Assessing fitness to drive for commercial and private vehicle drivers 2021 edition (draft for consultation purposes released 3 May, 2021) Assessing fitness to drive 2021 (draft) Contents PART A: General information .......................................................................................... 5 1. About this publication ............................................................................................... 6 Purpose ............................................................................................................ 6 Target audience ................................................................................................ 7 Scope................................................................................................................ 7 Content ............................................................................................................. 8 Development and evidence base ...................................................................... 9 2. Principles of assessing fitness to drive .................................................................. 11 The driving task ................................................................................................ 11 Medical conditions and driving ......................................................................... 13 Assessing and supporting functional driver capacity ........................................ 25 3. Roles and responsibilities ....................................................................................... 28 Roles and responsibilities of driver licensing authorities ................................... 30 Roles and responsibilities of drivers ................................................................. 31 Roles and responsibilities of health professionals ............................................ 31 4. Licensing and medical fitness to drive ................................................................... 36 Medical standards for private and commercial vehicle drivers .......................... 36 Considerations for commercial vehicle licensing .............................................. 37 Prescribed periodic medical examinations for particular licensing/authorisation classes ............................................................................................................. 39 Conditional licences ......................................................................................... 39 Reinstatement of licences or removal or variation of licence conditions ........... 43 5. Assessment and reporting process – step by step ............................................... 44 Steps in the assessment and reporting process ............................................... 45 Which forms to use .......................................................................................... 52 6. References and further reading ............................................................................... 53 PART B: Medical standards ............................................................................................ 56 1. Blackouts .................................................................................................................. 59 Relevance to the driving task ........................................................................... 59 General assessment and management guidelines ........................................... 59 Medical standards for licensing ........................................................................ 60 References and further reading ........................................................................ 63 2. Cardiovascular conditions ....................................................................................... 64 Relevance to the driving task ........................................................................... 64 General assessment and management guidelines ........................................... 64 Medical standards for licensing ........................................................................ 71 References and further reading ........................................................................ 91 3. Diabetes mellitus ...................................................................................................... 93 Relevance to the driving task ........................................................................... 93 2 Assessing fitness to drive 2021 (draft) General assessment and management guidelines ........................................... 93 Medical standards for licensing ........................................................................ 98 References and further reading ....................................................................... 102 4. Hearing loss and deafness ..................................................................................... 104 Relevance to the driving task .......................................................................... 104 General assessment and management guidelines .......................................... 105 Medical standards for licensing ....................................................................... 108 References and further reading ....................................................................... 109 5. Musculoskeletal conditions .................................................................................... 111 Relevance to the driving task .......................................................................... 111 General assessment and management guidelines .......................................... 112 Medical standards for licensing ....................................................................... 116 References and further reading ....................................................................... 117 6. Neurological conditions .......................................................................................... 118 Dementia ........................................................................................................ 119 Seizures and epilepsy ..................................................................................... 126 Other neurological and neurodevelopmental conditions .................................. 147 7. Psychiatric conditions ............................................................................................ 163 Relevance to the driving task .......................................................................... 163 General assessment and management guidelines .......................................... 165 Medical standards for licensing ....................................................................... 168 References and further reading ....................................................................... 169 8. Sleep disorders ....................................................................................................... 170 Relevance to the driving task .......................................................................... 170 General assessment and management guidelines .......................................... 170 Medical standards for licensing ....................................................................... 175 References and further reading ....................................................................... 177 9. Substance misuse ................................................................................................... 179 Relevance to the driving task .......................................................................... 179 General assessment and management guidelines .......................................... 183 Medical standards for licensing ....................................................................... 185 References and further reading ....................................................................... 188 10. Vision and eye disorders ........................................................................................ 190 Relevance to the driving task .......................................................................... 190 General assessment and management guidelines .......................................... 190 Medical standards for licensing ....................................................................... 196 References and further reading ....................................................................... 199 PART C: Appendices...................................................................................................... 201 Appendix 1: Regulatory requirements for driver testing ............................................. 202 Appendix 2: Forms ......................................................................................................... 210 Appendix 3: Legislation relating to reporting ............................................................... 214 3 Assessing fitness to drive 2021 (draft) Appendix 4: Drivers’ legal BAC limits ........................................................................... 221 Appendix 5: Alcohol interlock programs ...................................................................... 223 Appendix 6: Disabled car parking and taxi services .................................................... 227 Appendix 7: Seatbelt use ............................................................................................... 229 Appendix 8: Helmet use ................................................................................................. 231 Appendix 9: Driver licensing authority