Driving with medical conditions or disabilities

All NSW licence holders have a legal responsibility to notify Roads and Maritime Services (RMS) of any serious or long term medical conditions or injuries as soon as practicable.  If you have a medical condition, injury, illness or disability it is important that you consult with your medical practitioner before driving/riding a motor vehicle.

Just because you have a serious medical or physical condition, does not automatically mean that you can not drive.  It may just mean that you need to undertake regular medical reviews with your treating doctor/specialist to ensure that you remain medically fit to drive.

However, if your medical practitioner recommends that you not drive for the duration of your illness or injury then it is important that you abide by these recommendations.  If you continue to drive and are involved in a motor vehicle accident or incident you may be liable for prosecution through the Courts and will not be covered for insurance purposes.

Drivers with serious or long-term medical conditions must meet certain medical criteria before being deemed medically fit to drive/ride a motor vehicle.  All licensing jurisdictions in Australia have adopted the national ‘Assessing Fitness to Drive’ medical standards published by Austroads.  These medical standards may be viewed on the Austroads website.

Below are some commonly asked questions, if you require any further information please telephone our Contact Centre on 13 22 13, or attend one of our RMS registry offices.

 Frequently Asked Questions

1.I have been diagnosed with a serious medical condition/illness (such as epilepsy, diabetes, sleep disorder, cardio-vascular disease, dementia, stroke, mental health disorder) what do I need to do in order to hold or maintain a driver licence?

2. I have no medical conditions or disabilities but I have received a request to undertake a medical review with my treating doctor. Why?

3. Why have I been requested to undertake a medical review with a specialist?

4. I have been asked to undertake a medical review with my treating doctor and/or specialist and can not obtain an appointment until after the due date. Can I get an extension?

5. Can I drive with a cast on my leg?

6. Can I drive with a cast on my arm/hand?

7. Can I drive while using oxygen therapy/wearing an oxygen mask?

8. Can I apply for a seatbelt exemption if I have a medical condition which restricts me from wearing a seatbelt?

9. My treating doctor has recommended that I have specific licence conditions endorsed on my licence, (e.g. radius restriction, daylight hours only), how do I get the conditions removed in the future?

10. I have been advised that I must wear glasses and/or contact lenses when I am driving. What do I need to do in order to have my driver licence updated?

11. My licence has been cancelled or suspended on medical grounds, what are my options?

12. My doctor has referred me to undertake a driving assessment with an occupational therapist. What do I need to do?

 

1. I have been diagnosed with a serious medical condition/illness (such as epilepsy, diabetes, sleep disorder, cardio-vascular disease, dementia, stroke, mental health disorder) what do I need to do in order to hold or maintain a driver licence?

You must consult with your treating doctor or specialist before commencing to drive if you have a serious or long term medical condition, illness, injury or disability.  If your doctor recommends that you do not drive, then you must comply with these recommendations.  Failing to do so could result in legal prosecution, loss of insurance and monetary fines.

It is important that you notify RMS of your medical condition as soon as practicable to ensure that you meet the relevant medical standards and legal requirements to drive a motor vehicle.  In order to notify RMS of your condition please attend a RMS registry office, or telephone our Contact Centre on 13 22 13 for further information.

Once RMS has been notified of your medical condition you will be required to provide a medical report from your treating doctor/specialist.  If you are the holder of a commercial class of licence (ie class MR or above) you may also be required to provide information from an appropriate specialist before RMS can provide approval for you to continue to drive or be issued with a driver licence.

For some particular medical conditions there are specific medical standards that RMS applies, to ensure that medical fitness to drive is appropriately assessed.  There are also in some cases mandatory non-driving periods if a person has suffered particular symptoms of a condition, such as a seizure, blackout, loss of consciousness or hypoglycaemic episode.  The specific non-driving periods and medical standards that RMS applies are detailed in the national ‘Assessing Fitness to Drive’ publication, which can be viewed at the Austroads wesbiste.

