The Federal Motor Carrier Safety Administration (FMCSA) issued a notice officially withdrawing exemptions processes set up in 2003 and 2005 for individuals with insulin-treated diabetes mellitus (ITDM) to be medically certified to operate commercial motor vehicles (CMVs) in interstate commerce.
The agency determined that an exemption program for these individuals is no longer necessary. A new rule published Sept. 19, 2018 allows certified medical examiners, in consultation with the driver's treating clinician, to evaluate and determine whether to grant an ITDM individual a medical examiner's certificate to drive a CMV in interstate commerce.
"Obtaining certification under the new standard should be much less burdensome in terms of both time and resources than the lengthy process of applying for and maintaining an exemption," FMCSA said. Any medical examiner's certificate obtained under an exemption when the new standard took effect will remain in effect until it expires or is replaced by a certificate issued under the new standard.
Before those current certifications expire, a new medical examiner's certificate must be issued under the new standard to operate a CMV, FMCSA explained.
The new rule allows individuals with stable insulin regimens and properly controlled ITDM to drive CMVs in interstate commerce if:
—They have an annual or more frequent examination by a certified medical examiner,
—Are found physically qualified to operate a CMV, and
—Are issued a medical examiner's certificate from a certified medical examiner.
Prior to the at least annual examination, the individual must have an evaluation by his or her treating clinician. The "treating clinician" is defined as the health care professional who manages and prescribes insulin for the treatment of the individual's diabetes as authorized by the health care professional's state licensing authority.
FMCSA claims the amended diabetes standard "provides a less burdensome approach that emphasizes individualized assessment and utilizes the treating clinician of the ITDM individual to assist the certified medical examiner in making the certification determination."
Under the new standard, note that an ITDM individual who has a severe hypoglycemic episode is prohibited from operating a CMV and must report the episode to and be evaluated by a treating clinician "as soon as is reasonably practicable."
The prohibition from operating a CMV continues until the ITDM individual has been evaluated by a treating clinician who determines that the cause of the severe hypoglycemic episode has been addressed and that the individual again has a stable insulin regimen and properly controlled ITDM.
In addition, ITDM individuals who have been diagnosed with severe non-proliferative diabetic retinopathy or proliferative diabetic retinopathy are disqualified permanently from operating a CMV in interstate commerce. FMCSA determined that these advanced stages of diabetic retinopathy present a serious risk to visual function, safe operation of a CMV and public safety.
Detailed explanations of the process for complying with the new physical qualification requirements are included in the final rule available at www.federalregister.gov/documents/2018/09/19/2018-20161/qualifications-of-drivers-diabetes-standard.