There are two parts to a Commercial Driver’s License: the operator’s license, issued by a state, and the operator’s medical certification, issued by a certified medical examiner. Each state has its own criteria for issuance of a commercial driver’s license, in addition to criteria set by federal law in 49 CFR Part 383.

Medical certification (also known as “DOT card” or “medical examination”) is a process to ensure all commercial motor vehicle operators meet certain minimum physical qualification standards to ensure safety of the driver and the traveling public. Medical certification can include a physical exam (including a vision exam), medical history, examination by specialists, and completion of forms. In most cases, it must be performed by an individual who is registered as a certified medical examiner. For issuance of interstate medical certification, it must be performed by an individual who is registered as a certified medical examiner on the FMCSA National Registry of Certified Medical Examiners. For more information on the general medical certification process, visit the FMCSA website.

For commercial drivers with diabetes, the medical certification process varies depending on whether the driver is prescribed insulin

• Drivers who do not take insulin may complete the standard medical certification process by submitting for an examination with a certified medical examiner. There are no specific diabetes-related restrictions or limitations on drivers with non-insulin treated type 2 diabetes. However, the medical examiner has discretion to inquire about the driver’s diabetes and diabetes management to ensure the driver can safely operate a commercial motor vehicle.
• Drivers who take insulin must complete a 2-step process. The first step is a diabetes evaluation by the driver’s treating clinician. The second step is an examination by a certified medical examiner. Once both steps are complete, the certified medical examiner may issue the driver an interstate medical certificate.
  • Treating Clinician is defined as “a healthcare professional who manages, and prescribes insulin for, the treatment of the individual’s diabetes mellitus as authorized by the healthcare professional’s State licensing authority.” 49 CFR 391.46(b)
  • Specific diabetes criteria are outlined in the new diabetes rule
  • Compare the new rule to the old rule and Diabetes Exemption Program