Diabetes and the DMV

| Jan 1, 2002

As a trial lawyer in California who has type 1 diabetes, I have represented more than two dozen people with diabetes whose driver's licenses were suspended by the state Department of Motor Vehicles (DMV). While all of my clients eventually had their licenses returned, they all suffered emotionally and financially while inadequately trained and overworked DMV hearing officers delayed and denied the return of their driving rights for weeks or months at a time.

California law, like that of all states, provides that a driver's license may be suspended if a person with diabetes is found to be an unsafe driver. This necessary regulation, however, is all too often mishandled and misunderstood by people who have not been sufficiently trained to make a reasonable judgment about the relationship between blood-glucose control and driving ability.

Anyone who has been diagnosed with diabetes, or who is closely involved with someone who has diabetes, knows all too well that blood-glucose control is a complex issue. Those of us fortunate enough to have good long-term blood-glucose levels know that it can take a great deal of work to achieve those results. However, despite our best efforts, we can still make mistakes that lead to low or high blood-glucose levels.

An irony of tight blood-glucose control is that the very people who are most successful at managing their diabetes may also be the very ones whose blood-glucose levels are more likely to fall too low, which can cause them to experience a dangerous hypoglycemic reaction. People practicing tight control can, of course, be educated to avoid and handle hypoglycemia.

The confusion that inadequately trained DMV hearing officers often have about these facts is well illustrated by one client whose license was suspended after his doctor wrote on a DMV medical form that his type 2 diabetes was "poorly controlled." That comment alone caused the suspension.

When we looked more carefully at his diabetes, it was immediately obvious that he posed no driving safety risk whatsoever and that his suspension was plainly improper. This client had never taken insulin in his life and had never experienced hypoglycemia. He had never been hospitalized, fallen unconscious or become disoriented from going too low. He might have been slowly killing himself from poorly controlled blood-glucose levels, but his death would be unlikely to result from a driving accident. His "poor control" was entirely irrelevant to driving safety and should never have led to his license suspension.

If the DMV hearing officer reviewing the case had been better trained, these facts would have been obvious at my client's initial license review, and he would not have needed an attorney. Unfortunately, either this client did not explain the facts well enough for the hearing officer to understand or the hearing officer was unable or unwilling to review and understand the facts sufficiently to make a reasonable determination.

More often, I have represented people whose licenses were suspended after they were rushed to the hospital with a low blood-glucose level and an emergency room physician reported the incident to the DMV. In the cases I have reviewed, it apparently made no difference to the DMV whether the hypoglycemic event occurred while the person was home in bed in the middle of the night, was exercising, or was driving a car. The driver's license was suspended because of a single significant low blood-glucose event that was reported to the DMV, regardless of how or why the incident occurred and regardless of whether any driving safety risk was involved.

The real issues that need to be considered are whether the driver with diabetes:

  1. has hypoglycemic unawareness that can be improved,
  2. takes the necessary precautions to avoid hypoglycemia while driving and
  3. is prepared to handle a hypoglycemic event if one does occur while he or she is driving. Unfortunately, too few DMV hearing officers are trained to understand and consider these critical issues.

In other states, such as Hawaii, a license cannot be suspended for a medical reason without the review of a panel of physicians. Assuming the physicians have specific knowledge of the medical condition at issue, this type of review is clearly preferable.

At a minimum, all states need to develop pertinent and up-to-date criteria for assessing the safety risk of drivers with diabetes and need to educate the people reviewing the information to understand the nature of the illness and the precautions necessary to avoid dangerous driving events.

Most people with diabetes can learn to understand, avoid and properly handle hypoglycemic events. Therefore, more effort should be made to ensure that necessary education and medical care are being provided before taking the ultimate and drastic step of suspending a driver's license when there is no significant basis for considering the driver a safety risk. Those efforts will enable us to avoid the unintended consequence of causing people with diabetes to resist or avoid proper medical care for fear of being reported to the DMV.

