DOT Medical Card Diabetes Regulations

Non-Insulin Treated Diabetics

An operator using non-insulin methods of controlling his diabetes is eligible to receive the recommended 1 year certification pending no history of severe hypoglycemia events, no signs of organ damage or other comorbidities that may increase an operator’s risk of incapacitation.

Insulin Treated Diabetics

Insulin-treated operators can still acquire and renew their DOT medical card using the following new two-step certification process (effective November 19,2018). 

Step 1: Treating physician evaluation

The physician who is currently managing the diabetes of the operator will need to complete Form MCSA-5780 (available here through the Federal Motor Carrier Safety Administration). This form must be completed within 45 before the applicant’s DOT physical. To complete this form the managing physician will need the preceding 3 months of blood glucose records. These record must be electronic and cannot be handwritten. 

Included with this form should also be the applicant’s most recent (within the past 3 months) Ha1c results. If the lab results are not included or any part of the form is not complete, the applicant will not be able to undergo his/her DOT physical.

Step 2: DOT physical with a certified medical examiner. 

Upon completion of form MCSA-5780, a certified DOT medical examiner will perform the applicant’s physical and certify or disqualify the operator based on the physical findings and also taking into account the managing physician’s diabetic assessment. 

The maximum certification that a driver with controlled diabetes can attain is 1 year. Limited certifications may also be given in lieu of a full certification if applicant is unable to provide 3 months of electronic blood glucose records to the treating physician.

Applicants will be disqualified if an unstable insulin regimen if present or the diabetes is uncontrolled.

Applicants will be permanently disqualified from receiving a DOT medical card if there is evidence of severe non-proliferative diabetic retinopathy or proliferative diabetic retinopathy is diagnosed.  

Regarding Severe Hypoglycemic Events

Should a certified driver or operator experience a severe hypoglycemic event he prohibited from operating. He must immediately report the event and be evaluated by his treating clinician. Once the applicant’s condition is controlled, and he has been placed on a stable insulin regimen, the managing physician will need to complete a new MCSA-5870 form, and the operator will need to undergo another DOT physical before returning to operation.