2010 BC Guide in Determining Fitness to Drive

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ConditionType of drivingimpairment andassessmentapproachPrimaryfunctionalabilityaffectedAssessment toolsCoronary artery diseaseArrhythmiasValvular heart diseaseEpisodicimpairment:Medical assessment– likelihood ofimpairmentAll – suddenincapacitationDriver’s MedicalExamination ReportSpecialist’s reportCardiomyopathyCongestive heart failurePersistentImpairment:FunctionalassessmentCognitiveMay also resultin generaldebility or lackof staminaDriver’s MedicalExamination ReportICBC road testCognitive screening toolssuch as; MOCA, MMSE,SIMARD-MD, Trails Aor BDriveABLE assessmentEpisodicimpairment:Medical assessment– likelihood ofimpairmentAll – suddenincapacitationDriver’s MedicalExamination ReportSpecialist’s reportPost cardiac arrestPost-operative cognitivedecline (POCD)PersistentImpairment:FunctionalassessmentCognitiveDriver’s MedicalExamination ReportCognitive screening toolssuch as; MOCA, MMSE,SIMARD-MD, Trails Aor BDriveABLE assessment17.5 CompensationIndividuals with cardiovascular disease are not able to compensate for their functionalimpairment.164
GUIDELINES17.6 Policy rationaleThese guidelines are based primarily on recommendations contained in the final report of the2003 Canadian Cardiovascular Society (CCS) Consensus Conference Assessment of the CardiacPatient for Fitness to Drive and Fly. The CCS recommendations focus exclusively on thepotential episodic impairments associated with cardiovascular diseases.Additional guidelines have been added to address potential persistent cognitive impairmentcaused by congestive heart failure, and the potential for co-morbid cognitive impairment inrelation to cardiac arrest, and post-operative cognitive decline (POCD) following coronary arterybypass graft (CABG) surgery. Where guidelines have been added or changed, the rationale isincluded in the table.17.7 Private and commercial drivers with congenital heart defectsApplicationAssessment guidelinesFitness guidelinesOSMV determinationguidelinesConditionsRestrictionsRe-assessmentguidelinesPolicy rationaleThese guidelines apply to driver fitness determinations for privateand commercial drivers who have a congenital heart defect.If further information regarding an individual’s medical condition isrequired, OSMV will request: a Driver’s Medical Examination Report additional information from the treating physician, or an assessment from a cardiologist.Individuals may drive if they meet any guidelines related to a specificcardiovascular condition or event.Individuals are fit to drive.No conditions are required.No restrictions are required.If the defect has been repaired and the treating physician does notindicate any concerns, no re-assessment, other than routinecommercial or age-related re-assessment, is required. If the defecthas not been repaired, OSMV will re-assess every 5 years, unlessroutine commercial or age-related re-assessment applies.Congenital heart defects are not specifically addressed in the CCSguidelines. It is included here in recognition that a congenital heartdefect may be reported to OSMV. The nature of congenital heartdefects and their treatment is variable; therefore there are no specificfitness guidelines for them.165
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Ministry of Public Safety and Solic
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AcknowledgmentsResearcherBonnie M.
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Table of Contents (click on any ite
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11.7 Private and commercial drivers
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BACKGROUND ........................
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PART 1:BACKGROUND1
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Appendix 2: Excerpts from the MVA t
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Chapter 2: The Driver Fitness Progr
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for the exercise of discretion by O
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1. SCREENINGA driver disclosesa med
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2.3 Roles and responsibilitiesOSMV
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Medical practitionersMedical practi
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Chapter 3:Driver Fitness Program Pr
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Because of these limitations, OSMV
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Example: the temporary storage of i
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Motor functions (including sensorim
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an individual with poor contrast se
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3.5 Best informationDriver fitness
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Chapter 4: Introduction to the Poli
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3. DETERMINATIONFrom2. AssessmentAn
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Once identified, a DMER is mailed t
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5.3 Screening aging driversDefiniti
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5.5 Transient impairmentsDefinition
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Chapter 6: Assessment Policies and
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6.2 Assessments will only be reques
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6.4 Requesting specialist assessmen
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Policy6.5.1 If a case manager or ad
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Persistent and episodic impairments
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further assessment. Drivers who sco
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6.9.4 A case manager or adjudicator
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ASSESSMENT PROCEDURESCase manager o
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A driver fitness determination is a
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Policy rationaleBecause individuals
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7.5.3 Generally, an individual whos
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7.6.2 In particular, the case manag
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7.8.3 Whether an individual can com
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in order to be fit to drive, the ca
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has the judgment and willingness to
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Policy7.11.1 If a case manager or a
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(e) the medical condition results i
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7.12 Communicating a decisionPolicy
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7.13 Determination proceduresThe fo
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During the reconsideration, the adj
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8.3 Reconsideration proceduresThe f
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Chapter 9:Introduction to the Medic
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9.4 Medical condition chapter templ
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Private and commercial drivers who
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Chapter 11: Diabetes - Hypoglycemia
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PercentFigure 1 - Prevalence of Dia
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neuropathy, nephropathy, cardiovasc
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11.8 Private drivers with diabetes
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11.9 Commercial drivers with diabet
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RestrictionsRe-assessmentguidelines
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Policy rationaleSevere hypoglycemia
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11.12 Private drivers who have pers
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11.13 Commercial drivers who have a
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11.14 Commercial drivers who have a
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11.15 Commercial drivers who have p
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PART B - HYPOGLYCEMIA11a. Has the p
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Produce my glycemic log for my doct
Page 127 and 128: Deep-vein thrombosisDeep-vein throm
Page 129 and 130: Aneurysms less than 5 cm in diamete
Page 131 and 132: GUIDELINES12.6 Private and commerci
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Page 135 and 136: 12.9 Commercial drivers who have an
Page 137 and 138: Chapter 13: Musculoskeletal Conditi
