81 FR 72640 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

DEPARTMENT OF TRANSPORTATION
Federal Motor Carrier Safety Administration

Federal Register Volume 81, Issue 203 (October 20, 2016)

Page Range		72640-72641
FR Document		2016-25383

FMCSA confirms its decision to exempt 37 individuals from its rule prohibiting persons with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in interstate commerce. The exemptions enable these individuals to operate CMVs in interstate commerce.

Federal Register, Volume 81 Issue 203 (Thursday, October 20, 2016)

[Federal Register Volume 81, Number 203 (Thursday, October 20, 2016)]
[Notices]
[Pages 72640-72641]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2016-25383]


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DEPARTMENT OF TRANSPORTATION

Federal Motor Carrier Safety Administration

[FMCSA Docket No. FMCSA-2016-0219]


Qualification of Drivers; Exemption Applications; Diabetes 
Mellitus

AGENCY: Federal Motor Carrier Safety Administration (FMCSA), DOT.

ACTION: Notice of final disposition.

-----------------------------------------------------------------------

SUMMARY: FMCSA confirms its decision to exempt 37 individuals from its 
rule prohibiting persons with insulin-treated diabetes mellitus (ITDM) 
from operating commercial motor vehicles (CMVs) in interstate commerce. 
The exemptions enable these individuals to operate CMVs in interstate 
commerce.

DATES: The exemptions were effective on September 30, 2016. The 
exemptions expire on September 30, 2018.

FOR FURTHER INFORMATION CONTACT: Ms. Christine A. Hydock, Chief, 
Medical Programs Division, (202) 366-4001, [email protected], FMCSA, 
Department of Transportation, 1200 New Jersey Avenue SE., Room W64-113, 
Washington, DC 20590-0001. Office hours are from 8:30 a.m. to 5 p.m. 
e.t., Monday through Friday, except Federal holidays.

SUPPLEMENTARY INFORMATION: 

I. Electronic Access

    You may see all the comments online through the Federal Document 
Management System (FDMS) at: http://www.regulations.gov.
    Docket: For access to the docket to read background documents or 
comments, go to http://www.regulations.gov and/or Room W12-140 on the 
ground level of the West Building, 1200 New Jersey Avenue SE., 
Washington, DC, between 9 a.m. and 5 p.m., Monday through Friday, 
except Federal holidays.
    Privacy Act: In accordance with 5 U.S.C. 553(c), DOT solicits 
comments from the public to better inform its rulemaking process. DOT 
posts these comments, without edit, including any personal information 
the commenter provides, to www.regulations.gov, as described in the 
system of records notice (DOT/ALL-14 FDMS), which can be reviewed at 
www.dot.gov/privacy.

II. Background

    On August 30, 2016, FMCSA published a notice of receipt of Federal 
diabetes exemption applications from 37 individuals and requested 
comments from the public (81 FR 59723. The public comment period closed 
on September 29, 2016, and 2 comments were received.
    FMCSA has evaluated the eligibility of the 37 applicants and 
determined that granting the exemptions to these individuals would 
achieve a level of safety equivalent to or greater than the level that 
would be achieved by complying with the current regulation 49 CFR 
391.41(b)(3).

