The Federal Motor Carrier Safety Administration (FMCSA) has published a final rule that will allow drivers with a stable insulin regimen and properly controlled diabetes mellitus to be qualified to operate commercial motor vehicles in interstate commerce.
Men and women with diabetes have been prohibited from driving commercial vehicles unless they obtain an FMCSA exemption. The rule eliminates the exemption program and replaces it with another clinical review process.
Effective Nov. 19, 2018, an applicant’s treating clinician (the health care professional who prescribes insulin and monitors the person’s medical condition) will review three months of glucose logs and attest on a form that the individual’s condition is stable. The form and other information will be reviewed by a qualified medical examiner listed on the National Registry of Certified Medical Examiners to determine whether the individual meets the FMCSA’s physical qualification standards.
FMCSA officials estimate eliminating the exemption program will save nearly 5,000 drivers with diabetes more than $5 million a year, and reduce annual costs for applicants and employers by about $215,000. The agency expects to save more than $1 million annually over the next three years in costs associated with administering the diabetes exemption program.
“The rule will put the responsibility on (certified medical) examiners, essentially relying on the information provided by the treating clinician on the Insulin-Treated Diabetes Mellitus Assessment Form, MCSA-5870,” said Natalie P. Hartenbaum, M.D., M.P.H., president and chief medical officer of OccuMedix and an expert on federal transportation regulations.
The driver would be disqualified if he or she experiences a severe hypoglycemic episode requiring the assistance of others or resulting in loss of consciousness, seizure or coma. Dr. Hartenbaum said “significant differences with the current process include no exemption, no annual eye exam, no annual visit and quarterly evaluation by an endocrinologist.”
WorkCare occupational physicians who are qualified as Medical Review Officers (MROs) and commercial driver Medical Examiners perform clinical reviews for applicants and employees on behalf of client companies.