Trucking Law: Coping with Diabetes Easier Than in the Past

By Overdrive

Drivers have diabetes mellitus (DM), specifically Type II DM, at a higher rate than the general public. This is likely rooted in the sedentary lifestyle and poor food choices many drivers make, so some of them are treated with simple lifestyle and diet changes. Others receive oral medications or insulin.

Years ago, the Federal Motor Carrier Safety Administration automatically disqualified drivers if they were dependent on insulin to treat their DM. Later, the agency allowed individuals with ITDM (insulin-treated diabetes mellitus) to drive professionally but only after jumping through hoops and obtaining a federal exemption.

As of November 2018, FMCSA has streamlined the process. Drivers need only to complete the DOT medical exam with an additional form, but there is no need for a federal exemption. This also has reduced significantly the financial burden of getting cleared to drive.

The driver needs to provide form MCSA-5870 (available online here) to the insulin prescribing physician and bring the completed form to their next DOT physical. Based on how well-maintained the driver’s DM is on an insulin regimen, the certified medical examiner (CME) then can grant a medical certificate for up to 12 months.

When performing DOT medical exams, I often see patients with poorly controlled DM. Many are on a variety of expensive and sophisticated medications.

They often say, “My doctor really wants me on insulin, but I can’t drive on it.” I usually send these patients on their way with the new form, and their physicians most likely start them on an insulin regimen. Most return with improved diabetic control and better health.

When you fill out your medical examination form MCSA-5875, you’re asked if you’ve ever had certain medical problems. It may seem like a harmless omission to leave off certain medications or ignore certain conditions you may have been diagnosed with, but it’s not.

FMCSA regulations state the driver must “certify that the responses are complete and true.” It also covers potential penalties for omission or other falsifications. If you are caught by a CME, you likely will be disqualified medically. If it is egregious enough, the CME may contact FMCSA. You also might be fined and even barred from driving commercially.

In addition to what is clearly stated by the federal government, general legal principles and common sense apply. As a truck driver, you owe it to the public to refrain from driving if you cannot do so safely.

As soon as a wreck occurs, lawyers will be combing through your records. In 2015, a driver was involved in a fatal crash in Minnesota. He repeatedly had denied to his CME about his diagnosis of obstructive sleep apnea. His lying contributed heavily to his three-year prison sentence.

If it can be proved that you had a medical condition that was not documented in your DOT physical and it contributed to an accident, you will be held criminally responsible. It is not worth it to provide anything less than full disclosure on your DOT physical.

Overdrive. (2019). Trucking Law: Coping with diabetes easier than in the past. Retrieved from



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