Diabetes Mellitus and Driving Experience of the Applicants

    The Agency established the current requirement for diabetes in 1970 
because several risk studies indicated that drivers with diabetes had a 
higher rate of crash involvement than the general population. The 
diabetes rule provides that ``A person is physically qualified to drive 
a commercial motor vehicle if that person has no established medical 
history or clinical diagnosis of diabetes mellitus currently requiring 
insulin for control'' (49 CFR 391.41(b)(3)).
    FMCSA established its diabetes exemption program, based on the 
Agency's July 2000 study entitled ``A Report to Congress on the 
Feasibility of a Program to Qualify Individuals with Insulin-Treated 
Diabetes Mellitus to Operate in Interstate Commerce as Directed by the 
Transportation Act for the 21st Century.'' The report concluded that a 
safe and practicable protocol to allow some drivers with ITDM to 
operate CMVs is feasible. The September 3, 2003 (68 FR 52441), Federal 
Register notice in conjunction with the November 8, 2005 (70 FR 67777), 
Federal Register notice provides the current protocol for allowing such 
drivers to operate CMVs in interstate commerce.
    These 37 applicants have had ITDM over a range of 1 to 43 years. 
These applicants report no severe hypoglycemic reactions resulting in 
loss of consciousness or seizure, requiring the assistance of another 
person, or resulting in impaired cognitive function that occurred 
without warning symptoms, in the past 12 months and no recurrent (2 or 
more) severe hypoglycemic episodes in the past 5 years. In each case, 
an endocrinologist verified that the driver has demonstrated a 
willingness to properly monitor and manage his/her diabetes mellitus, 
received education related to diabetes management, and is on a stable 
insulin regimen. These drivers report no other disqualifying 
conditions, including diabetes-related complications. Each meets the 
vision requirement at 49 CFR 391.41(b)(10).
    The qualifications and medical condition of each applicant were 
stated and discussed in detail in the August 30, 2016, Federal Register 
notice and they will not be repeated in this notice.

III. Discussion of Comments

    FMCSA received 2 comments in this proceeding. John Grubbs stated 
that he believes FMCSA should grant exemptions to drivers that use 
slow-acting insulin. FMCSA does grant exemptions to drivers who use 
slow-acting insulin. Deb Carlson stated that the state of Minnesota has 
no concerns with granting exemptions to Craig W. Dennis, Ross L. 
Christenson, Troy M. Keller, and Ray E. Vaughn.

IV. Basis for Exemption Determination

    Under 49 U.S.C. 31136(e) and 31315, FMCSA may grant an exemption 
from the diabetes requirement in 49 CFR 391.41(b)(3) if the exemption 
is likely to achieve an equivalent or greater level of safety than 
would be achieved without the exemption. The exemption allows the 
applicants to operate CMVs in interstate commerce.
    To evaluate the effect of these exemptions on safety, FMCSA 
considered medical reports about the applicants' ITDM and vision, and 
reviewed the treating endocrinologists' medical opinion related to the 
ability of the driver to safely operate a CMV while using insulin.
    Consequently, FMCSA finds that in each case exempting these 
applicants from the diabetes requirement in 49 CFR 391.41(b)(3) is 
likely to achieve a level of safety equal to that existing without the 
exemption.

V. Conditions and Requirements

    The terms and conditions of the exemption will be provided to the 
applicants in the exemption document and they include the following: 
(1) That each individual submit a quarterly monitoring checklist 
completed by the treating endocrinologist as well as an annual 
checklist with a comprehensive medical evaluation; (2) that each 
individual reports within 2 business days of occurrence, all episodes 
of severe hypoglycemia, significant complications, or inability to 
manage diabetes; also, any involvement in an accident or any other 
adverse event in

[[Page 72641]]

a CMV or personal vehicle, whether or not it is related to an episode 
of hypoglycemia; (3) that each individual provide a copy of the 
ophthalmologist's or optometrist's report to the medical examiner at 
the time of the annual medical examination; and (4) that each 
individual provide a copy of the annual medical certification to the 
employer for retention in the driver's qualification file, or keep a 
copy in his/her driver's qualification file if he/she is self-employed. 
The driver must also have a copy of the certification when driving, for 
presentation to a duly authorized Federal, State, or local enforcement 
official.

VI. Conclusion

    Based upon its evaluation of the 37 exemption applications, FMCSA 
exempts the following drivers from the diabetes requirement in 49 CFR 
391.41(b)(3), subject to the requirements cited above 49 CFR 391.64(b):

