Are applicants for a driver's license asked questions about diabetes?

All first-time and renewal applicants are asked whether they have any physical or mental conditions or disabilities that may interfere with their ability to operate a motor vehicle safely. Del. Admin. Code tit. 11, § 2217-10.2.6 (2013). Individuals who answer "yes" to this question or report serious medical conditions to a licensing agency employee are often asked questions while in line to have their applications processed. These questions are to determine the nature of their medical condition, and if it requires a medical evaluation.

What other ways does the state have to find out about people who may not be able to drive safely because of a medical condition?

The state accepts reports of potentially unsafe drivers from police officers, the courts, physicians, immediate family members, and "any other person acceptable" to the licensing agency. Del. Code Ann. tit. 21, § 2714(c) (2013). The reports must be in writing. Id. The licensing agency does not accept anonymous reports, nor does it investigate any of the reporting sources before it initiates an evaluation. Physicians are required to report to the licensing agency any individuals they are treating with losses of consciousness due to disease of the central nervous system. Del. Code Ann. tit. 24, § 1763 (2013) (see below). Drivers may also be required to have a medical evaluation if they have impairments which are observed by licensing agency personnel during the licensing process, or if they are involved in more than two serious crashes within a 24 month period. Del. Code Ann. tit. 21, § 2714 (2013).

What is the process for medical evaluations of drivers?

When the licensing agency receives information that an individual may not be medically qualified to be licensed, the driver is sent a registered letter stating that he or she must be examined by a private physician or optometrist of his or her choice. Del. Code Ann. tit. 21, § 2724 (a) (2013). The examination is at the driver's expense if able to pay. The physician must complete the enclosed medical evaluation form within 30 days of its receipt by the driver. Del. Code Ann. tit. 21, § 2724 (b) (2013). Failure to return the form by this date may lead to a license suspension until it is receives. Id. If the applicant's condition is considered "high-risk," the medical evaluation must be completed before a license can be issued; otherwise, a license can be issued and the individual can drive while the medical evaluation process is conducted.

The medical evaluation form asks how long the individual has had diabetes, the state of the person's current control, and whether there is "diabetic acidosis." Del. Dept. of Transp., "Medical Report of Physician's Findings," Form MV-346, Doc. No. 45-07-93-03-01, Revised 6/24/2003. The physician must briefly describe any of the above. Id. In addition, the physician is asked to list types and quantities of medications being prescribed; whether any of the medications affect driving ability; and from a medical standpoint, whether the physician feels the individual is capable of operating a motor vehicle safely. Id.

If the physician's recommendation is favorable, the licensing agency evaluates the information available and makes a licensing decision. Del. Code Ann. tit. 21, § 2724 (c) (2013). If the physician's recommendation so warrants, the case will be reviewed by the Medical Advisory Board, who upon review may suggest conditions on the driver's licensure, mandate periodic evaluations, or take no action. Del. Code Ann. tit. 21, § 2724 (c)-(d) (2013). This recommendation is only heavily relied on, but the licensing agency has ultimate decision-making authoriy. Del. Code Ann. tit. 21, § 2724 (e) (2013). Members of the Medical Advisory Board may not be held civilly or criminally liable for their official acts. Del. Code Ann. tit. 21, § 2724 (2013).

Any individual licensed on the basis of such a report may be required to provide renewed certification annually and no later than the last day of his or her birthday month. See Del. Code Ann. tit. 21, § 2707(b)(6) (requiring annual certification for loss of consciousness). Failure to provide recertification will result in suspension. Id. Del. Code Ann. tit. 21, § 2717 (2011) ("The Department, for sufficient reasons, may refuse to issue any form of license or permit to any applicant.").

Are physicians required by law to report drivers who have medical conditions that could affect their ability to drive safely?

Sometimes. A treating physician must report persons who are subject to losses of consciousness due to "disease of the central nervous system." Del. Code Ann. tit. 24, § 1763 (2013). This report must be made to the licensing agency within 1 week. Id. A physician failing to make such a report shall be fined $5.00 to $50.00 for each such failure. Id.

Are physicians who report drivers with medical conditions immune from legal action by the patient?