2. I have no medical conditions or disabilities but I have received a request to undertake a medical review with my treating doctor. Why?

Evidence suggests that the skills necessary to safely operate a motor vehicle start to decline from about the age of 75, including vision, cognition, memory, muscle strength and reflexes.  In order to recognise and closely monitor those drivers who may no longer have the necessary skills to drive, or are close to reaching the end of their driving days, it is mandatory in NSW for all drivers aged 75 years and older to undertake an annual medical examination with their treating doctor.  It is also necessary for drivers turning 85 to also undertake a driving assessment every two years in order to maintain an unrestricted driver licence.

In order to ensure that a regular medical review is completed, RMS aligns all standard medical reviews to a person’s birthday each year.  This means that a medical report and request is sent to a customer approximately eight weeks prior to their birthday, for completion and return to RMS by their birthday.

If you have received a medical report, and you do not have a serious or long term medical condition which is specified in the national ‘Assessing Fitness to Drive’ publication, (which can be viewed at the Austroads website) and you are not close to turning or over the age of 75 years, then you may need to contact RMS by telephoning our Contact Centre on 13 22 13.

3.  Why have I been requested to undertake a medical review with a specialist?

People with serious or long term medical conditions must undertake specific medical examinations and provide suitable information to RMS about their condition before approval can be given for them to be issued or to retain a driver licence.

The Road Transport (Driver Licensing) Regulations 2008 provides that RMS may request a holder of a driver licence to undergo a medical examination to determine their medical fitness to drive, and to attend a specified medical practitioner for the purpose of that examination.

The national ‘Assessing Fitness to Drive’ medical standards, published by Austroads, provides that in some cases a driver should be reviewed by an appropriate specialist before being granting a driver licence.  In particular drivers who hold commercial licence classes, such as MR (Medium-Rigid vehicle) or above must provide information from an appropriate specialist before being granted a conditional licence, for all serious medical conditions.

For full details of the medical requirements for particular conditions you may view the ‘Assessing Fitness to Drive’ medical standards at the Austroads website.

In some cases, RMS may think it appropriate for a person to undertake a specialist medical review, if there is reason to believe that they are not compliant with appropriate treatment prescribed for their medical condition, or there is concern that the person does not meet the relevant medical criteria prescribed in the medical standards.

4.  I have been asked to undertake a medical review with my treating doctor and/or specialist and can not obtain an appointment until after the due date.  Can I get an extension?

RMS requires that all medical examinations are completed within a certain timeframe, to ensure that up to date and accurate information is available at all times concerning a person’s medical fitness to drive.

If you have been requested to provide a medical report from your treating doctor/specialist, you will receive a specific due date, or be provided with a set period of time, for you to provide a satisfactory medical report to RMS.

RMS appreciates that in some areas, especially regional areas, obtaining an appointment with a doctor/specialist can be difficult.  Therefore, RMS will in some circumstances, and on a case to case basis, allow for an extension to the time allowed for you to provide a satisfactory medical report, subject to an appointment confirmation being provided.

Approval to extend the time allowed for you to provide a satisfactory medical report will only be given if arrangements to book an appointment has been made early in the medical review process, well before the due date or the end of the timeframe provided.

If you have reached the due date and/or received a suspension notice for not complying with RMS request to provide a satisfactory medical report, no consideration will be given to allow an extension on the time provided, unless sufficient proof is provided that you were absent from your address when the initial request and reminder notice was sent, and/or medical advice is provided confirming that your medical review has not yet been finalised.

5.  Can I drive with a cast on my leg?

You must consult with your treating doctor/specialist about whether or not your condition will impact on your ability to safely drive a motor vehicle, before commencing to drive with a cast fitted.

If you have fractured one of your legs/feet and require a cast to be fitted, you may be eligible to continue to drive, automatic cars only, if the cast is fitted to your left leg/foot.