Scott G. Barr (FL)
John L. Bauers (NE)
Robert J. Borgese (NJ)
Rodger L. Bratton (LA)
John T. Brecken (MI)
Ross L. Christenson (MN)
Daniel B. Cox (WA)
Raymond Davila, Jr. (NJ)
Craig W. Dennis (MN)
Lawrence M. Duffy, III (NY)
Douglas Endicott (VA)
Carmine Ferraro (CT)
Thomas P. Fogerty (MA)
M.A. Gandolfo, Jr. (NY)
Merlyn C. Gerdes (IA)
Fabian Guerrero-Rodriguez (NV)
Loren T. Hall (NY)
Mark A. Hersh (PA)
James C. Holcomb (LA)
Eric E. Humphrey (MA)
Troy M. Keller (MN)
Ronald C. Kolb (MT)
Robert J. Lockwood (CT)
Kenneth R. Logan, Sr. (IL)
Adam W. Martin (MI)
Michael L. Mitchell (IA)
Clarence H. Mitchell 3rd (CT)
Lucas J. Preston (ND)
William B. L. Robinson (AR)
Michael T. Salsedo (HI)
F. Marino M. Sanchez (NY)
Andrew D. Sanford (TN)
Jeffery J. Stricherz (SD)
Michael A. Taylor (CT)
Jerry W. Thomas (NC)
Ray E. Vaughn (MN)
Ronald L. Yeager (PA)

    In accordance with 49 U.S.C. 31136(e) and 31315 each exemption is 
valid for two years unless revoked earlier by FMCSA. The exemption will 
be revoked if the following occurs: (1) The person fails to comply with 
the terms and conditions of the exemption; (2) the exemption has 
resulted in a lower level of safety than was maintained before it was 
granted; or (3) continuation of the exemption would not be consistent 
with the goals and objectives of 49 U.S.C. 31136(e) and 31315. If the 
exemption is still effective at the end of the 2-year period, the 
person may apply to FMCSA for a renewal under procedures in effect at 
that time.

    Issued on: October 14, 2016.
 Larry W. Minor,
 Associate Administrator for Policy.
[FR Doc. 2016-25383 Filed 10-19-16; 8:45 am]
 BILLING CODE 4910-EX-P

