United States, Canada end prohibition on insulin-using truckers

March-April 2020

Jami Jones


An agreement between the United States and Canada has been updated to greenlight insulin-using diabetic truckers to operate in cross-border operations between the two countries.

In September, the Federal Motor Carrier Safety Administration and Transport Canada updated an agreement dating back to 1998 that agrees to mutual recognition of medical fitness requirement for truck drivers. That agreement previously prevented insulin-using diabetics from either country from operating in cross-border operations.

The ball started rolling in late 2018, when FMCSA 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, a move whole-heartedly supported by OOIDA.

FMCSA announced in September 2018 it would no longer require insulin-dependent truckers to obtain an exemption from the agency to operate in interstate commerce.

Rather, the agency allowed 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 has to maintain a stable insulin regime and proper control of his or her diabetes, according to the Federal Register notice.

The ban was ultimately lifted in November 2018. However, because of the existing agreement between the U.S. and Canada on physical fitness requirements, cross-border trucking was still off limits.

The new language states:

“Transport Canada and FMCSA agree that as of November 19, 2018, the standards in the Federal Motor Carrier Safety Regulations and the Canadian National Safety Code for commercial drivers with insulin-treated diabetes mellitus are equivalent. Commercial drivers with insulin-treated diabetes qualified to operate commercial motor vehicles under the standards of one country will also be qualified to operate such vehicles in the other country.”

Even with the ban lifted, Canadian drivers with insulin-treated diabetes can’t operate in the U.S. yet. As of mid-January, the Canadian Trucking Alliance reported that because of the change Canadian jurisdictions are searching the driver licensing system to identify licenses with the diabetes-related code W and notifying those individuals that the ban is lifted. According to the Alliance, that will take time to complete depending on jurisdiction. LL


Jami Jones

Jami Jones has been in journalism since 1991 – focused on the trucking industry since 2000. Whether judging Shell SuperRigs or writing hard-hitting analyses, she covers trucking from lug nuts to legislation – always with the trucker in mind.