7.3 Medical standards for licensing
Requirements for unconditional and conditional licences are outlined in the following table.
Medical standards for licensing – psychiatric conditions Health professionals should familiarise themselves with the information in this chapter and the tabulated standards before assessing a person’s fitness to drive. | ||
|---|---|---|
| Condition | Private standards (Drivers of cars, light rigid vehicles or motorcycles unless carrying public passengers or requiring a dangerous goods driver licence – refer to definition in Table 3) | Commercial standards (Drivers of heavy vehicles, public passenger vehicles or requiring a dangerous goods driver licence – refer to definition in Table 3) |
Psychiatric conditions (e.g. schizophrenia, bipolar affective condition, depression, anxiety conditions, and personality conditions) Refer also to section 7.1.1. Effects of psychiatric conditions on driving. | Private standards A person is not fit to hold an unconditional licence:
A conditional licence may be considered by the driver licensing authority subject to periodic review, taking into account the nature of the driving task and information provided by the treating doctor as to whether the following criteria are met:
| Commercial standards A person is not fit to hold an unconditional licence:
A conditional licence may be considered by the driver licensing authority subject to periodic review, taking into account the nature of the driving task and information provided by a psychiatrist* as to whether the following criteria are met:
* Where the treating psychiatrist considers a driver’s condition to be stable, well managed, and the driver has good insight, the driver licensing authority may agree to ongoing periodic review by the person’s regular GP on mutual agreement of all practitioners concerned. The initial allocation of a conditional licence must, however, be based on an assessment and information provided by the psychiatrist. |
Psychogenic nonepileptic seizures Refer also to section 6.2. Seizures and epilepsy | Private standards A person is not fit to hold an unconditional licence:
A conditional licence may be considered by the driver licensing authority subject to periodic review, taking into account information provided by the treating doctor as to whether the following criteria are met:
or
or
and
* The seizure and epilepsy standards also apply in cases where there is co-existent epilepsy (refer to section 6.2. Seizures and epilepsy). If psychogenic and epileptic seizures cannot be differentiated, the Blackouts of uncertain mechanism standards apply (refer to section 1.2.4. Blackouts of undetermined mechanism). If more than one standard applies, the standard with the longer non-driving period prevails. | Commercial standards A person is not fit to hold an unconditional licence:
A conditional licence may be considered by the driver licensing authority subject to at least annual review, taking into account information provided by the treating neurologist or psychiatrist as to whether the following criteria are met:
* The seizure and epilepsy standards also apply in cases where there is co-existent epilepsy (refer to section 6.2. Seizures and epilepsy). If psychogenic and epileptic seizures cannot be differentiated, the Blackouts of uncertain mechanism standards apply (refer to section 1.2.4. Blackouts of undetermined mechanism). If more than one standard applies, the standard with the longer non-driving period prevails. |
IMPORTANT: The medical standards and management guidelines contained in this chapter should be read in conjunction with the general information contained in Part A of this publication. Practitioners should give consideration to the following:
Licensing responsibility
The responsibility for issuing, renewing, suspending or cancelling a person’s driver licence (including a conditional licence) lies ultimately with the driver licensing authority. Licensing decisions are based on a full consideration of relevant factors relating to health and driving performance.
Conditional licences
For a conditional licence to be issued, the health professional must provide to the driver licensing authority details of the medical criteria not met, evidence of the medical criteria met, as well as the proposed conditions and monitoring requirements. The presence of other medical conditions While a person may meet individual disease criteria, concurrent medical conditions may combine to affect fitness to drive – for example, hearing, visual or cognitive impairment (refer to Part A section 2.2.7. Older drivers and age-related changes and section 2.2.8. Multiple medical conditions).
The nature of the driving task
The driver licensing authority will take into consideration the nature of the driving task as well as the medical condition, particularly when granting a conditional licence. For example, the licence status of a farmer requiring a commercial vehicle licence for the occasional use of a heavy vehicle may be quite different from that of an interstate multiple combination vehicle driver. The examining health professional should bear this in mind when examining a person and when providing advice to the driver licensing authority.
Reporting responsibilities
Patients should be made aware of the effects of their condition on driving and should be advised of their legal obligation to notify the driver licensing authority where driving is likely to be affected. The health professional may themselves advise the driver licensing authority as the situation requires (refer to section 3.3 and step 6).
References and further reading
- Charlton, J.L., Di Stefano, M., Dow, J., Rapoport, M.J., O’Neill, D., Odell, M., Darzins, P., & Koppel, S. Influence of chronic Illness on crash involvement of motor vehicle drivers: 3rd edition. Monash University Accident Research Centre Reports 353. Melbourne, Australia: Monash University Accident Research Centre. (2021)
- American Psychiatric Association. Position statement on the role of psychiatrists in assessing driving ability. (2016).
- Unsworth, C. A., Baker, A. M., So, M. H., Harries, P. & O’Neill, D. A systematic review of evidence for fitness-to-drive among people with the mental health conditions of schizophrenia, stress/anxiety disorder, depression, personality disorder and obsessive compulsive disorder. BMC Psychiatry 17, (2017).
- Charlton, J. L. & Monash University Accident Research Centre. Influence of chronic illness on crash involvement of motor vehicle drivers. (Monash University, Accident Research Centre, 2010).
- Parekh, V. Psychoactive drugs and driving. Australian Prescriber 42, 182–185 (2019).
- North Western Mental Health. Guidelines for mental health professionals to assist consumers with safe driving. www.vicroads. vic.gov.au (2017).
- Canadian Medical Association. CMA driver’s guide: determining medical fitness to operate motor vehicles. (Joule, 2017).
- Asadi-Pooya, A. A. & Sperling, M. R. Epidemiology of psychogenic nonepileptic seizures. Epilepsy and Behavior 46, 60–65 (2015).
- Asadi-Pooya, A. A. et al. Driving a motor vehicle and psychogenic nonepileptic seizures: ILAE Report by the Task Force on Psychogenic Nonepileptic Seizures. Epilepsia Open 5, 371–385 (2020).