Profile Levels Degree of Impairment2/ Potential for At Risk Driving Condition Definition / Example Interval for Review and Other Actions 1. No diagnosed condition No known disorder N/A 2. Condition fully recovered Any pulmonary condition, recovered or cured; or Minimal, reversible, episodic, controlled pulmonary condition. N/A 3. Active impairment Pulmonary disease a. Mild Gold A-B, mild dyspnea; or Gold C-D, maintains O2 sat 89% or greater on room air. Moderate dyspnea, no hypoxia less than 89%; or Restrictive or other pulmonary disease of mild severity, maintains O2 sat 89% or greater on room air. 4 years b. Moderate Gold C-D, moderate dyspnea. O2 sat 88% or less, or PO2 55 or less on room air, but able to maintain O2 sat 89% or greater on oxygen supplementation; or Restrictive or other pulmonary disease of moderate severity, O2 sat 88% or less on room air but able to maintain O2 sat 89% or greater on oxygen supplementation; or Exercise or sleep induced O2 sat 88% or less. 2 year If O2 sat less than 88% (on room air) while at rest or driving must use O2 while driving. Note: Those with only sleep or exercise induced hypoxia are not required to use O2 while driving. c. Severe Gold D, hypoxia cannot be controlled to maintain O2 sat 89% or greater, or PO2 56 or greater; or severe restrictive or other pulmonary disease, cannot maintain O2 sat 89% or greater; or new condition under investigation, unable to maintain O2 sat 89% or greater on room air. No driving 1 For further discussion regarding PULMONARY DISORDER, please refer to NARRATIVE found at beginning of this section. 2 For further explanation of degree of impairment, please refer to SECTION 3. DEMENTIA
Driving 1. No diagnosed condition No known disorder N/A 2. Condition fully recovered Condition which caused hypoglycemic episode is fully recovered; or No hypoglycemic episodes within past 3 years and/or low risk for recurrence. N/A 3. Active impairment a. Mild Single episode of hypoglycemia within the past 12 months readily explained by one-time event that is not likely to recur (e.g. accidental overdose of insulin); or History of hypoglycemic episodes, more than 12 months ago, and condition is stable. 3 years b. Moderate One or more hypoglycemic episodes requiring third party assistance 3-12 months ago and condition is stable. Clinician should indicate if person has hypoglycemic unawareness. 1 year Note: Review drivers with hypoglycemic unawareness every 3 months until profile level 3a. c. Severe One or more hypoglycemic episodes requiring third party assistance, with or without hypoglycemic unawareness, within the past 3 months. No driving 1 For further discussion regarding HYPOGLYCEMIA, please refer to NARRATIVE found at beginning of this section. 2 For further explanation of degree of impairment, please refer to SECTION 3. MENTAL DISORDERS There is no certain way of predicting which persons with mental disorders (the American Psychiatric Association’s preferred term for psychiatric illness) will have accidents, but many high risk drivers are such because of symptoms from psychiatric conditions. In a review of medical literature spanning 1960-2000, the National Highway Traffic Safety Administration noted that people with schizophrenia, personality disorders and chronic alcohol abuse are at highest risk for unsafe driving.A (Refer to Substance Use Disorders FAP for guidelines)
a. Mild Chronic condition that does not pose risk for safe driving and does not require use of assistive medical equipment or nonstandard accessory driving devices; or Clinician documents stable condition that is unlikely to deteriorate and driver has already passed road test. N/A b. Moderate Chronic condition, which may impair ability to drive safely and/or requires personal assistive medical equipment (such as prosthesis, orthosis, or any type of nonstandard accessory driving device such as hand/foot controls). 4 years4 ROAD TEST c. Severe Chronic condition, which causes impairments that interfere with the ability to drive safely despite use of personal assistive medical equipment, or any nonstandard accessory driving devices. No driving 1 For further discussion regarding MISCELLANEOUS MUSCULOSKELETAL AND NEUROLOGICAL DISORDERS, please refer to NARRATIVE found at beginning of this section. 2 For further explanation of degree of impairment, please refer to SECTION 3. 3 Persons who have an implanted spinal cord/dorsal column stimulator are advised turn off the device prior to driving due to the potential for unexpected changes in stimulation with activity that could possibly be unsafe. 4 Interval for review may be more frequent if recommended by clinician. FUNCTIONAL ABILITY PROFILE Multiple Sclerosis1 Profile Levels Degree of Impairment2/ Potential for At Risk Driving Condition Definition / Example Interval for Review and Other Actions 1. No diagnosed condition No known disorder N/A 2. Condition fully recovered There is no recovery from multiple sclerosis N/A
FOR REFERENCES, SEE BIBLIOGRAPHY AT END OF DOCUMENT. FUNCTIONAL ABILITY PROFILE Unexplained Alteration of Consciousness (AOC)1 Profile Levels Degree of Impairment2/ Potential for At Risk Driving Condition Definition / Example Interval for Review and Other Actions 1. No diagnosed condition No known disorder N/A 2. Condition fully recovered History of unexplained AOC but none in 4 years N/A 3. Active impairment a. Mild History of AOC greater than 1 year ago. 2 years b. Moderate History of any unexplained AOC within 6 months – 1 year ago. 1 year c. Severe Any unexplained AOC within the past 6 months No driving 1 For further discussion regarding UNEXPLAINED ALTERATION OF CONSCIOUSNESS, please refer to NARRATIVE found at beginning of this section. 2 For further explanation of degree of impairment, please refer to SECTION 3. VISUAL DISORDERS
Visual Disorders1: Double Vision Profile Levels Degree of Impairment2/ Potential for At Risk Driving Condition Definition / Example Interval for Review and Other Actions 1. No diagnosed condition Never sees double. N/A 2. Condition fully recovered History of diplopia that has recovered or eyes crossed but no diplopia without patch. N/A 3. Active impairment If diplopia is due to a head injury or stroke, also require an evaluation using that profile. a. Mild Intermittent diplopia or constant double vision correctable by patching one eye. 4 years b. Moderate Monocular diplopia in the only eye meeting visual acuity requirements, with potential for correction. No driving c. Severe Monocular diplopia in the only eye meeting visual acuity requirements, without potential for correction. No driving 1 For further discussion regarding VISUAL DISORDERS, please refer to NARRATIVE found at beginning of this section. 2 For further explanation of degree of impairment, please refer to SECTION 3.