Assessing Fitness to Drive

Table of Contents

4.4.4 What sort of conditions/restrictions may be recommended?

Examples of licence conditions, restrictions or vehicle modifications are shown in Table 4. These are indicative only and will vary depending on the medical condition and the type of licence. They include standard conditions that will appear as codes on the driver licence (e.g. corrective lenses, automatic transmission, hand controls). They also include conditions that are ‘advisory’ in nature and as such may not appear on the actual licence (e.g. take medication as prescribed, use a built-up seat or cushions, don’t drive more than x hours in any 24-hour period).

Table 4: Examples of licence conditions that may be required by the driver licensing authority*

Example of disability/situationExamples of licence conditions
Left leg disability / left arm disabilityAutomatic transmission
Short statureBuilt-up seat and pedals
Loss of leg functionHand-operated controls
Reduced lower limb strengthPower brakes required
Reduced upper limb strengthPower steering required; steering knob with hand controls
Short leg(s)Extended pedals
Hearing deficiency (commercial drivers)Hearing aid must be worn (commercial vehicles)
Deafness, both ears (commercial vehicle driver)Vehicle fitted with two external rear-view mirrors and other devices as required to assist external visual surveillance and recognition of emergency vehicles (e.g. additional wide-angle internal mirror)
Eyesight deficiencyPrescribed corrective lenses must be worn
Loss of limb functionProsthesis must be worn
Degenerative diseasesPeriodic review by driver assessor
Night blindnessDriving in daylight hours only
Age-associated deteriorations, for example, attentionDriving during off-peak only; drive within a 20 km radius of place of residence; in daylight hours only; no freeway driving
Spinal cord injury (above T12)Not to drive when temperature more than 25°C unless vehicle air-conditioned
Substance misuse (alcohol)Ignition interlock device

* These are not mandatory requirements and may be unsuitable in some circumstances.

One option available to maintain a driver’s independence despite a reduction in capacity is to recommend that an area restriction be placed on the licence. This effectively limits where the person can drive and is most commonly expressed as a kilometre radius restriction based on their home address. Drivers should be capable of managing usual driving demands (e.g. negotiating intersections, giving way

to pedestrians) as required in their local area. These licence conditions are only suitable for drivers who can reasonably be expected to understand and remember the limits as well as reliably compensate for any functional declines. The ability to respond appropriately and in a timely manner to unexpected occurrences such as roadworks or detours that require problem solving should also be considered. Thus, individuals lacking insight or with significant visual, memory or cognitive-perceptual impairments are usually not suitable candidates for a radius restriction (refer to Part B section 6.1 Dementia).

The health professional can support a patient in making an application for a conditional licence by indicating the patient’s driving needs, but the final decision/responsibility rests with the driver licensing authority.