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
Menieres 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
Parkinsons 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 nights sleep, so reducing daytime sleepiness and
improving concentration.
Other sleep related conditions
Illnesses of the nervous system, such as Parkinsons 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
Parkinsons 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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