72640 Federal Register / Vol. 81, No. 203 / Thursday, October 20, 2016 / Notices

the INA (8 U.S.C. 1189), shall be described in the system of records demonstrated a willingness to properly
maintained. notice (DOT/ALL–14 FDMS), which can monitor and manage his/her diabetes
This determination shall be published be reviewed at www.dot.gov/privacy. mellitus, received education related to
in the Federal Register. diabetes management, and is on a stable
II. Background
Dated: September 28, 2016. insulin regimen. These drivers report no
On August 30, 2016, FMCSA other disqualifying conditions,
John F. Kerry,
published a notice of receipt of Federal including diabetes-related
Secretary of State. diabetes exemption applications from complications. Each meets the vision
[FR Doc. 2016–25421 Filed 10–19–16; 8:45 am] 37 individuals and requested comments requirement at 49 CFR 391.41(b)(10).
BILLING CODE 4710–AD–P from the public (81 FR 59723. The The qualifications and medical
public comment period closed on condition of each applicant were stated
September 29, 2016, and 2 comments and discussed in detail in the August
DEPARTMENT OF TRANSPORTATION were received. 30, 2016, Federal Register notice and
FMCSA has evaluated the eligibility they will not be repeated in this notice.
Federal Motor Carrier Safety of the 37 applicants and determined that
Administration granting the exemptions to these III. Discussion of Comments
[FMCSA Docket No. FMCSA–2016–0219] individuals would achieve a level of FMCSA received 2 comments in this
safety equivalent to or greater than the proceeding. John Grubbs stated that he
Qualification of Drivers; Exemption level that would be achieved by believes FMCSA should grant
Applications; Diabetes Mellitus complying with the current regulation exemptions to drivers that use slow-
49 CFR 391.41(b)(3). acting insulin. FMCSA does grant
AGENCY: Federal Motor Carrier Safety
Diabetes Mellitus and Driving exemptions to drivers who use slow-
Administration (FMCSA), DOT. acting insulin. Deb Carlson stated that
ACTION: Notice of final disposition.
Experience of the Applicants
the state of Minnesota has no concerns
The Agency established the current with granting exemptions to Craig W.
SUMMARY: FMCSA confirms its decision requirement for diabetes in 1970
to exempt 37 individuals from its rule Dennis, Ross L. Christenson, Troy M.
because several risk studies indicated Keller, and Ray E. Vaughn.
prohibiting persons with insulin-treated that drivers with diabetes had a higher
diabetes mellitus (ITDM) from operating rate of crash involvement than the IV. Basis for Exemption Determination
commercial motor vehicles (CMVs) in general population. The diabetes rule Under 49 U.S.C. 31136(e) and 31315,
interstate commerce. The exemptions provides that ‘‘A person is physically FMCSA may grant an exemption from
enable these individuals to operate qualified to drive a commercial motor the diabetes requirement in 49 CFR
CMVs in interstate commerce. vehicle if that person has no established 391.41(b)(3) if the exemption is likely to
DATES: The exemptions were effective medical history or clinical diagnosis of achieve an equivalent or greater level of
on September 30, 2016. The exemptions diabetes mellitus currently requiring safety than would be achieved without
expire on September 30, 2018. insulin for control’’ (49 CFR the exemption. The exemption allows
FOR FURTHER INFORMATION CONTACT: Ms. 391.41(b)(3)). the applicants to operate CMVs in
Christine A. Hydock, Chief, Medical FMCSA established its diabetes interstate commerce.
Programs Division, (202) 366–4001, exemption program, based on the To evaluate the effect of these
fmcsamedical@dot.gov, FMCSA, Agency’s July 2000 study entitled ‘‘A exemptions on safety, FMCSA
Department of Transportation, 1200 Report to Congress on the Feasibility of considered medical reports about the
New Jersey Avenue SE., Room W64– a Program to Qualify Individuals with applicants’ ITDM and vision, and
113, Washington, DC 20590–0001. Insulin-Treated Diabetes Mellitus to reviewed the treating endocrinologists’
Office hours are from 8:30 a.m. to 5 p.m. Operate in Interstate Commerce as medical opinion related to the ability of
e.t., Monday through Friday, except Directed by the Transportation Act for the driver to safely operate a CMV while
Federal holidays. the 21st Century.’’ The report concluded using insulin.
SUPPLEMENTARY INFORMATION: that a safe and practicable protocol to Consequently, FMCSA finds that in
allow some drivers with ITDM to each case exempting these applicants
I. Electronic Access operate CMVs is feasible. The from the diabetes requirement in 49 CFR
You may see all the comments online September 3, 2003 (68 FR 52441), 391.41(b)(3) is likely to achieve a level
through the Federal Document Federal Register notice in conjunction of safety equal to that existing without
Management System (FDMS) at: http:// with the November 8, 2005 (70 FR the exemption.
www.regulations.gov. 67777), Federal Register notice provides
Docket: For access to the docket to the current protocol for allowing such V. Conditions and Requirements
read background documents or drivers to operate CMVs in interstate The terms and conditions of the
comments, go to http:// commerce. exemption will be provided to the
www.regulations.gov and/or Room These 37 applicants have had ITDM applicants in the exemption document
W12–140 on the ground level of the over a range of 1 to 43 years. These and they include the following: (1) That
West Building, 1200 New Jersey Avenue applicants report no severe each individual submit a quarterly
SE., Washington, DC, between 9 a.m. hypoglycemic reactions resulting in loss monitoring checklist completed by the
and 5 p.m., Monday through Friday, of consciousness or seizure, requiring treating endocrinologist as well as an
except Federal holidays. the assistance of another person, or annual checklist with a comprehensive
mstockstill on DSK3G9T082PROD with NOTICES

Privacy Act: In accordance with 5 resulting in impaired cognitive function medical evaluation; (2) that each
U.S.C. 553(c), DOT solicits comments that occurred without warning individual reports within 2 business
from the public to better inform its symptoms, in the past 12 months and no days of occurrence, all episodes of
rulemaking process. DOT posts these recurrent (2 or more) severe severe hypoglycemia, significant
comments, without edit, including any hypoglycemic episodes in the past 5 complications, or inability to manage
personal information the commenter years. In each case, an endocrinologist diabetes; also, any involvement in an
provides, to www.regulations.gov, as verified that the driver has accident or any other adverse event in

