Driver's License Requirements for People with Diabetes

Legal Issues

Driver's License Requirements for People with Diabetes

It is a fact of life for people with diabetes that they have a  medical condition that can potentially cause them to be a danger to themselves and others while driving a car.  If a person becomes hypoglycemic, the person can become confused and disoriented and sometimes can lose consciousness. This can cause accidents.  This does not mean that a person with diabetes cannot obtain a drivers license.

The U.S. Supreme Court held in Bell v. Burson that driving is an "important interest" that may not be taken away from a licensed driver without a government agency providing procedural due process. Several lower courts have held that even person with insulin-dependent diabetes is not automatically subject to license forfeiture or nonrenewal, and an agency may do so only if the diabetes affects the driver's safe operation of a motor vehicle.

These decisions mean that a person with diabetes cannot be denied a driver’s license solely because they have diabetes. Some states however do require a person to affirmatively state that they have diabetes. A person with diabetes must also do what they can to minimize the chance of their diabetes causing an accident. If a person has an accident or violates traffic laws because of uncontrolled blood sugar, they may need to get a note from their doctor verifying that they are safe to drive or they can have their license suspended. For specialized licenses this right has been hard won and comes with some additional requirements.

For commercial truck licenses, for years there was a federal law banning people with insulin dependent diabetes from operating a commercial motor vehicle in “interstate commerce.”  Intestate commerce is broader than driving between states. The term interstate commerce also includes driving that involves freight or passengers that go between states, even if the driver only drives within one state. Recent federal legislation allows people with insulin dependent diabetes to obtain a commercial drivers license for interstate commerce if the driver has a clean commercial driving record for three years using a state commercial drivers license. Many states have medical waiver programs that allow a person with insulin-treated diabetes who meets the state’s criteria to operate intrastate commercial vehicles which provides an opportunity for some drivers to get three years of clean commercial driving.  If you are a person with insulin dependent diabetes and you wish to obtain a commercial driver’s licence, contact your state Department of Transportation, Department of Motor Vehicles, or Secretary of State’s office to find out whether there is an option in your state and what requirements you must meet.  However, since it is difficult to obtain a three years experience in commercial driving without operating a vehicle in the broadly defined “interstate commerce” this requirements may be difficult to satisfy.

For school bus drivers there is a new court settlement between the federal government and the state of North Carolina that prohibits the state from having a blanket prohibition against people with insulin dependent diabetes driving school buses.  The federal government argued this case as an application of the Americans with Disabilities Act. This settlement, however, does not preclude a State from imposing additional restrictions on people with insulin dependent diabetes.  For example a driver may be required to keep a glucose log that they submit to their supervisor periodically or to carry a source of rapidly absorbable glucose at all times while driving

Another situation may occur for people whose job requires them to drive. People with diabetes are eligible for accommodations under the American with Disabilities Act. The definition of an accommodation, however, does not include the removal of a critical job element or a requirement for a employer to provide a second chance. Courts have held that if a person has a job that has driving as a critical job element, and the person’s diabetes causes an accident, which in turn causes the State to suspend their driving privileges, the person may be fired for cause because they cannot perform a critical job requirement (i.e, drive). Also, the employer has no obligation to provide “a second chance.”  

In summary, in most situations a person with diabetes, even insulin dependent diabetes, can obtain any class of drivers license.  However, care should be taken to avoid situations where they might become disoriented or worse because of low blood sugar.

Kriss Halpern, an attorney who has diabetes, has developed the following list of suggestions for people with diabetes to use when driving.  Although this list was developed for drivers who have had their licenses suspended because of a complication of diabetes, this list contains good suggestions to avoid future problems:  

1.  If you feel low blood sugar symptoms, pull over promptly as soon as it is safe to do so.

2. TREAT THE LOW IMMEDIATELY. Make absolutely certain you have something to treat the low in a place where you will not forget it. This is critical because your mind will not be working properly if you get too low. You may not remember where you put your juice unless it is very obvious and can be easily reached. Don't ever bury your juice in a messy glove box.

Things that spoil quickly will not work, so keep something that will last and not be destroyed by weather conditions. Orange juice will not last long, but apple juice does. Glucose tablets work quickly and weather well, but be sure you have enough of them. You need to know how many tablets it normally takes for you to treat a low, then keep three or four times that amount nearby while driving.

3. Do not start driving again until your blood sugar is back to normal and you feel okay. Have your testing equipment nearby while driving, and not in the trunk or too far away to reach easily.

4. Drive calmly and carefully until you reach the next place you can stop and get a meal.

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Note: This is not legal advice.  I'm not your attorney.  This type of claim is covered under State law and not Federal law, therefore, law that applies in the State where the injury occurred is what applies to your case. This provides general information and a start in deciding what to tell your lawyer.