Although not directly related to drivers with diabetes, a physician that examines an individual subject to loss of consciousness because of a disease of the central nervous system is immune from any civil or criminal liability for having certified that that individual "can reasonably be expected to suffer no further losses of consciousness on account of such disease." Del. Code Ann. tit. 21, § 2707(b)(6) (2013).

Who makes decisions about whether drivers are medically qualified?

The licensing agency employs non-medical personnel who screen paperwork and make most licensing decisions, based on physician reports. Cases that cannot be resolved by these personnel are referred to the state's independent Medical Advisory Board for a recommendation. Del. Code Ann. tit. 21, § 2724(c) (2013). The majority of the cases forwarded to the Board are resolved by the recommendation of the Board President (the Director of the Division of Public Health) or his staff in the Division of Health (who are not on the Board). The licensing agency makes the final decision on all cases referred to the Board, but generally follows the Board's recommendation. Del. Code Ann. tit. 21, § 2724(e) (2013).

Has the state adopted specific policies about whether people with diabetes are allowed to drive?

No. Delaware generally relies on physician recommendations and has no standards for specific medical conditions other than its vision standards.

What is the state's policy about episodes of altered consciousness or loss of consciousness that may be due to diabetes?

>An applicant is given 30 days following the department becoming aware of a loss of consciousness to complete a medical evaluation, which is then submitted to the Medical Advisory Board. The case is reviewed by the Board, which considers the recommendation of the individual's treating physician. A physician who has treated the individual for at least three months certifies that the underlying "condition of the central nervous system" that caused the loss of consciousness is sufficiently under control to enable the person to drive safely. Del. Code Ann. tit. 21, § 2707(b)(6) (2013). There is no specified seizure-free period. Drivers issued a license must obtain a certificate each year from the physician, indicating that the condition is under sufficient control to permit safe operation of a motor vehicle. Physicians make such reports to the licensing agency via written letter. Del. Code Ann. tit. 21, § 2707(b)(6) (2013).

Does the state allow for waivers of this policy, e.g., a waiver for a one-time episode of severe hypoglycemia that has mitigating factors (e.g., recent change in medication, illness, etc.) or that has been addressed with a physician?

The state allows a physician that has been treating the driver's underlying condition for at least 3 months to certify that the driver's "condition of the central nervous system" no longer requires treatment and no longer poses any danger of loss of consciousness." Del. Code Ann. tit. 21, § 2707(b)(6) (2013). Upon accepting, the physician's certification, the licensing agency will no longer require annual certification from a physician. Id. Again, there is no statutorily specified seizure-free period during which time an individual who has recently experienced a seizure may not drive.

What is the process for appealing a decision of the state regarding a driver's license?

Immediate suspension can take place if the driver caused or contributed to an accident resulting in death, or if the department has information that the driver is incompetent to drive because of a physical impairment. See Del. Code Ann. tit. 21, § 2714(a), (c) (2013). Otherwise, the suspension does not take place until the case, including the medical evaluation and the physician's recommendation, has been reviewed by the Department.

Regardless of how the suspension or revocation is accomplished, the applicant has a right to appeal the decision by requesting an administrative hearing. Del. Code Ann. tit. 21, § 2724(f) (2013). The driver can appeal the hearing officer's decision to the Court of Common Pleas in the county in which they live. Del. Code Ann. tit. 21, § 2717 (2013).

May an individual whose license is suspended or denied because of diabetes receive a probationary or restricted license?

There is no probationary license. There may be a special restricted license, or "suitable" restrictions imposed on the usual driver's license. Del. Code Ann. tit. 21, § 2722(a)-(b) (2013). Failure to comply with these restrictions is a misdemeanor. Del. Code Ann. tit. 21, § 2722(d) (2013).

Is an identification card available for non-drivers?

Yes, with proper identification, as required for a driver's license, and payment of a $20 fee. Del. Code Ann. tit. 21, § 3103(a) (2013). For more information, see Delaware Division of Motor Vehicles, Drivers Services.


Driver licensing in Delaware is administered by the Division of Motor Vehicles in the state Department of Transportation.