The Trucking Law segment is a monthly feature on Overdrive, in which we pose commonly asked questions from truckers and owner-operators to legal experts. In this installment, Dr. Alex Underwood goes into what is required of truck drivers with diabetes mellitus and the dangers of trying to lie about having the disease. Find all Trucking Law installments via this link.
Drivers have diabetes mellitus (DM), specifically Type II DM, at a higher rate than the general public. This is likely rooted in the sedentary lifestyle and poor food choices many drivers make, so some of them are treated with simple lifestyle and diet changes. Others receive oral medications or insulin.
Years ago, the Federal Motor Carrier Safety Administration automatically disqualified drivers if they were dependent on insulin to treat their DM. Later, the agency allowed individuals with ITDM (insulin-treated diabetes mellitus) to drive professionally but only after jumping through hoops and obtaining a federal exemption.
As of November 2018, FMCSA has streamlined the process. Drivers need only to complete the DOT medical exam with an additional form, but there is no need for a federal exemption. This also has reduced significantly the financial burden of getting cleared to drive.
The driver needs to provide form MCSA-5870 (available online here) to the insulin prescribing physician and bring the completed form to their next DOT physical. Based on how well-maintained the driver’s DM is on an insulin regimen, the certified medical examiner (CME) then can grant a medical certificate for up to 12 months.
When performing DOT medical exams, I often see patients with poorly controlled DM. Many are on a variety of expensive and sophisticated medications.
They often say, “My doctor really wants me on insulin, but I can’t drive on it.” I usually send these patients on their way with the new form, and their physicians most likely start them on an insulin regimen. Most return with improved diabetic control and better health.