If the cast is fitted to your right leg/foot then it may be necessary for you to refrain from driving while the cast is fitted.  A cast fitted to your right leg/foot may interfere with the safe use of the accelerator and brake pedals.

If you have casts fitted to both legs/feet, then of course you should not drive.

If you are the holder of a rider licence, then you should refrain from riding motorcycles until your injury has fully recovered.

6.  Can I drive with a cast on my arm/hand?

You must consult with your treating doctor/specialist about whether or not your condition will impact on your ability to safely drive a motor vehicle, before commencing to drive with a cast fitted.

If you have fractured one of your arms/wrist/hand and require a cast to be fitted then you may continue to drive using one hand, if you are able to safely use your fractured arm/hand to operate all appropriate vehicle controls, such as indicators, windscreen wipers and lights.

You must have a hand on the steering wheel at all times when driving a motor vehicle.  To take your hand from the steering wheel is deemed as not having proper control of the motor vehicle.  Therefore, if you have a cast fitted to one of your arms/hands it is not safe to drive manual vehicles, unless you can safely change gears while continuing to have a hand controlling the steering wheel.

If you are the holder of a rider licence, then you should refrain from riding motorcycles until your injury has fully recovered.

7.  Can I drive while using oxygen therapy/wearing an oxygen mask?

You must consult with your treating doctor/specialist about whether or not your medical condition, which has lead to the requirement for you to undergo oxygen therapy, will impact on your ability to safely drive a motor vehicle.

Your treating doctor/specialist must examine you in accordance with the national ‘Assessing Fitness to Drive’ medical standards.  If it is considered that you meet the relevant criteria to maintain a driver licence, you may drive while using oxygen therapy as long as the mask and tank does not interfere with the use of the vehicle controls, or impact on your vision or sight when driving.

The oxygen tank must be securely positioned in the motor vehicle (ie firmly strapped into the vehicle).

8.  Can I apply for a seatbelt exemption if I have a medical condition which restricts me from wearing a seatbelt?

The use of seatbelts is compulsory in Australia for drivers of all motor vehicles.  This includes trucks and buses, but excludes taxi drivers in NSW and Queensland.

Unrestrained occupants are over three times more likely to be killed in the event of a crash than those wearing a seatbelt.

There are really no medical conditions for which a person should be unable to wear a seatbelt.  Health professionals are discouraged from providing letters to people stating that the use of a seatbelt is not required. For conditions such as obesity, a seatbelt can be modified and an inertia seatbelt fitted.  For conditions such as scars to the chest or abdomen, padding can be used to prevent any problems of seatbelt irritation.

RMS does not issue a certificate of exemption for seatbelt use.

If you require a seatbelt exemption then it is the responsibility of your treating doctor/specialist to grant the exemption.  Your treating doctor/specialist must issue you with a certificate of exemption in the following manner:

  • The certification must be dated and issued on the practitioner’s letterhead
  • State the name, address, sex and date of birth of the person exempt
  • Must state the reason for the exemption
  • Clearly show the date the exemption expires.  In NSW an exemption certificate is only valid for 12 months from the date of issue. Musculo-skeletal conditions or deformities of a permanent nature do not require an expiry date

The certificate must be carried with you at all times when travelling in a motor vehicle without using a seatbelt, and must be shown to police and authorised officers when requested.

9.  My treating doctor has recommended that I have specific licence conditions endorsed on my licence, (e.g. radius restriction, daylight hours only), how do I get the conditions removed in the future?

If specific licence conditions have been added to your driver licence as a result of a medical decision, or from the advice of your medical practitioner, the condition(s) can not be removed until further written confirmation from your treating doctor or specialist has been presented to RMS, confirming that the conditions can be removed.

If you have specific licence conditions on your licence referring to vehicle modifications or the use of special aids, such as a limb prosthesis to be worn, it will be necessary for you to successfully pass a RMS driving test in order to prove that you may drive your vehicle safely without the use of the modification(s) and/or special aid.

