Medical Examination Info

Medical Assessment 1. Neurological disorders Epilepsy or liability to epileptic attacks If you have been diagnosed as having epilepsy, (this includes all events: major, minor and auras), you will need to remain free of seizures without taking anti-epilepsy medication for 10 years. If you have a condition that causes an increased liability to seizures, for example a serious head injury, the risk of you having a seizure must have fallen to no greater than 2% per annum prior to application. If you have had only an isolated seizure, you may be entitled to drive lorries and buses 5 years from the date of the seizure, provided that you are able to satisfy the following criteria: • no relevant structural abnormality has been found in the brain on imaging • no definite epileptic activity has been found on EEG (record of the brain waves)7 • you have not been prescribed medication to treat the seizure for at least 5 years since the seizure • you have the support of your neurologist • your risk of a further seizure is considered to be 2% or less per annum (each year). DVLA must refuse an application or revoke the licence if you cannot meet these conditions. You are strongly advised to discuss your eligibility to apply for your driving licence with your doctor before getting a D4 report filled in. See following conditions: • a stroke or transient ischemic attack (TIA) within the last 12 months • unexplained loss of consciousness with liability to recurrence • Meniere’s disease, or any other sudden and disabling dizziness or vertigo within the past year, with a liability to recurrence • major brain surgery or recent severe head injury with serious continuing after-effects or a likelihood of causing seizures • Parkinson’s disease, multiple sclerosis or other chronic neurological disorders with symptoms likely to affect safe driving. DVLA must refuse an application or revoke the licence if you cannot meet these conditions. 2. Diabetes mellitus Insulin treated diabetes If you have insulin-treated diabetes you may apply for a Group 2 licence as long as you can meet the strict criteria for controlling and monitoring diabetes. This includes: • having at least 3 continuous months of blood glucose (sugar) readings available for inspection on a blood glucose meter(s) with a memory function • drivers must undertake blood glucose monitoring at least twice daily (even on days when not driving) and at times relevant to driving (no more than 2 hours before the start of the first journey and every 2 hours while driving). If you are able to meet all the criteria (see leaflet INS186) you will be required to undertake an annual assessment by a hospital consultant specialising in the treatment of diabetes. This will be arranged by DVLA. Leaflet INS186 (A guide for drivers with diabetes who wish to apply for vocational entitlement) is available to download from www.gov.uk/diabetes-driving8 Sulphonylurea or glinide treated diabetes If you have diabetes treated with a sulphonylurea or glinide for example Gliclazide, you must undertake blood glucose (sugar) monitoring at least twice daily and at times relevant to driving (no more than 2 hours before the start of the first journey and every 2 hours while driving). 3. Cardiac Other medical conditions An applicant or existing licence holder is likely to be refused a Group 2 licence if they cannot meet the recommended medical guidelines for any of the following: • within 3 months of a coronary artery bypass graft (CABG) • angina, heart failure or cardiac arrhythmia which remains uncontrolled • implanted cardiac defibrillator • hypertension where the resting blood pressure is consistently 180 mm/Hg systolic or more or 100 mm/Hg diastolic or more. 4. Psychiatric illness An applicant or existing licence holder is likely to be refused a Group 2 licence if they cannot meet the recommended medical guidelines for any of the following: • psychotic illness in the past 12 months • serious psychiatric illness • if major psychotropic or neuroleptic medication is being taken • dementia • cognitive impairment likely to affect safe driving 5. Substance misuse An applicant or existing licence holder is likely to be refused a Group 2 licence if they cannot meet the recommended medical guidelines for the following: • Alcohol or drug misuse in the past 1 year or alcohol or drug dependance in the past 3 years. 6. Sleep disorders Facts you should know about excessive sleepiness or tiredness and driving There is no excuse for falling asleep at the wheel and it is not an excuse in law. • Up to one fifth of accidents on motorways and other monotonous types of roads may be caused by drivers falling asleep at the wheel. • 18 to 30 year old males are more likely to fall asleep at the wheel when driving late at night.9 • Modern life styles such as early morning starts, shift work, late and night socialising, often lead to excessive tiredness by interfering with adequate rest. • Drivers who fall asleep at the wheel usually have a degree of warning. • Natural sleepiness or tiredness occurs after eating a large meal. • Changes in body rhythm produce a natural increased tendency to sleep at two parts of the day: Midnight to 6am and 2pm to 4pm. • Although no one should drink and drive at any time, alcohol consumed in the afternoon may be twice as potent in terms of producing sleepiness and driving impairment as the same amount taken in the evening. • Prescribed or over-the-counter medication can cause sleepiness as a side effect, always check the label if you intend to drive. Medical conditions causing sleepiness All drivers are subject to the pressures of modern life, but many drivers are unaware that some medical conditions also cause excessive sleepiness or tiredness. These, alone or in combination with the factors mentioned previously, may be sufficient to make driving unsafe. A road traffic accident may be the first clear indication of such a sleep disorder. If you know you have uncontrolled sleepiness you MUST not drive. Obstructive Sleep Apnoea (OSA) and Obstructive Sleep Apnoea Syndrome (OSAS) OSAS is a condition