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Federal Register / Vol. 81, No. 203 / Thursday, October 20, 2016 / Notices 72641

a CMV or personal vehicle, whether or conditions of the exemption; (2) the Management System (FDMS) at: http://
not it is related to an episode of exemption has resulted in a lower level www.regulations.gov.
hypoglycemia; (3) that each individual of safety than was maintained before it Docket: For access to the docket to
provide a copy of the ophthalmologist’s was granted; or (3) continuation of the read background documents or
or optometrist’s report to the medical exemption would not be consistent with comments, go to http://
examiner at the time of the annual the goals and objectives of 49 U.S.C. www.regulations.gov and/or Room
medical examination; and (4) that each 31136(e) and 31315. If the exemption is W12–140 on the ground level of the
individual provide a copy of the annual still effective at the end of the 2-year West Building, 1200 New Jersey Avenue
medical certification to the employer for period, the person may apply to FMCSA SE., Washington, DC, between 9 a.m.
retention in the driver’s qualification for a renewal under procedures in effect and 5 p.m., Monday through Friday,
file, or keep a copy in his/her driver’s at that time. except Federal holidays.
qualification file if he/she is self- Privacy Act: In accordance with 5
Issued on: October 14, 2016.
employed. The driver must also have a U.S.C. 553(c), DOT solicits comments
Larry W. Minor, from the public to better inform its
copy of the certification when driving,
Associate Administrator for Policy. rulemaking process. DOT posts these
for presentation to a duly authorized
Federal, State, or local enforcement [FR Doc. 2016–25383 Filed 10–19–16; 8:45 am] comments, without edit, including any
official. BILLING CODE 4910–EX–P personal information the commenter
provides, to http://www.regulations.gov,
VI. Conclusion as described in the system of records
Based upon its evaluation of the 37 DEPARTMENT OF TRANSPORTATION notice (DOT/ALL–14 FDMS), which can
exemption applications, FMCSA be reviewed at http://www.dot.gov/
Federal Motor Carrier Safety privacy.
exempts the following drivers from the Administration
diabetes requirement in 49 CFR II. Background
391.41(b)(3), subject to the requirements [FMCSA Docket No. FMCSA–2015–0322]
cited above 49 CFR 391.64(b): On May 9, 2016, FMCSA published a
Qualification of Drivers; Exemption notice announcing receipt of
Scott G. Barr (FL) applications from 27 individuals
Applications; Epilepsy and Seizure
John L. Bauers (NE) requesting an exemption from the
Disorders
Robert J. Borgese (NJ) epilepsy prohibition in 49 CFR
Rodger L. Bratton (LA) AGENCY: Federal Motor Carrier Safety 391.41(b)(8) and requested comments
John T. Brecken (MI) Administration (FMCSA), DOT. from the public (81 FR 28131). The
Ross L. Christenson (MN) ACTION: Notice of final disposition. public comment period ended on June
Daniel B. Cox (WA) 8, 2016, and three comments were
Raymond Davila, Jr. (NJ) SUMMARY: FMCSA announces its
received.
Craig W. Dennis (MN) decision to exempt 17 individuals from FMCSA has evaluated the eligibility
Lawrence M. Duffy, III (NY) the requirement in the Federal Motor of these applicants and determined that
Douglas Endicott (VA) Carrier Safety Regulations (FMCSRs) granting exemptions to 17 of 27
Carmine Ferraro (CT) that interstate commercial motor vehicle individuals would achieve a level of
Thomas P. Fogerty (MA) (CMV) drivers have ‘‘no established safety equivalent to or greater than the
M.A. Gandolfo, Jr. (NY) medical history or clinical diagnosis of level that would be achieved by
Merlyn C. Gerdes (IA) epilepsy or any other condition which complying with the current regulation
Fabian Guerrero-Rodriguez (NV) is likely to cause loss of consciousness 49 CFR 391.41(b)(8). On September 30,
Loren T. Hall (NY) or any loss of ability to control a CMV.’’ 2016, a notice announcing the denial of
Mark A. Hersh (PA) The exemptions enable these the remaining 10 applicants was
James C. Holcomb (LA) individuals who have had one or more published in the Federal Register (81
Eric E. Humphrey (MA) seizures and are taking anti-seizure FR 67424).
Troy M. Keller (MN) medication to operate CMVs in The physical qualification standard
Ronald C. Kolb (MT) interstate commerce. for drivers regarding epilepsy found in
Robert J. Lockwood (CT) DATES: The exemptions were effective 49 CFR 391.41(b)(8) states that a person
Kenneth R. Logan, Sr. (IL) on June 9, 2016. The exemptions expire is physically qualified to drive a CMV
Adam W. Martin (MI) on June 9, 2018. if that person:
Michael L. Mitchell (IA) FOR FURTHER INFORMATION CONTACT: Ms. Has no established medical history or clinical
Clarence H. Mitchell 3rd (CT) Christine A. Hydock, Chief, Medical diagnosis of epilepsy or any other condition
Lucas J. Preston (ND) Programs Division, (202) 366–4001, which is likely to cause the loss of
William B. L. Robinson (AR) fmcsamedical@dot.gov, FMCSA, consciousness or any loss of ability to control
Michael T. Salsedo (HI) Department of Transportation, 1200 a CMV.
F. Marino M. Sanchez (NY) New Jersey Avenue SE., Room W64– In addition to the regulations, FMCSA
Andrew D. Sanford (TN) 224, Washington, DC 20590–0001. has published advisory criteria 1 to
Jeffery J. Stricherz (SD) Office hours are from 8:30 a.m. to 5 p.m. assist medical examiners in determining
Michael A. Taylor (CT) e.t., Monday through Friday, except whether drivers with certain medical
Jerry W. Thomas (NC) Federal holidays. If you have questions conditions are qualified to operate a
Ray E. Vaughn (MN) regarding viewing or submitting CMV in interstate commerce. [49 CFR
mstockstill on DSK3G9T082PROD with NOTICES

