FMCSA Revises its Regulations on Insulin-Treated Diabetes Mellitus

(This article first appeared in the January/February 2019 issue of the American Postal Worker magazine) 

By MVS Division Director Michael O. Foster

In a significant change to Department of Transportation (DOT) rules, the Federal Motor Carrier Safety Administration (FMCSA) has issued a revision to the policy on insulin dependent diabetics operating Commercial Motor Vehicles, 49 CFR Part 391 [Docket No. FMCSA -2005-23151].

This change should also impact USPS drivers who are required to possess a Commercial Drivers License (CDL) in their postal duties. The USPS, since 1995, has voluntarily participated in the DOT CDL process, but has yet to respond to the APWU’s October 3 inquiries on this issue. Insulin-dependent diabetes and respiratory dysfunctions, including sleep apnea, are among the illnesses that our members experience. DOT’s acknowledgement that these illnesses should not be an automatic disqualification is an indication that medicine continues to make major progress in the treatment of these illnesses. The rule change was effective Nov. 18, 2018. Highlights of the changes are listed below:

Previously, the Federal Motor Carrier Safety Administration regulations prohibited individuals who had an insulin-treated diabetes mellitus (ITDM) from driving a commercial motor vehicle in interstate commerce, unless they first obtained an exemption from the FMCSA.

On Sept. 11, 2018, the FMCSA issued a public notice to all interested parties that it had revised the qualification standards of drivers with diabetes. The notice advises that the FMCSA revised its regulations to permit individuals with a stable insulin regimen and properly controlled ITDM to be qualified to operate commercial motor vehicles (CMVs) in interstate commerce. The notice also established a process for drivers to obtain the needed medical certification.

This rule enables a certified medical examiner to grant an ITDM-dependent individual a Medical Examiner’s Certificate, MCSA-5876, for up to a maximum of 12 months. To do so, the treating clinician, the health care professional who manages and prescribes insulin for the treatment of the individual’s diabetes, provides the Insulin-Treated Diabetes Mellitus Assessment Form MCSA-5870 to a certified medical examiner indicating that the individual maintains a stable insulin regimen and proper control of his or her diabetes. The certified medical examiner then determines that the individual meets FMCSA’s physical qualification standards and can operate a commercial motor vehicle in interstate commerce.

This final rule amends the Federal Motor Carrier Safety Regulations to allow individuals with stable insulin regimens and properly controlled ITDM to drive CMVs in interstate commerce if they meet the physical qualifications standards in 391.41, 391.45, and 391.46. The final rule eliminates the diabetes grandfather provision under 391.649(a) one year after the effective date of this rule and also eliminates the need for the federal diabetes exemption program.

As is customary, it is a primary responsibility of MVS craft officers, when they hear from the National Business Agents or members out in the field of changes to regulations which may have an effect on the Craft and the capacity of the membership to do their jobs, to make the Postal Service aware of the change and impose on them a response to their position.

On Oct. 3, 2018, the APWU sent an inquiry to the Postal Service in reference to the Federal Motor Carrier Safety Administration’s revision to its regulation permitting drivers with IDTM to operate a commercial motor vehicle. The letter stated the obvious FMCSA revised regulation, and further asked the USPS for the instructions to their employees, management, and contract physicians concerning the implementation of this policy.

The expectation would be that since the USPS voluntarily participates in the DOT CDL process, they would adhere to the FMCSA revision and implement the new policy permitting insulin dependent diabetics to operate a commercial motor vehicle.