Assessing Fitness to Drive

Table of Contents

Appendix 7 Seatbelt use

Relevance to driving task

The use of seatbelts is compulsory in Australia for drivers of all motor vehicles. This includes drivers of trucks and buses but excludes taxi drivers in Queensland (while carrying passengers). It has been reported that unrestrained occupants are more than three times more likely to be killed in the event of a crash than those who wear seatbelts.

The granting of an exemption from the use of seatbelts places an individual’s safety at considerable risk. For a person who is otherwise medically fit to drive, there are very few circumstances in which a medical condition will render a person unable to wear a seatbelt.

Requests relating to seatbelt exemptions

Individuals may request a medical certificate recommending or granting exemption (depending on the state or territory); however, exemptions based on most medical grounds are considered invalid. Health professionals are discouraged from providing letters stating that the use of a seatbelt is not required.

In conditions such as obesity, health professionals should advise the patient to have the seatbelt modified and an inertia seatbelt fitted. In conditions in which there are scars to the chest or abdomen (i.e. post surgery/injury), the patient should be advised about the use of padding to prevent any problems of seatbelt irritation.

It must be stressed that exemptions due to any medical condition should be an extremely rare exception to the uniformity of a rule that enforces the legal obligation of a driver to wear a seatbelt if fit to drive.

Medical certificate regarding exemption

If a health professional recommends or grants (depending on state or territory law) an exemption, they must accept responsibility for granting the exemption. In order to comply with the requirements of the driver licensing authority, a certificate of exemption (or recommendation for exemption) should be issued in the following manner:

  • The certificate must be dated and issued on the practitioner’s letterhead (except in Queensland and Tasmania, refer below).
  • The certificate must state the name, address, sex and date of birth of the person for whom the exemption is requested.
  • The certificate must state the reason for which the exemption is requested.
  • The date the exemption expires must be clearly stated. It should not exceed one year from the date of issue of the certificate except for musculoskeletal conditions or deformities of a permanent nature. The certificate may not be legally valid without this date.
  • In Victoria a registered medical practitioner must issue the certificate stating that, because of medical unfitness or physical disability, it is impractical, undesirable or inexpedient that the person wears a seatbelt. Any conditions stated in the certificate must be complied with.
  • In Queensland an approved exemption certificate (form F2690) may be completed by the practitioner. Seatbelt exemption certificates in Queensland must only be issued for a maximum period of 12 months. Contact details are listed in Appendix 9: Driver licensing authority contacts
  • In Tasmania a special application form is required for exemption applications. See the website at <> for further information. Contact details are listed in Appendix 9: Driver licensing authority contacts.
  • In the Northern Territory a medical recommendation that clearly indicates that these guidelines have been referred to in reaching the exemption recommendation is required. All such recommendations should be sent to the Registrar of Motor Vehicles. Contact details are in Appendix 9: Driver licensing authority contacts.
  • Inform the patient that the certificate must be carried when travelling in motor vehicles without using a seatbelt and must be shown to police and authorised officers when requested.
  • All health professionals and licensing authorities should keep a record of all exemptions granted or recommended and document the reasons for exemption in case litigation occurs.

Medical exemptions

The table below suggests guidelines for possible exemptions.

Seatbelt exemptions
Ileostomies and colostomiesNo exemption. In normal circumstances, a properly worn seatbelt should not interfere with external devices. An occupational therapist can advise on seatbelt adjustments in other cases.
Musculoskeletal conditions and deformitiesExemption possible for passengers only, depending on the exact nature of the condition.
ObesityModification of restraint advised. If not feasible, an exemption is possible.
PacemakersNo exemption. If the pacemaker receives a direct compression force from a seatbelt, the device should be checked for malfunction.
Physical disabilityNo exemption. Advise patient about correct fitting.
PregnancyNo exemption. Advise patient about correct fitting.
Psychological conditionsNo exemption. Claustrophobia from seatbelt use can be overcome; if the condition is severe, refer the patient to a specialist.
Scars and woundsNo exemption. Advise the patient about the use of protective padding.