Frequently asked questions

The driver medical standards Assessing Fitness to Drive have been revised to reflect current medical and research knowledge and the current transport environment. Reviews are conducted regularly to ensure currency and to respond to feedback from health professionals, drivers and other stakeholders.

Feedback can be provided through to Austroads and the National Transport Commission at any time.

The new 2022 standards are effective from the 22 June 2022. From that date, all drivers must be assessed using the new standards. Driver Licensing Authorities will manage the transition to the new standards, including communication with drivers on conditional licences who may be affected by the changes. Note that some Driver Licensing Authorities may delay the application of some revisions and/or vary their application. For example, some Driver Licensing Authorities will consider the application of the revised criteria at the time of the driver’s next periodical review assessment unless the driver re-presents in the interim (e.g., deterioration of condition, pro-actively seeking consideration under new criteria).

The current review of Assessing Fitness to Drive has resulted in some changes to the licensing criteria to account for developments in medical understanding and practice.

The main changes are described in the Summary of Changes are explained in more detail in the National Transport Commission 2022 AFTD Review Report.

The updates to the standards also include clearer guidance for health professionals to support consistent assessment and decision making.

The standards have been produced through an extensive consultation process involving medical, research and health experts and consumer groups, as well as all State and Territory Driver Licensing Authorities, and the transport industry. Any member of the public could also contribute to the review process.

The review has also drawn on the latest Monash University Accident and Research Centre (MUARC) report Influence of chronic illness on crash involvement of motor vehicle drivers: 3^rd edition, which considers the evidence for crash risk for various medical conditions. The process has been overseen by the National Transport Commission and Austroads. The National Transport Commission 2022 AFTD Review Report describes the process and outcomes of the review.

Given the small number of significant changes to the licensing criteria, it is not expected that the revisions will have a major impact on practice for most health professionals. Some changes improve clarity and support the driver assessment process as described in the Summary of Changes. It is not anticipated that the standards will impact on health professionals’ workload in undertaking assessments.

Driver Licensing Authorities will apply the new standards to all newly referred drivers from 22 June 2022. A small number of significant changes will also need to be considered by Driver Licensing Authorities in terms of the impact on drivers already managed within the medical review system, including those on existing conditional licences. Improved guidance material contained in the standards will facilitate licensing management by Driver Licensing Authorities and support greater consistency in licensing decisions.

The new standards do not mean a change in responsibility for drivers. They must continue to ensure that they do not drive if they have a condition that is likely to affect their ability to drive safely, and they must report such conditions to the Driver Licensing Authority.

The standards reflect developments in medical science and improvements in diagnosis and treatment of various health conditions. They therefore provide scope for drivers with well-managed health conditions to continue to drive safely.

There are a small number of significant changes that will affect drivers. These are explained in the Summary of Changes.

The changes to the standards are outlined in the Summary of Changes. Drivers may also speak to their GP, optometrist, medical specialists or occupational therapist as well as their local Driver Licensing Authority about how the new standards will affect them.

The standards will be available in html format on the Austroads website, with improved layout and a search function to enable easy access to specific criteria and management guidelines. The publication can also be downloaded for free in pdf form from the website. Hard copies may be ordered for a fee of $35 which includes shipping and handling.

Health professionals and drivers can subscribe to receive emailed updates about Assessing Fitness to Drive. Austroads is engaging with all relevant health professional peak groups and consumer advocacy groups to provide updates and resources which can be shared with members and consumers.

The purpose of Assessing Fitness to Drive is to improve road safety in Australia by assisting health professionals to:

• Assess the fitness to drive of their patients in a consistent and appropriate manner, based on current medical evidence
• Provide advice to drivers about the impact of health conditions and disability on driving and to promote awareness of driver legal reporting obligations and responsible behaviour
• Conduct medical examinations for the licensing of drivers as required by State and Territory Driver Licensing Authorities
• Understand options for, and make recommendations regarding conditional licences
• Recognise the extent and limits of their professional and legal obligations with respect to reporting fitness to drive.

The publication also aims to provide guidance to Driver Licensing Authorities in making licensing decisions.

The best place to access the standards is via the Austroads website. The website has been redeveloped so that you can navigate to find the information you need quickly and efficiently. The changes to the standards are highlighted in each chapter and there is a dedicated search function for the standards. The website will be live from 22 June 2022.

Driving a motor vehicle is a complex task requiring perception, good judgment, responsiveness and reasonable physical capability. A range of medical conditions, disabilities and treatments, may therefore impair driving ability. Common examples include:

• Blackouts
• Cardiovascular conditions
• Diabetes
• Dementia and cognitive impairment
• Seizures and epilepsy
• Other neurological conditions
• Musculoskeletal conditions
• Psychiatric conditions
• Sleep disorders
• Alcohol and other substance misuse
• Vision and eye disorders
• Treatments that have either a short- or long-term impact on any of the functional pre-requisites listed above.

