Review board uses common sense in diabetes proposal, OOIDA says

By Mark Schremmer, staff writer

The Owner-Operator Independent Drivers Association says the Medical Review Board’s recommendations regarding the diabetes qualification process for drivers of commercial motor vehicles uses a "commonsense approach."

In September, the Federal Motor Carrier Safety Administration’s Medical Review Board (MRB) submitted its recommended guidance for drivers who are being treated for diabetes. OOIDA responded with its official comments on Nov. 8.

"MRB’s recommendations, although long overdue, are reflective of a commonsense approach to medical conditions and commercial vehicle operations," OOIDA wrote. "OOIDA hopes that MRB will maintain this approach in future proposals and guidance. The diabetes qualification process offered by the MRB builds upon the current program and suggests modifications that will benefit both the agency and the driver."

The road to allowing drivers with diabetes to receive a commercial driver’s license has been a long one. Before 2005, drivers with insulin-treated diabetes mellitus were virtually unable to obtain a CDL. An exemption had been allowed in 1992, but it was granted only to diabetes patients who operated in intrastate commerce while using insulin for three years without safety problems. The exemption was moot since most states had regulations that didn’t allow diabetes patients to obtain a CDL.

In 2005, diabetes patients were allowed to receive an exemption after meeting 57 screenings, operating guidelines, and accountability provisions.

"This burdensome process discourages individuals with insulin-treated diabetes mellitus from considering trucking as a viable employment opportunity and also puts existing drivers who are diagnosed with (diabetes) at financial risk," OOIDA wrote.

OOIDA says the inclusion of these drivers hasn’t led to more crashes.

"Since the implementation of the exemption program by the FMCSA in 2006, drivers with a stable history of treating their insulin-dependent diabetes have proven to be safe," OOIDA wrote. "OOIDA is unaware of any studies that have been conducted or any serious concerns that have been raised concerning those drivers who have completed the current exemption process."

The review board’s recommendations will improve efficiency, OOIDA says. Under the board’s guidance, the treating clinician would bear the responsibility to document that their patient has followed the proper protocols and that the patient’s diabetes is stable and well-controlled. The proposal also reduces paperwork by cutting the steps to exemption from six to three, and it could reduce the costs of doctor visits.

However, OOIDA also suggests some modifications. The review board’s proposal sets the disqualification standard at a single severe hypoglycemic episode within the past six months, including when the driver isn’t on duty.

"Prohibiting a driver to operate a vehicle until glucose levels are stabilized is understandable, but disqualifying a driver for six months when the driver did not put other roadway users at risk does not have a correlation to safety and will cost them financially," OOIDA wrote.

The Association also expressed concerns that the certified medical examiner would be able to override the treating clinician.

"OOIDA members have encountered situations where certified medical examiners have disregarded recommendations from treating clinicians who are family practice physicians or surgeons," OOIDA wrote. "We encourage the agency to direct certified medical examiners to clearly document any denial or challenge to the findings of the treating clinician."