Territory Medical Blog
Posted on 27 September, 2018

Medical Fitness to Drive

Medical Fitness to Drive

When you apply for or renew your driver's licence, you are asked to declare whether you are taking medication, or have a medical condition, that affects your ability to drive

Based on this information you may need to undergo a medical examination to confirm your fitness to hold a driver's licence.

All drivers are also required by law to report any medical condition that could affect their ability to drive safely. This must be done at the time the condition occurs, not just when renewing your licence.

Health practitioners are also required to report if a patient is diagnosed with a medical condition that may affect their ability to drive

Assessing fitness to drive

When assessing a person's medical fitness to hold a driver's licence, the health professional is required to examine the person in accordance with the standards contained in the National Transport Commission national guidelines Assessing fitness to drive - commercial and private vehicle drivers October 2016.

Medical assessments

All drivers must meet the eyesight standards set out in the publication Assessing Fitness to Drive. When you apply for, or renew your licence, you may be required to pass an eyesight test.

For car (class C) and rider (class R) licences, you need to pass an eyesight test every 10 yearsuntil you’re 45 years old, then every five years. Once you reach 75, you need to pass an eyesight test every year.

Note: Customers will need to pass an eyesight test when applying for a ten year licence. If a customer takes up the ten year licence renewal option and will be over 45 years of age within the ten year duration, the customer is exempt from having to pass an eyesight test until the next renewal.

For other vehicle licences (class LR and above), you need to pass an eyesight test, when renewing or replacing your licence.

If you only require glasses/contact lenses in specific circumstances, for example at night or when driving a heavy vehicle, this requirement will also be added as a condition on your licence.

Conditions which affect safe driving

Various medical conditions can affect your ability to drive safely, for example:

  • Blackouts, fainting or other sudden periods of unconsciousness
  • Vision problems
  • Heart disease or stroke
  • Epilepsy
  • Sleep disorders
  • Diabetes
  • Psychiatric disorders
  • Neurological disorders
  • Age-related decline.

Usually, this doesn’t mean that you can’t drive at all, but you may need to provide a satisfactory medical report before you can apply for, or renew your licence. In some cases you may also be required to pass a driving test.

Decisions about your ability to drive safely

Your doctor can provide advice about how your particular medical condition might affect your ability to drive safely, and how it might be managed.

Roads and Maritime makes the final decision about your licence. We take into consideration the advice of your doctor, as well as other factors, such as your accident history (if any) and the type of vehicle you drive. For example, truck, bus and taxi drivers need to meet a higher standard, due to the nature of their driving. See Commercial and passenger vehicle driversfor more information.

Dementia

The progressive and irreversible loss of mental functioning caused by dementia creates issues for driver safety. All drivers with dementia will likely face a situation where their condition deteriorates, to the point that they are no longer medically fit to drive.

If you’re a driver with dementia, it’s important that you regularly talk to your doctor about how your ability to drive is being affected.

By talking to doctors, family, friends and carers about driving issues as soon as possible after a diagnosis of dementia, you can make the difficult transition away from driving an easier process. It’s important to talk about any problems you have while driving, and what your transport needs might be, to work out when it’s the right time to stop driving.

Epilepsy

If you drive a private vehicle and have epilepsy, you’ll normally only be issued a licence if you’ve been free of seizures for at least one year. You’ll have a condition applied to your licence, that you must undergo regular medical reviews with your treating doctor or specialist.

If you drive a commercial vehicle (eg a truck, bus, taxi or hire car), you generally need to be seizure free for 10 years, to be issued a licence (which will have conditions added to it).

Some exceptions may be considered, for example first seizure, childhood seizures, or sleep only seizures. Allowances may also be considered, on the advice of an epilepsy specialist.

Vision in one eye only

If you have vision in one eye only (monocular vision) you must provide a certificate from an ophthalmologist or optometrist certifying you meet the required standards for your licence. This includes copies of any recent visual field testing.