Just because people have a disease or condition that might affect their driving, doesn’t mean that they won’t be able to drive at all. It might mean that they should refrain from driving when affected or must see their doctor more often to check that their illness is well managed. It might mean that there are some restrictions placed on their driving which enable them to drive in conditions that suit their capacities.

Follow this link for quick access to the medical standards for these conditions.

Assessing Fitness to Drive 2022 clearly outlines the responsibilities of drivers, examining health professionals and licensing authorities.

The new edition emphasises 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 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.

The Driver Licensing Authorities and various health organisations 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. These resources are usually available at no cost.

Many of these resources are referred to on the Assessing Fitness to Drive website but can also be accessed directly from the Driver Licensing Authority websites.

Assessing Fitness to Drive contains two sets of medical standards – private vehicle driver standards and commercial vehicle driver standards. The standards for commercial vehicle drivers are set at a higher level due to the increased risks generally associated with this type of driving.

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 (e.g. transportation of passengers or dangerous goods or driving large vehicles).

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.

In most cases, having a medical condition will not stop people from driving, as the licensing authority is able to issue a conditional licence. This means that the person may continue to drive as long as certain conditions or restrictions are met. Licensing conditions may include driving during daylight hours only, the use of vehicle modifications, driving only within a certain radius of the person’s home, the wearing of glasses or corrective lenses when driving or attending the doctor for a periodic review of a chronic condition (such as diabetes) at regular intervals and providing a report to the Driver Licensing Authority. A doctor may make recommendations to the Driver Licensing Authority about a conditional licence, but the authority will make the final decision.

If people are issued with a conditional licence, it is their responsibility to comply with any driving restrictions or other conditions and to be reviewed by their doctor as required if their condition deteriorates or changes.

The impact of a medical condition or multiple conditions on driving is not always clear, thus a practical driver assessment may be useful.

Driver licensing authorities offer different tests depending on their legislation and policy. For example, some jurisdictions require all drivers over a certain age to undergo an on-road competency test. On-road assessments conducted for medical review fitness to drive purposes are to be distinguished from the tests of competency to drive that are routinely conducted by driver licensing authorities for licensing purposes which are skill based (e.g., for novice drivers, or as part of an age-based requirement).

Practical driver assessments for the purpose of establishing fitness to drive are suitable for people with medical conditions or disabilities associated with impairments that fall under the Assessing Fitness to Drive standards. These assessments are usually conducted by occupational therapy driving assessors.

The assessments may be initiated by the health professional, others such as the police, a family member, the driver themselves, or the driver licensing authority. There may be a number of options available. For advice contact your Driver Licensing Authority or see the contact details for Specialist driver assessors in Appendix 10 of Assessing Fitness to Drive.

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

The type of health professional who can conduct fitness to drive assessments is defined in state and territory road transport legislation. Aspects of the legislation are summarised in Appendix 3.2 of Assessing Fitness to Drive in terms of the requirements to report and the protections offered to health professionals who make a report.  For example, in Victoria, reports to VicRoads are accepted from medical practitioners, optometrists and occupational therapists.

Of course, 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 optometrist or occupational 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 new edition of Assessing Fitness to Drive has more information to help guide the management of older drivers so that they can continue to drive for as long as it is safe to do so, while also considering and planning for a time when they may no longer be fit to drive. The Driver Licensing Authorities also have resources to support understanding of the potential impact of age-related decline, multiple morbidities, and the options for maintaining mobility and independence.

More information and resources here.

Assessing Fitness to Driver contains information relevant to the assessment and management of drivers who hold a commercial vehicle licence. This includes explanation about the increased risk posed by commercial vehicle drivers and how this is managed in the application of licensing criteria and assessment by medical specialists. The updated Austroads website also provides links to further information for both drivers and operators.

Alzheimer’s Australia has a range of resources to help people with dementia and their families, as well as resources to guide health professionals.

Some Driver Licensing Authorities also produce resources that align with their jurisdictional requirements and available supports.

The National Diabetes Services Scheme (NDSS) is an initiative of the Australian Government administered by Diabetes Australia. The NDSS provides information and support services to people with diabetes, including information about driving.

The ‘Above 5 to Drive’ resources are also available through Diabetes Australia.

Good vision is important for safe driving, so it’s important for drivers to have their eyes tested at least every two years (yearly for people over 65), or more frequently if recommended by a doctor or eye health professional.

Sources of information about vision and driving include:

• Good Vision for Life
• The Vision Initiative
• Some Driver Licensing Authorities may also have information about vision and driving.

The Stroke Foundation provides information about driving for those who have had a stroke or transient ischaemic attack (TIA).