Here’s a question about diabetes exemption in DOT Commercial driver from one of our NRCME training program students:
Let’s see if I understood <the diabetes> exemption guidelines sequence.
If the driver is insulin diabetic…
I do the exam. He is qualified except for the insulin…so I fill out the Medical Exam Form, indicate he is currently disqualified, say why, but don’t write anything on the certificate. ( in this case the driver has never had an exemption before).
Then…the driver applies for the Federal <diabetes> exemption program and shows a copy of my Medical Exam Form. In my geographic area they get that exemption application form from the DMV.
Then…if and when he receives the Federal exemption form, I fill out a follow-up Medical Exam Form and certificate indicating he can drive if accompanied by the Federal Exemption form.
Not exactly.
If the driver is otherwise qualified except for using insulin, on the exam form you mark qualified for one year due to diabetes AND :
- Mark the “accompanied by a __________ exemption checkbox
- Write “federal diabetes” on the line
- Circle “exemption”
So the confusing part about diabetes exemption in DOT Commercial driver is although you have marked “meets standards” they are still disqualified UNLESS accompanied by the exemption, which they now have to apply for. See driver exemption programs for more details. They do not have to return to you for another exam after getting the exemption, until the one year has passed.
Once they are already in the federal exemption program and presenting for recertification, they must provide for you:
- Federal diabetes exemption certificate (renewed every 2 yrs)
- annual opthalmologist evaluation
- quarterly endocrinologist report
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what qualifications need to be met in order to qualify for the dot diabetic exemption?
Dale, that’s exactly the stuff we cover in detail each month in the NRCME Seminar Series – there is also a single session available for exemptions-check it out: Exemptions
My patient is a 35 yo type 1 diabetic x 25 yrs. He needs a DOT ( but NOT a CDL ) to move 1 ton trucks around in a parking lot. He does not get out on the road. Does he still need a waiver? I would assume so but need to be sure.
Any driver required to have a DOT exam would have to meet the same federal standards. An insulin dependent diabetic would have to apply for a federal diabetes exemption to qualify.
If in a state that has a “state variance” for these types of drivers, you may be able to use the state determination section indicating the applicable state variance. Check with your state DMV for specifics.
Lastly, the company hiring this driver may not in fact need them to be “DOT certified”, so this may be a question to pose to the employer.
My understanding is that the Feds are not granting new exemptions for insulin dependent diabetic drivers. They are only allowing continuation of previously granted exemptions as part of the trial program which ended in the 80s.
Am I wrong?
If this is true than it is rather absurd and cruel to issue a card that is valid only with an exemption that is not available. Furthermore, I have concerns about giving a card with my name on it that is not valid. If the driver uses the card without getting the exemption and bad things happen he will probably deny that he was properly informed. I don’t see what would prohibit an independent truck driver with using such a card and ignoring the exemption. I can easily see that given our rather irrational court system I would somehow be partly responsible for an accident involving an insulin dependent driver.
The federal diabetes exemption process is alive and well. In fact, here is the most recent federal register notice of diabetes exemptions granted.
The proper procedures for the medical examiner in the case of a driver examinee with IDDM who is otherwise qualified is to check the box that the driver is qualified only when accompanied by a federal diabetes exemption, as described in the post.
As a certified medical examiner, you are obligated to follow proper procedures. My advice to you regarding your liability concern is to clearly document in the comments section that you have informed and discussed with the driver the limitation of the certification requiring a diabetes exemption and that you have provided the driver with the information to seek an exemption from FMCSA (links in post above).
It is the driver’s responsibility to obtain an exemption before driving commercially with the restricted certificate you have issued.