From 1 March 2017, optometrists and ophthalmologists can now submit the medical assessment form online. Submitting medical assessments to Roads and Maritime is immediate and results in faster case reviews and saves you from having to attend a service centre or registry.

If you drive a private vehicle, you may be issued with a conditional licence, subject to review every two years.

If you drive a commercial vehicle, you may be considered for a licence with conditions, subject to a yearly review. The nature of your driving will be taken into account, along with information provided by an optometrist or ophthalmologist.

In all cases, Roads and Maritime will consider the extent of any visual field loss and your visual acuity, before a conditional licence is granted.

Glaucoma

Glaucoma is an eye disease in which the optic nerve at the back of the eye is slowly destroyed. There are no warning signs and generally no pain associated with glaucoma. The loss of sight is gradual and a considerable amount of peripheral vision may be lost, before you become aware of any problem.

You must be able to see properly, to drive safely. Drivers with poor peripheral vision in both eyes are more at risk of crashing, than drivers with normal peripheral vision, particularly when pulling into, or out of traffic, or when overtaking. You may also not see pedestrians stepping onto the road.

For more information, visit the Glaucoma Australia website, or phone Glaucoma Australia on 1800 500 880.

Macular Degeneration

The macula is the central part of the retina, the light sensitive tissue at the back of the eye. The retina processes all visual images. It’s responsible for your ability to read, recognise faces, drive, and see colours clearly.

Macular Degeneration causes progressive macular damage, resulting in loss of central vision. Peripheral vision is not affected. Key symptoms include:

  • Difficulty with reading, or any other activity that requires fine vision
  • Distortion, where straight lines appear wavy or bent
  • Distinguishing faces becomes a problem
  • Dark patches, or empty spaces appear in the centre of your vision.

The need for increased lighting, sensitivity to glare, decreased night vision and poor colour sensitivity may indicate there’s something wrong. If you experience any of these symptoms, contact your eyecare professional immediately.

For more information, visit the Macular Disease Foundation website, or phone them on 1800 111 709.

Hearing loss and deafness

If you drive a private car, motorcycle or light rigid vehicle, hearing loss or deafness do not generally impair your ability to drive safely, and your licence does not need any special conditions or reviews.

If you drive a commercial vehicle however, you’re subject to hearing standards, and will need to be regularly reviewed by either an ear, nose and throat (ENT) specialist, or audiologist. There are allowances for congenital or childhood hearing loss.

Oxygen therapy and masks

If you require oxygen therapy, you must talk to your doctor about whether or not you’re medically fit to drive.

Provided your doctor states you are able to drive, you may use oxygen therapy, as long as the mask and tank do not interfere with your use of the vehicle controls, or block your view while driving.

The oxygen tank must be securely positioned and strapped into the vehicle.

Temporary medical conditions or injuries

Many temporary conditions or injuries will prevent you from driving. For example, if you’ve been under anaesthetic, your doctor will advise you not to drive, for at least 24 hours. Injuries such as broken bones will also affect your ability to drive.

In most cases, temporary conditions and injuries will not affect your licence, and you don’t need to report them to Roads and Maritime. However, you should consult with your doctor to determine whether your injury affects your ability to drive, until you’ve recovered.

Driving with a cast

If you have to wear a cast, for example due to a fractured leg, arm, hand or other injury, talk to your doctor about whether or not you’ll be able to drive.

Casts fitted to legs and feet may interfere with your ability to safely use the accelerator, brake and clutch pedals.

If you have a cast on your arm or hand, you may still be able to drive, however you must be able to operate all vehicle controls and have a hand on the steering wheel at all times. Driving a manual vehicle may not be possible, unless you can safely change gears while keeping one hand on the steering wheel.

For information specific to the Northern Territory go to https://nt.gov.au/driving/driverlicence/get-your-licence/medical-fitness-to-drive/health-professional-obligations-fitness-to-drive

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