1.3 Medical standards for licensing
Requirements for unconditional and conditional licences are outlined in the following tables. Health professionals should familiarise themselves with the information in this chapter and the tabulated standards before assessing a person’s fitness to drive.
Where a firm diagnosis has been made, the standard appropriate to the condition should be referred to in this publication (refer to Figure 6 Management of blackouts and driving). For blackouts due to medical causes not covered in the standard, refer to first principles (refer to Part A section 2. Assessing fitness to drive – general guidance). For blackouts where, after investigation, it is not possible to diagnose one of the conditions covered elsewhere in this publication, refer to the table for blackouts of uncertain nature over the page.
Figure 6: Management of blackouts and driving
Medical standards for licensing – blackouts of uncertain nature Health professionals should familiarise themselves with the information in this chapter and the tabulated standards before assessing a person’s fitness to drive. |
|---|
| Condition | Private standards (Drivers of cars, light rigid vehicles or motorcycles unless carrying public passengers or requiring a dangerous goods driver licence – refer to definition in Table 3) | Commercial standards (Drivers of heavy vehicles, public passenger vehicles or requiring a dangerous goods driver licence – refer to definition in Table 3) |
|---|---|---|
Blackouts – episode(s) or impaired consciousness – of uncertain nature | A person should not drive for 6 months following a single blackout of undetermined nature. A person should not drive for 12 months following two or more blackouts of undetermined nature separated by a 24- hour period. A person is not fit to hold an unconditional licence:
If there has been a single blackout or more than one blackout within a 24-hour period, a conditional licence may be considered by the driver licensing authority subject to at least annual review, taking into account information provided by the treating doctor as to whether the following criterion is met:
If there have been two or more blackouts separated by at least 24 hours, a conditional licence may be considered by the driver licensing authority subject to at least annual review, taking into account information provided by the treating doctor as to whether the following criterion is met:
| A person should not drive for 5 years following a single blackout of undetermined nature. A person should not drive for 10 years following two or more blackouts of undetermined nature separated by a 24- hour period. A person is not fit to hold an unconditional licence:
If there has been a single blackout or more than one blackout within a 24-hour period, a conditional licence may be considered by the driver licensing authority subject to at least annual review, taking into account information provided by an appropriate specialist as to whether the following criterion is met:
If there have been two or more blackouts separated by at least 24 hours, a conditional licence may be considered by the driver licensing authority subject to at least annual review, taking into account information provided by an appropriate specialist as to whether the following criterion is met: there have been no further blackouts for at least 10 years. |
| Exceptional cases | Where a person with one or more blackouts of undetermined mechanism does not meet the standards above for a conditional licence but may, in the opinion of the treating specialist, be safe to drive, a conditional licence may be considered by the driver licensing authority, subject to at least annual review:
| Where a person with one or more blackouts of undetermined mechanism does not meet the standards above for a conditional licence but may, in the opinion of the treating specialist, be safe to drive, a conditional licence may be considered by the driver licensing authority, subject to at least annual review: if the driver licensing authority, after considering information provided by the treating specialist(s), considers that the risk of a crash caused by a blackout is acceptably low. |
IMPORTANT: The medical standards and management guidelines contained in this chapter should be read in conjunction with the general information contained in Part A of this publication. Practitioners should give consideration to the following:
Licensing responsibility
The responsibility for issuing, renewing, suspending or cancelling a person’s driver licence (including a conditional licence) lies ultimately with the driver licensing authority. Licensing decisions are based on a full consideration of relevant factors relating to health and driving performance.
Conditional licences
For a conditional licence to be issued, the health professional must provide to the driver licensing authority details of the medical criteria not met, evidence of the medical criteria met, as well as the proposed conditions and monitoring requirements. The presence of other medical conditions While a person may meet individual disease criteria, concurrent medical conditions may combine to affect fitness to drive – for example, hearing, visual or cognitive impairment (refer to Part A section 2.2.7. Older drivers and age-related changes and section 2.2.8. Multiple medical conditions).
The nature of the driving task
The driver licensing authority will take into consideration the nature of the driving task as well as the medical condition, particularly when granting a conditional licence. For example, the licence status of a farmer requiring a commercial vehicle licence for the occasional use of a heavy vehicle may be quite different from that of an interstate multiple combination vehicle driver. The examining health professional should bear this in mind when examining a person and when providing advice to the driver licensing authority.
Reporting responsibilities
Patients should be made aware of the effects of their condition on driving and should be advised of their legal obligation to notify the driver licensing authority where driving is likely to be affected. The health professional may themselves advise the driver licensing authority as the situation requires (refer to section 3.3 and step 6).
References and further reading
- Charlton, J.L., Di Stefano, M., Dow, J., Rapoport, M.J., O’Neill, D., Odell, M., Darzins, P., & Koppel, S. Influence of chronic Illness on crash involvement of motor vehicle drivers: 3rd edition. Monash University Accident Research Centre Reports 353. Melbourne, Australia: Monash University Accident Research Centre. (2021)
- Chee, J. N. et al. A systematic review of the risk of motor vehicle collision in patients with syncope. Canadian Journal of Cardiology 37, 151–161 (2021).
- Shen, W. K. et al. 2017 ACC/AHA/ HRS guideline for the evaluation and management of patients with syncope: A report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines and the Heart Rhythm Society. Circulation 136, e60– e122 (2017).
- Sorajja, D. et al. Syncope while driving. Clinical characteristics, causes, and prognosis. Circulation 120, 928–934 (2009).
- Moya, A. et al. Guidelines for the diagnosis and management of syncope (version 2009). European Heart Journal 30, 2631– 2671 (2009).
- Tan, V. H., Ritchie, D., Maxey, C. & Sheldon, R. Prospective assessment of the risk of vasovagal syncope during driving. JACC: Clinical Electrophysiology 2, 203–208 (2016).