If DMV hearing officers are properly prepared to understand and handle physician assessments, it will allow drivers with serious medical conditions to be open and frank with their physicians when they seek treatment for their illness and the training necessary to avoid the dangerous consequences of hypoglycemia.

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Categories: Diabetes, Diabetes, Drivers License & Pilot License, Insulin, Legal, Low Blood Sugar, Type 1 Issues, Type 1 Issues, Type 2 Issues

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Posted by Anonymous on 17 July 2008

Can a person with type 1 diabetes automatically be denied a class c license (to drive an ambulance)? They way I read DMV standards an CA laws, they rely on a combination of federal and state standards.

I am inquiring on behalf of a woman who was told, before her application was even received, that she would automatically be turned down based on federal standards alone. She could appeal but if she had two or more episodes of hypoglycemia in the past 5 years, she would not be eligible for a class c license.

Posted by joseph on 16 September 2008

It can affect pregnancy and cause birth defects, as well. Although diabetes is a chronic and incurable disease (with the exception of gestational diabetes),
It also increases the chances of having a baby with birth defects, and it may result in larger babies and more difficult deliveries." ...
California DUi

Posted by kumarasamy.k on 16 September 2008

Wonderful post Catez, and a very challenging one. I read the book many years ago and even now when you are talking avbout it my spirit is stirring!
California DUI

Posted by Anonymous on 3 November 2009

Thank you for pointing out the inefficiencies of the DMV hearing officers. As I pulled my vehicle to the side in order to reach my candy, a police officer took away my candy and told me I could not eat it until I tested my blood. Since my BGL meter was at home on the bathroom counter, he waited to call the paramedics despite the fact that I told him I needed my candy. I never lost consciousness and was coherent the entire time. By the time the paramedics arrived I had dropped very low, still, I was forced to test my blood before being allowed to eat my candy. By then, my BGL had dropped to 30. Based on this incident my license was suspended. Both police officers and the DMV hearing officers need more training. For one thing, if a diabetic says, "I need my candy," it should not be taken away from her !

Posted by Anonymous on 26 March 2010

I had my drivers license suspended here in california 6 yrs ago. I appealed it twice but still denided. I am currently unemployed and when potential employers ask about a dirvers license I must reveal to them it is suspended and then they want to know why. I would really love to be able to drive again so that I could work more than just a bicycle rides distance from my house. I did have an accident due to a hypoglycemic incedent but since that time I have changed insulins and currently on an insulin pump for the last 5 months. I have reached an end with dealing with the DMV.

Posted by Anonymous on 27 March 2011

I am curious about those who are reported due to high HbA1Cs. Those who are hyPERglycemic. My daughter does not suffer from lows, yet her doctor has turned her in to the DMV in our state. How can this happen????

Posted by Anonymous on 6 September 2011

I drive a tour bus, Dr. looking at adding insulin. I believe DMV rules I can not drive.
Can someone guide me to that ruling so I know for sure

Posted by davdanger on 29 October 2011

You cannot by California law have a Passenger or Hazardous Materials licence and be a insulin controlled diabetic. Possibilities would be get an out of state drivers license and a federal medical card, a bit difficult but it is a availability. I have a commercial (B) license, with a medical card issued by California DMV. With the restriction that I can only drive commercial vehicle in California. I am looking into getting property in another state and a license there to escape California's stupidity. I have been on insulin since 8 (44 years). Recently my licence was suspended because of commercial licence, diabetic, and at the scene of an accident. Hearing officer did not care that I don't drive commercially, it is a requirement of work. I need to find an attorney that has some knowledge of DMV and Diabetes in the Sacramento-Auburn area.

Posted by Anonymous on 14 November 2012

I want to obtain an Ambulance permit for my California Drivers license , and I am on insulin for my type 1 diabetes. Does anyone know if this is possible here in California and what is required? Help....

Posted by Anonymous on 22 June 2014

how does ny allow a tour bus driver with diabetic nueropathy which affects the feet allow a driver to transport passengers?

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