10.  I have been advised that I must wear glasses and/or contact lenses when I am driving.  What do I need to do in order to have my driver licence updated?

There are certain visual standards that all drivers must meet in order to retain or be issued with a driver licence.  For the full visual standards you may refer to the national ‘Assessing Fitness to Drive’ publication, which can be viewed at the Austroads website.

If you have been informed by a registered Optometrist or Ophthalmologist that you must wear glasses and/or contact lenses when driving, you must comply with the specialists’ recommendations and notify RMS of the requirement as soon as possible.

To notify RMS of the requirement please attend a RMS registry with the licence card currently in your possession so that a specific licence condition can be added to your driver licence; (‘must wear glasses or contact lenses while driving.’)  You may also need to undertake an eyesight test at the registry, while wearing your glasses before a replacement licence card can be issued with the new licence condition added.

In some cases, people may only require the use of glasses or contact lenses when driving at night and/or when driving heavy vehicles.  RMS has particular licence conditions that can suit these situations, such as ‘must wear specs or contacts when driving at night’ and ‘must wear glasses or contact lenses when driving a vehicle with gross vehicle mass over 8 tonnes.’  If you require one of these licence conditions to be added to your driver licence, please attend a RMS registry office.

11.  My licence has been cancelled or suspended on medical grounds, what are my options?

RMS will notify you in writing just prior to the cancellation or suspension of your driver licence.  The notice of cancellation or suspension will provide you with a commencement date and the reasons for the cancellation or suspension action.  The notice will also provide you with the relevant course of action to have the cancellation or suspension withdrawn or lifted.

For example, if RMS requires further medical evidence to be provided from a medical practitioner, the notice will specify the details required and the type of medical practitioner that needs to provide the information.  It is very important to present the RMS notice of cancellation or suspension to the medical practitioner when you are being examined so that the doctor/specialist can provide all relevant information that is required.

If you need to undertake a driving assessment, then the notice will provide you with details on how to arrange such an assessment.

You will also have a right of appeal against the decision to cancel or suspend your driver licence.  You must lodge the appeal within 28 days of receiving the notice, to a NSW Local Court.  The Local Court will need you to present the cancellation or suspension notice when lodging the appeal.  A fee is payable to the Local Court when lodging an appeal.  Lodging an appeal does not stop or lift the decision to cancel or suspend your licence, the action will still proceed.

12.  My doctor has referred me to undertake a driving assessment with an occupational therapist.  What do I need to do?

Driving assessments conducted by an occupational therapist are a specialised driving assessment process which thoroughly assesses the impact that a medical condition, or physical disability or injury, may have on the driving task.  Driver trained occupational therapist are specially qualified to assess all areas of driving including cognition, memory, reflexes, judgement, driving behaviour, motor function, knowledge of road rules, application of road rules and response times.

Driving assessments conducted by an occupational therapist are available through a number of services, including private and public practices. Drivers referred for a driving assessment with an occupational therapist are responsible for arranging the assessment and meeting all costs associated. For more information on occupational therapist driving assessment and to locate a driver trained occupational therapist, you may view the Occupational Therapist Association of Australia website.

If a driver is required to undertake a driving assessment with an occupational therapist, RMS will notify them of the requirement in writing.  In some cases, RMS may consider it necessary for the driver to downgrade or be issued with a restricted learner licence until the driving assessment process has been completed.  This is to ensure the safety of the driver and other road users, until it has been determined whether or not the person is safe to drive.

Following the completion of an on-road driving assessment with an occupational therapist, the assessor will notify RMS of their recommendations relating to the drivers medical fitness and ability to drive to a safe standard.  RMS will then decide whether or not the driver can be issued or retain a driver licence.

If you are a driver with a disability, and may require the use of vehicle modifications in order to drive a motor vehicle, you may wish to consult with a driver trained occupational therapist before purchasing and installing modifications.  This will ensure that the modifications are correctly suited to your condition.