The Federal Motor Carrier Safety Administration (FMCSA) has removed its former prohibition against truck drivers with diabetes being allowed to drive commercial motor vehicles (CMVs) of any kind in interstate commerce.
Specifically, the federal government has changed its regulations. Effective November 19, 2018, individuals with (1) a stable insulin regimen and (2) properly controlled insulin-treated diabetes mellitus (ITDM) will be considered qualified to drive commercial rigs and other CMVs (think buses).
You can read the complete Final Rule as it appears in the Federal Register online.
Diabetic Truck Drivers No Longer Need FMCSA Exemption
Under the prior federal law, any trucker suffering from diabetes that wanted to drive a rig (or semi-truck, 18-wheeler, tractor-trailer, etc.) across state lines had to go through a burdensome, time-consuming, and expensive process to get an official FMCSA exemption. The regulation applied to any driver who had been diagnosed with diabetes mellitus that was treated with insulin.
The condition, as described in the federal regulations, is “insulin-treated diabetes mellitus” or “ITDM.” The old FMCSA Rule excluded any truck driver who treated his or her diabetes with insulin regardless of how well a person managed his or her diabetes.
Why did the federal government have a general rule that drivers with diabetes could NOT drive commercial vehicles across state lines, and only an exception that some could if they were able to get an agency exemption?
FMCSA took the position that drivers with diabetes were too risky to be trusted with a commercial motor vehicle. Unless convinced by medical professionals (and this was not easy to do), the truck driver diagnosed with diabetes and needing to use insulin was forced to find another line of work, or try to find someone who would allow him or her to drive within state lines (or local routes).
The agency’s position has changed.
New Procedure: Medical Examiner Confirms Treating Doctor’s Assessment
Starting next month, a truck driver does not have to apply for the agency exemption. Instead, he or she can go to a “certified medical examiner” to get a “Medical Examiner’s Certificate” (MEC) (FMCSA form MCSA-5876).
The MEC covers the trucker for a year; then he or she has to return for another evaluation and another MEC.
The certified medical examiner cannot be the truck driver’s own personal doctor. The doctor who is treating the trucker for diabetes (and prescribing the insulin) completes a form called the Insulin-Treated Diabetes Mellitus Assessment Form (FMCSA MCSA-5870).
This form is given to the certified medical examiner. The examiner confirms that the truck driver (1) maintains a stable insulin regimen and (2) has proper control of his or her diabetes. The certified medical examiner then checks to make sure that the truck driver meets FMCSA’s physical qualification standards. If so, then the driver is approved to drive commercial vehicles in interstate commerce.
From FMCSA Administrator Raymond P. Martinez:
“This final action delivers economic savings to affected drivers and our agency, and streamlines processes by eliminating unnecessary regulatory burdens and redundancy. It’s a win-win for all parties involved.”
Saves Money for FMCSA and Truck Drivers
According to FMCSA, this new Final Rule will save both truck drivers and the federal government a lot of money. Specifically, FMCSA looks to save over $1 Million each year (2018-2021) just from not having to incur the costs of handling all those diabetes exemption requests.
FMCSA also forecasts that for the 5000 or so truck drivers who successfully received exemptions under the old rule, as a group they will save over $5 Million each year, as compared to the old system.
As for new ITDM exemption applicants (and their associated motor carriers), FMCSA estimates that they will save around $215,000 each year in costs related with the exemption waiting period.
American Diabetes Association Welcomes the FMCSA Change Regarding Truck Drivers with Diabetes
The American Diabetes Association (ADA) immediately announced that it “applauded” the new FMCSA rule. The ADA sees the change as a victory in a battle it has been fighting for truck drivers for over 20 years.
The ADA’s position was the old procedure discriminated against drivers “simply because of how they treat their diabetes.” It hurt more drivers than those driving interstate routes; the ADA pointed out how employers often adopted the old FMCSA Drivers with Diabetes rule, even if their drivers were not involved in interstate trucking.
From Katie Hathaway, JD, Vice President of Legal Advocacy for the American Diabetes Association:
“This rule eliminates a longstanding barrier that prevented people with diabetes from fully realizing their potential in the workforce. I’m proud of ADA’s commitment to this issue and to leading the fight for what’s right for people with diabetes. We are so pleased to celebrate this victory alongside those affected by the outdated rule.”
Truck Driver Health Issues and Fatal Truck Crashes
Of course, the concern that created the old rule was that the truck driver suffering from diabetes (ITDM) was placing himself (or herself) and others at risk by driving a heavy commercial vehicle of any type (bus, big rig, semi, tractor-trailer, 18-wheeler, etc.).
Truck accidents are often fatal crashes. Often, the truck driver perishes in the accident.
For more information, see: Truck Driver Fatalities at Highest Rate in Six Years: Where’s the Impact of Safety Regulations Like New HOS Rules?
Medical advancements in the understanding of diabetes and its treatment reveal that the broad-brush ban (unless an exemption was granted) is not needed for public safety.
Explains Daniel Lorber, MD, FACP, CDE, member of the FMCSA Diabetes Expert Panel:
“Data show people with diabetes do not pose an unacceptable risk to public safety, and blanket bans based on science and medicine from 1970 are not medically supported…. FMCSA is ending its exemption program not because it doesn’t work, but precisely because it has demonstrated the feasibility of identifying qualified drivers and the safety of putting them on the roads.”
We know from FMCSA research that an overwhelming majority of fatal commercial truck accidents are caused by the truck driver. The risk of a fatal truck crash is especially high here in our part of the country, the “Crossroads of America.” Indiana and Illinois are second only to California and Texas in the number of fatal large truck and bus crashes in this country.
How many truck drivers on the roadways of Indiana and Illinois suffer from medical conditions, like diabetes, that can impact their ability to drive? How many truckers are operating their rigs or semis with serious and undiagnosed medical conditions?
In our next post, we’ll discuss the dangers of trucker medical conditions and truck driver illness or disease as a factor in fatal truck crashes. Diabetes is one issue; others include sleep apnea and heart disease. Please be careful out there!
