2010 BC Guide in Determining Fitness to Drive

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20.4 Effect of cerebrovascular disease on functional ability to driveTransient ischemic attackThe primary concern for licensing is the potential for a subsequent CVA. The greatest risk iswithin the 3 months following the TIA.Cerebrovascular accidentThe primary concern for licensing is the potential for a persistent impairment of functionalability following a CVA. Depending on what part of the brain is affected, cognitive, motor orsensory functions may be impaired.Cerebral aneurysmThe primary concern for licensing is the risk of an episodic impairment caused by rupture of theaneurysm. Generally, this risk is not considered significant for licensing purposes unless theaneurysm is symptomatic or has been identified as requiring surgical interventionA large or leaking cerebral aneurysm could result in a persistent impairment of cognitive, motoror sensory functions depending on its size and location.ConditionType of drivingimpairment andassessmentapproachPrimaryfunctionalabilityaffectedAssessment toolsTransient ischemic attack(TIA)Episodicimpairment (riskfor stroke):Medical assessment– likelihood ofimpairmentVariable –suddencognitive,motor orsensoryimpairmentDriver’s MedicalExamination ReportSpecialist’s report242
ConditionType of drivingimpairment andassessmentapproachPrimaryfunctionalabilityaffectedAssessment toolsCerebrovascular accident(CVA)Persistentimpairment:FunctionalassessmentVariable –cognitive,motor orsensoryDriver’s MedicalExamination ReportSpecialist’s reportCognitive screening toolssuch as; MOCA, MMSE,SIMARD-MD, Trails A orBICBC road testDriveABLE assessmentFunctional assessment byan occupational therapist ordriver rehabilitationspecialistCerebral aneurysmEpisodicimpairment (risk ofrupture): Medicalassessment –likelihood ofimpairmentAll – suddenimpairmentDriver’s MedicalExamination ReportSpecialist’s reportPersistentimpairment (wheresymptomatic):FunctionalassessmentVariable –cognitive,motor orsensoryDriver’s MedicalExamination ReportSpecialist’s reportCognitive screening toolssuch as; MOCA, MMSE,SIMARD-MD, Trails A orBICBC road testDriveABLE assessmentFunctional assessment byan occupational therapist ordriver rehabilitationspecialist243
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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
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Deep-vein thrombosisDeep-vein throm
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Aneurysms less than 5 cm in diamete
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GUIDELINES12.6 Private and commerci
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12.7 Private drivers who have an an
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12.9 Commercial drivers who have an
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Chapter 13: Musculoskeletal Conditi
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ConditionType of drivingimpairment
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ConditionsRestrictionsRe-assessment
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14.3 Chronic renal disease and adve
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14.8 Private drivers with end-stage
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14.10 Private and commercial driver
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Level ofImpairmentMildlyImpairedMod
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15.8 Commercial drivers with modera
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15.10 Commercial drivers with sever
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Policy rationaleDrivers who require
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Chapter 16: Vestibular DisordersBAC
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One study identified that 32.5% of
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ConditionType ofdrivingimpairmentan
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Re-assessmentguidelinesPolicy ratio
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Individuals who have undergone valv
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Episodic impairmentThe potential ep
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GUIDELINES17.6 Policy rationaleThes
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17.9 Commercial drivers with corona
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17.11 Private drivers who have had
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17.15 Private drivers who have vent
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17.19 Private drivers who have sust
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17.21 Commercial drivers who have s
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17.27 Private drivers with atrioven
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17.28 Commercial drivers with atrio
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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
Page 227 and 228: 17.51 Private drivers with hypertro
Page 229 and 230: 17.53 SyncopeSee the guidelines in
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Page 233 and 234: Chapter 18: Hearing LossBACKGROUND1
Page 235 and 236: GUIDELINES18.6 Private drivers with
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Page 239 and 240: PLEASE COMPLETE THE FOLLOWING: YES
Page 241 and 242: this manual. Axis IV addresses exte
Page 243 and 244: Negative symptoms are characterized
Page 245 and 246: Schizophrenia (Axis I)Schizophrenia
Page 247 and 248: 19.4 Effect of psychiatric disorder
Page 249 and 250: Suicidal ideationSuicidal ideation
Page 251 and 252: GUIDELINES19.6 Private and commerci
Page 253 and 254: Chapter 20: Cerebrovascular Disease
Page 255: Cerebrovascular accidentCVAs are th
Page 259 and 260: GUIDELINES20.6 Private and commerci
Page 261 and 262: Re-assessmentguidelinesPolicy ratio
Page 263 and 264: 20.9 Private drivers who have had s
Page 265 and 266: 20.10 Commercial drivers who have h
Page 267 and 268: Visual field impairment refers to a
Page 269 and 270: Right homonymous hemianopiaBinasal
Page 271 and 272: An example of the effects of diabet
Page 273 and 274: Retinitis pigmentosaRetinitis pigme
Page 275 and 276: GlaucomaApproximately 67 million pe
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Page 281 and 282: Policy rationaleretinopathy dependi
Page 283 and 284: Policy rationaleIndividuals with be
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Page 289 and 290: 21.13 Commercial drivers with a los
Page 291 and 292: 21.15 Private and commercial driver
Page 293 and 294: 21.17 Visual field impairmentsTypes
Page 295 and 296: 21.18 Examination of visual functio
Page 297 and 298: VISUAL FIELD TEST (VFT)For drivers
Page 299 and 300: To the Driver:Under section 29 of t
Page 301 and 302: Please note:Goldman, Esterman and H
Page 303 and 304: Cardiac syncopeCardiac syncope refe
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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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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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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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