Frequently asked questions for health professionals

The current 2022 edition of the Standards came into effect on the 22 June 2022.

The Driver Licensing Authority in your State or Territory can provide advice in this regard. See Contacts for Health Professionals for details.

Assessing Fitness to Drive contains two sets of medical standards – private vehicle driver standards and commercial vehicle driver standards.

The choice of which standards to apply when examining a patient for fitness to drive is guided by both the type of vehicle and the purpose for which the driver is being authorised to drive.

The private standards should be applied to:

• Drivers applying for or holding a license class C (Car), R (Motorcycle) or LR (Light Rigid) UNLESS the driver is also applying for an authority or is already authorised to use the vehicle for carrying public passengers for hire or reward or for the carriage of bulk dangerous goods or in some jurisdictions for a driver instructor's license.

The commercial standards should be applied to:

• Drivers of 'heavy vehicles' i.e. those holding or applying for a licence of class MR (Medium Rigid), HR (Heavy Rigid), HC (Heavy Combination) or MC (Multi-combination).
• Drivers applying for an authority /already authorised to carry public passengers for hire or reward (bus drivers, taxi drivers, chauffeurs, drivers of hire cars and small buses etc).
• Drivers applying for an authority / already authorised to carry bulk dangerous goods.

A person who does not meet the commercial vehicle medical criteria may still be eligible to retain a private vehicle driver licence.  In such cases, both sets of standards may need to be consulted.

The National Heavy Vehicle Accreditation Scheme was introduced in 2008 to support improved safety in the heavy vehicle industry. Under the scheme, standards are set for various aspects of heavy vehicle operators, including fatigue management.

Basic Fatigue Management and Advanced Fatigue Management modules of the scheme set out standards relating to drivers' health. These standards require that drivers are in a fit state to safely perform their duties. Specifically the standards require that drivers undergo regular health assessments to make sure they meet the medical criteria for commercial vehicle drivers contained in Assessing Fitness to Drive, with a particular focus on aspects such as sleep disorders, substance abuse etc. Assessments must be carried out every three years for drivers below the age of 50 and yearly for those 50 and over.

In addition to health assessments, the standard also sets out a range of measures to support drivers' health.

To comply with the standards, heavy vehicle operators must ensure drivers attend for assessments and are certified fit to drive.

Forms to facilitate these assessments are included on this site.

A health professional may request a practical driver assessment to provide information to supplement the clinical assessment in some borderline cases and to assist in making recommendations regarding a person’s fitness to drive. However, practical assessments have limitations in that a patient’s condition may fluctuate (good days and bad days) and it is not possible to create emergency situations on the road to assess quickness of response. Thus, practical assessments are intended to inform but not override the clinical opinion of the examining health professional. In addition, there are clinical situations that are clearly unsuitable for on-road assessments, such as visual impairment or significant cognitive impairment.

There is a wide range of practical assessments available, including off-road, on-road and driving simulator assessments, each with strengths and limitations. Assessments may be conducted by occupational therapists trained in driver assessment or by others approved by the particular driver licensing authority. Processes for initiating and conducting driver assessments vary between the states and territories and choice of assessment depends on resource availability, logistics, cost and individual requirements. The assessments may be initiated by the examining health professional, other referrers (e.g. police, self, family) or by the driver licensing authority.

Recommendations following assessment may relate to licence status, the need for vehicle modifications, rehabilitation or retraining, licence conditions and reassessment.

It is not the intent of Assessing Fitness to Drive to specify the assessment to be used in a particular situation. Health professionals should contact their local driver licensing authority for details of options or refer to Appendix 10 of Assessing Fitness to Drive: Specialist driver assessors.

If a person continues to drive despite your advice and they do not report their condition or any significant change to their condition to the Driver Licensing Authority, they are not fulfilling their legal responsibility. If they are involved in a crash under these circumstances and it is found that their health condition was a contributing factor, they may be prosecuted, and their insurance may not be valid.

If you are aware that they are continuing to drive and feels that their driving is a serious risk to them and other road users, you have an ethical responsibility to notify the Driver Licensing Authority directly. Legislation in South Australia and Northern Territory compels direct reporting in this situation.

Further information about how to notify Driver Licensing Authorities is available here.

State and territory legislation usually defines which health professionals can make a fitness to drive determination for the driver licensing authority. This varies between the jurisdictions as shown in the table below. Where this is not covered in legislation, the licensing authority policy will determine the requirements for reporting.

The health professional can make a report about aspects of fitness to drive relevant to their scope of clinical practice.

The legislation also covers aspects such as mandatory reporting by health professionals and legal protections for those who report in good faith. Refer Appendix 3.2 for details.

Any member of the public can make a report about an unsafe driver, including nurses, paramedics and other health professionals not identified in the legislation, and they can do so anonymously.  However, those reports do not determine fitness to drive – they will likely result in the driver being referred to their doctor (or other approved health professional) therapist) for a formal fitness to drive assessment, the result of which will be considered by the driver licensing authority when they make the licensing decision.

If you are in doubt, it is a good idea to go to the legislation in your state or territory for clarification, or contact your Driver Licensing Authority.

The Standards emphasise the important role of health professionals in advising their patients about the impact of their health conditions, treatments, or disabilities on safe driving.

In turn this enables drivers to fulfill their responsibility to report to the driver licensing authority any permanent or long-term condition that is likely to affect their ability to drive safely. It is the licensing authority not the health professional that makes the final decision about whether a person will be able to hold a licence.

In states and territories where online reporting systems have been initiated (currently Victoria and New South Wales), health professionals may submit reports directly to the licensing authority, which facilitates secure immediate report submission, reduces overall time for processing and enhances the monitoring and management of health conditions and conditional licensing.

Elsewhere, reports from health professionals to the licensing authority are usually made/submitted via the patient, in line with their reporting responsibilities.

Health professionals also have an obligation to public safety so if they believe that a patient is not heeding advice to cease driving, they may report directly to the Driver Licensing Authority. Confidential reporting systems may operate in these jurisdictions (check individual websites). Note that in South Australia and the Northern Territory, legislation currently requires the health professional to report directly to the licensing authority if they judge the patient to be unfit to drive.

Austroads produces a number of Consumer Fact Sheets to help communicate responsibilities about driving and health. These include:

• Driving and health – your questions answered
• Driving commercial vehicles – Why is your health important

The Driver Licensing Authorities and various health organisations also produce information about driving and health conditions and disabilities, as well as about issues such as driving assessments and the transition to not driving for older people or those with progressive conditions.

Many of these resources are referred to on this website but can also be accessed directly from the Driver Licensing Authority and other organisation websites.