Assessing Fitness to Drive

Table of Contents

4.2 Considerations for commercial vehicle licensing

The assignment of medical standards for vehicle drivers is based on an evaluation of the driver, passenger and public safety risk, where risk = likelihood of the event × severity of consequences.

Commercial vehicle crashes may present a severe threat to passengers, other road users (including pedestrians and cyclists) and residents adjacent to the road. Such crashes present potential threats in terms of spillage of chemicals, fire and other significant property damage.

Commercial vehicle drivers generally spend considerable time on the road, thus increasing the likelihood of a motor vehicle crash. They may also be monitoring various in-vehicle communication and work-related systems – a further factor that increases the likelihood of a crash. Crash data identifies that commercial vehicle drivers are more than twice as likely to be involved in a fatal crash compared with other drivers. On the other hand, crashes involving private vehicle drivers are likely to have less severe consequences. Therefore, to ensure that the risk to the public is similar for private and commercial vehicle drivers, the medical fitness requirements for the latter must be more stringent. This is required in order to reduce to a minimum the risk of crash due to long-term injuries or illnesses. The standards outlined in this publication reflect these differences.

The standards also acknowledge and allow for the variability in risk among different commercial vehicle drivers. 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 (refer to section 4.4 Conditional licences). For example, the licence status of a farmer requiring a commercial vehicle licence for the occasional use of a heavy vehicle on his/her own property 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 patient and when providing advice to the driver licensing authority.

In developing the standards, a number of approaches have been adopted to manage the increased risk associated with driving a commercial vehicle (refer to Table 3). These approaches include:

  • There are generally longer non-driving periods prescribed for commercial vehicle drivers compared with private vehicles, for example, after a seizure or heart attack.
  • There is generally a requirement that a specialist (rather than general practitioner) provide information regarding a conditional licence for a commercial vehicle driver (refer to section 4.4 Conditional licences).
  • Some medical conditions may preclude a person from driving a commercial vehicle, but they may still be eligible to hold a full or conditional licence for a private vehicle, for example, early dementia.
  • The review period for a conditional licence may be shorter for a commercial vehicle driver.

Table 3: Choice of standard according to vehicle/licence type

National licence classesWhich standard to apply
(private or commercial)

Motorcycle (R)

Motorbike or motortrike.Private standards apply UNLESS driver holds or is applying for an authority to carry public passengers for hire or reward, in which case the commercial standards apply.

Car (C)

Vehicle not more than

4.5 tonnes GVM (gross vehicular mass) and seating up to 12 adults including the driver.

Private standards apply UNLESS:

  • driver holds or is applying for an authority to carry public passengers for hire or reward (e.g. taxi driver)
  • is undertaking a medical assessment as a requirement under an accreditation scheme
  • holds or is applying for an authority to hold a dangerous goods driver licence
  • holds or is applying to hold authority to be a driving instructor (may vary between jurisdictions).

In these cases the commercial standards apply.

Light rigid (LR)

Any rigid vehicle greater than 4.5 tonnes GVM or a vehicle seating more than 12 adults, that is not more than 8 tonnes, plus a trailer of no more than 9 tonnes GVM.

Medium rigid (MR)

Any two-axle rigid vehicle greater than 8 tonnes GVM, plus a trailer of no more than 9 tonnes GVM.Commercial standards apply at ALL times.

Heavy rigid (HR)

Any rigid vehicle with three or more axles greater than 8 tonnes GVM, plus a trailer of no more than 9 tonnes GVM.

Heavy combination (HC)

Prime mover + single semi-trailer greater than 9 tonnes GVM and any unladen converter dolly trailer.

Multiple combination (MC)

Heavy combination vehicle with more than one trailer.


  • A person who does not meet the commercial vehicle medical requirements may still be eligible to retain a private vehicle driver licence. In such cases, both sets of standards may need to be consulted.
  • The standards are intended for application to drivers who drive within the ambit of ordinary road laws. Drivers who are given special exemptions from these laws, such as emergency service vehicle drivers, should have a risk assessment and an appropriate level of medical standard applied by the employer. At a minimum, they should be assessed to the commercial vehicle standard.