Page 139 and 140: ConditionType of drivingimpairment
Page 143 and 144: ConditionsRestrictionsRe-assessment
Page 145 and 146: 14.3 Chronic renal disease and adve
Page 149 and 150: 14.8 Private drivers with end-stage
Page 151 and 152: 14.10 Private and commercial driver
Page 153 and 154: Level ofImpairmentMildlyImpairedMod
Page 157 and 158: 15.8 Commercial drivers with modera
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Page 161 and 162: Policy rationaleDrivers who require
Page 163 and 164: Chapter 16: Vestibular DisordersBAC
Page 165 and 166: One study identified that 32.5% of
Page 167 and 168: ConditionType ofdrivingimpairmentan
Page 169 and 170: Re-assessmentguidelinesPolicy ratio
Page 171 and 172: 16.8 Private and commercial drivers
Page 175 and 176: Individuals who have undergone valv
Page 177: Episodic impairmentThe potential ep
Page 181 and 182: 17.9 Commercial drivers with corona
Page 183 and 184: 17.11 Private drivers who have had
Page 187 and 188: 17.15 Private drivers who have vent
Page 191 and 192: 17.19 Private drivers who have sust
Page 193 and 194: 17.21 Commercial drivers who have s
Page 199 and 200: 17.27 Private drivers with atrioven
Page 201 and 202: 17.28 Commercial drivers with atrio
Page 203 and 204: 17.29 Private drivers with permanen
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Page 207 and 208: 17.33 Private drivers where ICD the
Page 209 and 210: 17.35 Commercial drivers who have d
Page 211 and 212: 17.37 Commercial drivers with inher
Page 213 and 214: 17.39 Commercial drivers with medic
Page 215 and 216: 17.41 Private drivers with surgical
Page 217 and 218: 17.43 Private drivers with mitral v
Page 219 and 220: 17.45 Private drivers with congesti
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Page 223 and 224: 17.47 Private drivers with left ven
Page 225 and 226: 17.49 Private drivers with a heart
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17.53 SyncopeSee the guidelines in
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Stable coronary syndromes - waiting
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Chapter 18: Hearing LossBACKGROUND1
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GUIDELINES18.6 Private drivers with
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equirement for commercial drivers i
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PLEASE COMPLETE THE FOLLOWING: YES
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this manual. Axis IV addresses exte
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Negative symptoms are characterized
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Schizophrenia (Axis I)Schizophrenia
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19.4 Effect of psychiatric disorder
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Suicidal ideationSuicidal ideation
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GUIDELINES19.6 Private and commerci
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Chapter 20: Cerebrovascular Disease
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Cerebrovascular accidentCVAs are th
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ConditionType of drivingimpairment
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Re-assessmentguidelinesPolicy ratio
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20.9 Private drivers who have had s
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20.10 Commercial drivers who have h
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Visual field impairment refers to a
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Right homonymous hemianopiaBinasal
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An example of the effects of diabet
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Retinitis pigmentosaRetinitis pigme
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GlaucomaApproximately 67 million pe
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indicates that wait times of 6 mont
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Although telescopic spectacles, hem
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Policy rationaleretinopathy dependi
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Policy rationaleIndividuals with be
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Re-assessmentguidelines cont’dPol
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Re-assessmentguidelines cont’dPol
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21.13 Commercial drivers with a los
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21.15 Private and commercial driver
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21.17 Visual field impairmentsTypes
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21.18 Examination of visual functio
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VISUAL FIELD TEST (VFT)For drivers
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To the Driver:Under section 29 of t
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Please note:Goldman, Esterman and H
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Cardiac syncopeCardiac syncope refe
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22.7 Private drivers who have had a
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22.9 Private drivers with recurrent
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22.11 Commercial drivers who have h
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22.13 Commercial drivers with recur
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Chapter 23: Seizures and EpilepsyBA
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abnormal numbnesstingling and a cra
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23.10 Private drivers with single u
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23.12 Private drivers with epilepsy
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23.18 Commercial drivers with epile
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Level of disabilityor worsening of
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Parkinson’s diseaseThere is a sma
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ConditionsRestrictionsRe-assessment
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25.2 Prevalence and incidence of tr
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Chapter 26: Intracranial TumoursBAC
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Some examples of compensatory mecha
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i. aphasia (language disturbance)ii
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27.2 Prevalence and incidence of co
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27.4 Effect of cognitive impairment
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Chapter 28: Sleep DisordersBACKGROU
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An immediate reduction in daytime s
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28.5 CompensationIndividuals with s
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OSMV determinationguidelines cont
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ConditionsRestrictionsRe-assessment
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Policy rationaleThe general approac
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Chapter 29: Prescription and Over-T
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Examples of newer antihistamines in
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Stimulants (for ADHD)Examples of st
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AntiepilepticsIn general, individua
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Sedating EffectLowModerateHighTCAsd
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dizziness, andblurred or double vis
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30.2 Effect of general debility and
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Appendix 1: Glossary of TermsCommer
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Medical assessmentis any kind of as
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Transient impairmentmeans a tempora
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must cause to be issued to the appl
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(ii) cancel the person's driver's l
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Appendix 3: Aging DriversAbout agin
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Percentadults. The survey also foun
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Appendix 4: Licence ClassesThe tabl
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Appendix 5: Drafting and Approval P
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drivers, this means that BC commerc
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2010 BC Guide in Determining Fitness to Drive

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