which often goes undiagnosed. If it is not fully assessed and treated, this can cause sleepiness and other symptoms which can be a serious risk factor in road traffic accidents. For further details about how to recognise symptoms go to www.gov.uk/obstructive-sleep-apnoea-and-driving You must tell us immediately if you are diagnosed with OSAS. • OSAS is the most common sleep-related medical disorder. • OSAS increases the chances of a vehicle crash by about five times. • OSAS occurs most commonly, but not exclusively, in overweight individuals. • Partners often complain about snoring and notice that the sufferers have breathing pauses during sleep. • OSAS sufferers rarely wake from sleep feeling fully refreshed and tend to fall asleep easily when relaxing. • Long distance lorry and bus drivers affected by OSAS are of great concern as most will be driving on motorway type of roads and the size or nature of the vehicle gives little room for error. • Sleep apnoea affects on average about 25% of men and 10% of women. 10 • OSAS affects on average 4% of men and 2% of women. • Sleep problems arise more commonly in older people. • Lifestyle changes, for example weight loss or cutting back on alcohol, will help ease the symptoms of OSA. • The most widely effective treatment for OSAS is Continuous Positive Airway Pressure (CPAP), this requires the patient to wear a soft face mask during sleep to regulate breathing. This treatment enables patients to have a good night’s sleep, so reducing daytime sleepiness and improving concentration. Other sleep related conditions Illnesses of the nervous system, such as Parkinson’s disease, multiple sclerosis (MS), motor neurone disease (MND) and narcolepsy may also cause excessive sleepiness or fatigue although sometimes these illnesses alone may cause drivers to be unfit for driving. Tiredness or excessive sleepiness can be a non-specific symptom of Parkinson’s disease, MS, MND or may also be related to prescribed medication. Narcolepsy also causes daytime sleepiness and tiredness as well as other symptoms that may be disabling for drivers. 7. Other medical conditions An applicant or existing licence holder is likely to be refused a Group 2 licence if they cannot meet the recommended medical guidelines for any of the following: • any malignant condition in the last 2 years, with a significant liability to metastasise (spread) to the brain • any other serious medical condition likely to affect the safe driving of a Group 2 vehicle • cancer of the lung.   Vision assessment Visual acuity All drivers must be able to read in good light with glasses or contact lenses if worn, a car number plate from 20 metres (post 01.09.2001 font) and have eyesight (visual acuity) of 6/12 (decimal Snellen equivalent 0.5) or better. Applicants for Group 2 entitlements must also have, as measured by the 6 metre Snellen chart: • a visual acuity of at least 6/7.5 (decimal Snellen equivalent 0.8) in the better eye • a visual acuity of at least 6/60 (decimal Snellen equivalent 0.1) in the worse eye. This may be achieved with or without glasses or contact lenses. If glasses (not contact lenses) are worn for driving, the spectacle prescription of either lens used must not be of a corrective power greater than plus 8 (+8) dioptres in any meridian. If you cannot meet the above standard we may still be able to issue a Group 2 licence if: Group 2 licence held on 31 December 1996 • have a corrected visual acuity of at least 6/9 (decimal Snellen equivalent 0.6) in the better eye and 6/12 (decimal Snellen equivalent 0.5) in the worse eye, and • an uncorrected visual acuity of 3/60 (decimal Snellen equivalent 0.05) in at least one eye Group 2 licence held on 1 March 1992 • you have a corrected visual acuity of at least 6/12 (decimal Snellen equivalent 0.5) using both eyes together • have an uncorrected visual acuity of at least 3/60 (decimal Snellen equivalent 0.05) in at least one eye • you will also need to complete a certificate about your recent Group 2 driving experience, DVLA will send this certificate for you to fill in once they get a valid application. You will not be able to apply for any new lorry or bus entitlements that you have not previously held. Car driving licence holders who are renewing category C1 (small or medium lorries between 3500 – 7500kg) need to: • meet the number plate test, and • have eyesight (visual acuity) of 6/12 (decimal Snellen equivalent 0.5) or better. Car driving licence holders who are renewing category D1 (minibuses not for hire or reward) must meet the eyesight standard for Group 2 drivers.6 Monocular vision Drivers who have sight in one eye only or their sight in one eye has deteriorated to a corrected acuity of less than 3/60 (decimal Snellen equivalent 0.05) cannot normally be licensed to drive Group 2 vehicles. The exceptions are: 1. You were licensed to drive Group 2 vehicles before 1 April 1991 and the Traffic Commissioner who issued the licence knew that you had sight in only one eye before 1 January 1991, you must have: • a visual acuity of at least 6/12 (decimal Snellen equivalent 0.5) if you held a Group 2 licence on 1 April 1983 • 6/9 (decimal Snellen equivalent 0.6) if you were licensed after that date DVLA will send you a certificate of experience for you to fill in once they get a valid application. You cannot apply for new vehicle category entitlements only those you had previously held. 2. You are applying to renew entitlement to drive category C1 (vehicles between 3500kg and 7500kg) that was granted with your Group 1 (car and motorcycle) licence if you had passed a car driving test before 1 January 1997. Uncontrolled symptoms of double vision If you have uncontrolled symptoms of double vision, or you have double vision treated with a patch, you will not be allowed to hold a Group 2 licence. Visual field • The horizontal visual field should be at least 160 degrees. • The extension should be at least 70 degrees left and right and 30 degrees up and down • No defect should be present within a radius of the central 30 degrees.

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