Federal Insulin Exemption

As the ME, your responsibility is to determine if the driver is otherwise medically fit to drive. The driver must carry the medical examiner’s certificate and the exemption when driving. To apply drivers must have a copy of their Medical Exam Form and Medical Examiner’s Certificate.

Instruct drivers to use the following email address medicalexemptions@dot.gov or call 703-448-3094. Instruct drivers not to drive until they have obtained a Federal or State Insulin Exemption, which requires 6 months.

Insulin Therapy - Federal Exemption Requirements
Rescue Glucose: Those with exemptions must carry a rapidly absorbable glucose while driving.
May avert a hypoglycemic reaction for less than 2 hours.
Waiting Period:
• 1 month if previously diagnosed and treatment did not include use of insulin
• 2 months if newly diagnosed and not on prior treatment

The Medical Examiner will certify CDL Driver Only If:
• The driver meets all physical qualification standards except use of insulin
• Has an exemption or eligible to apply for one.

Do Not Certify CDL Driver Only If:
• Any other disqualifying medical condition or condition that prevents certification in accordance with 391.64
• In the last 5 years had two or more disqualifying severe hypoglycemic reactions
• Loss of positional sensation
• Loss of pedal sensation
• Resting tachycardia
• Orthostatic hypotension
• Diagnosis of
– Peripheral neuropathy that interferes with safe driving
– Proliferative retinopathy (unstable proliferative or non-proliferative)
• In last 12 months had a severe hypoglycemic reaction resulting in: – Seizure – Loss of consciousness – Need of assistance from another person – Period of impaired cognitive function that occurred without warning

Annual Recertification Exams:
• Provide ME a completed Annual Diabetes Assessment that includes: – Vision annual Evaluation Checklist • Exemption requires evaluation by an ophthalmologist or optometrist
• If diagnosis of diabetic retinopathy, exam must be performed by ophthalmologist – Endocrinologist Annual Evaluation checklist
• Exemption requires evaluation by board-certified or board-eligible endocrinologist
Glycosuria or poor blood glucose control may indicated need for further evaluation or more frequent monitoring.

Blood glucose monitoring:
• Use of a device that records blood glucose tests for later review: – Before driving – Every 2 to 4 hours while driving.
Blood glucose levels that remain within 100 mg/dl to 400mg/dl range are generally considered safe for commercial driving.
Certify the CDL Driver for : 1 year
Note: The insulin exemption is issued for two years but driver must comply every year and have a new medical certificate every year.


Advise the Driver:
• Glucose monitoring is required while driving:
• Possess rapid absorbing form of glucose
• Self-monitor glucose one hour before driving and at least once every four hours while driving
• Comply with all conditions of their exemption
• Be prepared to present blood glucose monitoring logs at each recertification

Dr. Paul McLemore D.C.
National Certified Medical Examiner

Dr. Paul McLemore R.M.T., E.M.T., B.S., B.S., M.S., D.C.
Certified in acupuncture
Fax (940) 644-2067
Texas State Chiropractic License 8843
National DOT Medical Examiners Certificate 8404451981


CHICO
101 N Weatherford St
on the Chico Square
Chico, TX 76431-0511
940-644-2568
Tues, Thurs, Sat

DECATUR
1816 Hwy 51 South #200
inside Herb’s & More
Decatur, TX 76234
940- 627-6778
Mon, Wed, Fri