Initial licensing procedures vary substantially in the United States. Renewal procedures, however, are not as varied. Applicants' driving records are checked to ensure there are no suspensions or revocations and, if not, upon payment of renewal fees new licenses are issued.
Most states require renewal applicants to appear in person and to pass a vision test.
The significant differences are the length of time between renewals, ranging from 2 to 8 years, and the existence of provisions in 20 states and the District of Columbia designed to guarantee that older adults continue to meet license requirements. These special renewal procedures for older drivers apply in addition to the license renewal procedures that exist in all states for dealing with licensed drivers of any age who no longer meet the standards for licensure because of physical or mental infirmities. States typically have medical review boards composed of health care professionals who advise on licensing standards and on individual cases in which a person's ability to drive safely is in doubt. After reviewing a person's fitness to drive, the licensing agency may allow the person to retain the license, refuse to renew the license, or suspend, revoke, or restrict the license. Typical restrictions prohibit nighttime driving, require the vehicle to have additional mirrors, or restrict driving to specified places or a limited radius from the driver's home.