On May 4th the FMCSA posted a Notice of Proposed Rulemaking, Qualifications of Drivers; Diabetes Standard, proposing to do away with the Diabetes Exemption Program.
Under the current regulation, a driver with insulin treated diabetes may not operate a CMV in interstate commerce unless he or she obtains an exemption from FMCSA.
When you first look at the proposed rule, it looks like a victory for professional drivers who have their ITDM (insulin treated diabetes mellitus) stable and under control. As you read the NPRM closer however, it appears that details are missing, or at least vague to some degree, as described in a recent article by Dr Randolph Rosarion, certified medical examiner listed in the US DOT FMCSA National Registry of Certified Medical Examiners….
Presently, the Diabetes exemption program requires drivers to wait 6 months after starting insulin before applying for an exemption. It also requires drivers to send in quarterly reports to the FMCSA from an endocrinologist on the status of diabetes management, and to undergo an annual eye examination for retinopathy (a complication of diabetes). However, without an exemption process, the FMCSA is no longer responsible for monitoring these reports and is depending on the Certified Medical Examiner to “make the call” to issue a medical card. The issue is however, the ME will be depending on the CDL drivers treating clinician to send in the needed “documentation”, which does not clearly defined what those documents are in the NPRM.
Dr Rosarion proceeds to state in the above article, “The burden will only now be shifted to the medical examiner, and probably will not necessarily be alleviated for the driver either, that is, if the treating clinician properly evaluates and medical examiner certifies accordingly. Then we need to ask, once certified how do we enforce this entire new process in lieu of the current Diabetes Exemption Program, to ensure that the driver using insulin remains compliant?”
In another recent article, Elaine Papp, former Division Chief of the Office of Medical Programs at the Federal Motor Carrier Safety Administration (FMCSA), recently stated
“FMCSA is not only proposing to eliminate the diabetes exemption program but is also eliminating all the prevention and safety requirements that accompanied the exemption program.” Read more
Now, if this isn’t confusing and vague enough, it appears that the Certified Medical Examiners were possibly not notified by the FMCSA of the NPRM, this same rule which would put most of the burden on them( ME’s) when deciding if the driver with ITDM is indeed stable and well controlled enough to be certified.
When we asked Dr Rosarion on this last Saturday evenings AskTheTrucker “Live’ radio show, Pros and Cons of FMCSA Proposed Rule – Drivers with insulin dependent Diabetes, if he had received notice from the FMCSA of the NPRM, he said he had not, and then continued to say he found out about it by checking their website.
I don’t know about you, but I would think that the FMCSA would not only want their ME’s to know about the NPRM, but would want also their valuable input on the NPRM comment section. Comments are due July 6th
In our opinion, if the Medical Examiners were not notified of the NPRM, a letter should be sent out to them. Also, there should be an extension for those who want to submit comments to the website.
Listen to the replay as there were many other eye opening facts and questions that came up during the show.