency wasn’t done yet.

In March 2006 the agency published an advance notice of proposed rulemaking. The notice went so far to say that “upon completion of this rulemaking, drivers might not be required to apply for exemptions from the current rule.”

That process took 12 years – with OOIDA actively advocating for drivers who, with their personal physicians, maintain proper treatment and control of their diabetes – to finally eliminate the exemption requirement.

The rule will enable the certified medical examiners to grant a 12-month medical card to insulin-dependent truckers whose treating clinician provides a form saying that the driver maintains a stable insulin regiment and proper control of his or her diabetes.

One major win for OOIDA and the truckers it represents is that drivers with insulin-treated diabetes will work with their personal healthcare provider, who treats and assists with management of the driver’s diabetes, to be instrumental in determining the driver’s fitness to drive. The certified medical examiner may confer with the driver’s personal physician on an individual’s medical history and status or request medical records.

The final rule goes into effect on Nov. 19.