Ronald L. Yeager (PA) material to the docket, contact Docket part 391, APPENDIX A TO PART 391—
In accordance with 49 U.S.C. 31136(e) Services, telephone (202) 366–9826.
and 31315 each exemption is valid for SUPPLEMENTARY INFORMATION: 1 See http://www.ecfr.gov/cgi-bin/text-idx?SID=

two years unless revoked earlier by e47b48a9ea42dd67d999246e23d97970&mc=
FMCSA. The exemption will be revoked I. Electronic Access true&node=pt49.5.391&rgn=div5#ap49.5.391_171.a
and https://www.gpo.gov/fdsys/pkg/CFR-2015-
if the following occurs: (1) The person You may see all the comments online title49-vol5/pdf/CFR-2015-title49-vol5-part391-
fails to comply with the terms and through the Federal Document appA.pdf.

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Document Created: 2016-10-21 09:58:55
Document Modified: 2016-10-21 09:58:55

Category		Regulatory Information
Collection		Federal Register
sudoc Class		AE 2.7: GS 4.107: AE 2.106:
Publisher		Office of the Federal Register, National Archives and Records Administration
Section		Notices
Action		Notice of final disposition.
Dates		The exemptions were effective on September 30, 2016. The exemptions expire on September 30, 2018.
Contact		Ms. Christine A. Hydock, Chief, Medical Programs Division, (202) 366-4001, [email protected], FMCSA, Department of Transportation, 1200 New Jersey Avenue SE., Room W64-113, Washington, DC 20590-0001. Office hours are from 8:30 a.m. to 5 p.m. e.t., Monday through Friday, except Federal holidays.
FR Citation		81 FR 72640

81 FR 72640 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

DEPARTMENT OF TRANSPORTATIONFederal Motor Carrier Safety Administration

Federal Register Volume 81, Issue 203 (October 20, 2016)

DEPARTMENT OF TRANSPORTATION
Federal Motor Carrier Safety Administration