What is a waiver? An exemption?

A waiver is temporary regulatory relief from one or more of the FMCSRs given to a person subject to the regulations, or a person who intends to engage in an activity that would be subject to the regulations. A waiver provides the person with relief from the regulation for up to three months. 49 CFR 391.64  provides waivers to CMV drivers who were in the initial vision and insulin programs in the early 1990’s.

An exemption is a temporary regulatory relief from one of more of the FMCSRs given to a person or class of persons subject to the regulations, or who intend to engage in an activity that would make them subject to the regulation. An exemption provides the person or class of persons with relief from the regulations for up to two years, but may be renewed.

 No Current Waiver Programs


Prior to the implementation of the Federal Vision Exemption Program, FMCSA conducted an initial vision study program that ran from 1992 to 1996. At the conclusion of that study, 2,656 drivers received a one-time letter confirming participation in the study and granting a continued exemption from the monocular vision requirement, as long as the driver is otherwise medically fit for duty and can meet the vision qualification requirements with the one eye. The driver who was grandfathered must have an annual medical examination and an eye examination by an ophthalmologist or optometrist. There are very few remaining drivers from that program.

At the annual medical examination, the driver should present to the medical examiner the letter identifying the driver as a participant in the vision study program and a copy of the specialist eye examination report. Certify the qualified driver for 1 year and issue a medical examiner’s certificate with the “Qualified by operation of 49 CFR 391.64” checkbox marked.


The diabetic insulin exemption was just phased out on November 19, 2018.

The diabetes exemption program is now discontinued.

Summary of new insulin treated driver rule:

FMCSA revises its regulations to permit individuals with a stable insulin regimen and properly controlled insulin-treated diabetes mellitus (ITDM) to be qualified to operate commercial motor vehicles (CMVs) in interstate commerce.

Previously, ITDM individuals were prohibited from driving CMVs in interstate commerce unless they obtained an exemption from FMCSA.

This rule enables a certified medical examiner (ME) to grant an ITDM individual a Medical Examiner’s Certificate (MEC), MCSA-5876, for up to a maximum of 12 months.

To do so, the treating clinician (TC), the healthcare professional who manages, and prescribes insulin for, the treatment of the individual’s diabetes, provides the Insulin-Treated Diabetes Mellitus Assessment Form (ITDM Assessment Form), MCSA-5870, to the certified ME indicating that the individual maintains a stable insulin regimen and proper control of his or her diabetes.

The certified ME then determines that the individual meets FMCSA’s physical qualification standards and can operate CMVs in interstate commerce.

MCSA 5870 form to be filled out by treating physician and provided to medical examiner.

The full rule is published here

“Just give me a waiver doc!”

Medical Examiners do not issue waivers or exemptions!

I’ve had numerous drivers over the years, when failing their exam for diabetes or monocular vision, say to me “Just give me a waiver, doc!”

When you get trained, you’ll learn exactly the procedures to follow that allow a driver to apply for a diabetes or vision exemption, how to complete and record the exam in such cases, and how to fill out the medical certificate, checking the correct boxes and restrictions regarding diabetes or vision waivers and exemptions.

You must get trained and certified in order to perform DOT exams!

For course and CME credit information visit http://www.nadme.org/

Click here to begin your training today!

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