2010 BC Guide in Determining Fitness to Drive

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28.7 Private and commercial drivers with treated OSAApplicationAssessment guidelinesFitness guidelinesOSMV determinationguidelinesThese guidelines apply to driver fitness determinations for private andcommercial drivers who have obstructive sleep apnea (OSA) that has beentreated or surgically treated.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 a sleep study report, or an assessment from a respirologist.If cognitive screening indicates that the cognitive functions necessary fordriving are impaired, OSMV will not request further assessments.If the treating physician, or cognitive screening, indicates possible persistentimpairment of the cognitive functions necessary for driving, OSMV willrequest a DriveABLE assessment, unless there has been no significantchange in the individual’s condition or cognitive ability since a previousfunctional assessment.Individuals may drive if: the effectiveness of their treatment has been established through repeatsleep monitoring where applicable, they remain compliant with their treatment regime.For CPAP treatment, compliance means a minimum of 4 hours of useon at least 70% of nights, objectively documented. the results of a cognitive screening test such as MOCA, MMSE,SIMARD-MD, Trails A or Trails B indicate that they have sufficientcognitive function to drive, or where required, a DriveABLEassessment indicates that they are fit to drive they understand the nature of their condition and the potential impact onfitness to drive, and they agree to report any episodes of sleep at the wheel to their treatingphysician and OSMV.OSMV may find individuals fit to drive if: the effectiveness of their treatment has been established through repeatsleep monitoring where applicable, they remain compliant with their treatment regime.For CPAP treatment, compliance means a minimum of 4 hours of useon at least 70% of nights, objectively documented. the results of a cognitive screening test such as MOCA, MMSE,SIMARD-MD, Trails A or Trails B indicate that they have sufficientcognitive function to drive, or where required, a DriveABLEassessment indicates that they are fit to drive they understand the nature of their condition and the potential impact onfitness to drive, and they agree to report any episodes of sleep at the wheel to their treatingphysician and OSMV.348
ConditionsRestrictionsRe-assessmentguidelinesPolicy rationaleOSMV will impose the following conditions on an individual who is foundfit to drive: you must cease driving and report to OSMV and your physician if youhave an episode of sleep at the wheel, and you must routinely follow your treatment regime and physician’s adviceregarding prevention of sleep at the wheel.No restrictions are required.OSMV will re-assess private drivers every two years or as recommended bythe treating physician.OSMV will re-assess commercial drivers annually.The fitness guidelines for drivers with treated OSAHS focus on mitigatingthe risk by ensuring that treatment is effective and drivers are compliantwith their treatment where applicable.349
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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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17.31 Private drivers who have decl
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17.33 Private drivers where ICD the
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17.35 Commercial drivers who have d
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17.37 Commercial drivers with inher
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17.39 Commercial drivers with medic
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17.41 Private drivers with surgical
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17.43 Private drivers with mitral v
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17.45 Private drivers with congesti
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17.46 Commercial drivers with conge
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17.47 Private drivers with left ven
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17.49 Private drivers with a heart
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17.51 Private drivers with hypertro
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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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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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21.17 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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Page 315 and 316: abnormal numbnesstingling and a cra
Page 317 and 318: ConditionType of drivingimpairment
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Page 323 and 324: 23.12 Private drivers with epilepsy
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Page 331 and 332: Level of disabilityor worsening of
Page 333 and 334: Parkinson’s diseaseThere is a sma
Page 335 and 336: ConditionType of drivingimpairment
Page 337 and 338: ConditionsRestrictionsRe-assessment
Page 339 and 340: 25.2 Prevalence and incidence of tr
Page 341 and 342: GUIDELINES25.6 Private and commerci
Page 343 and 344: Chapter 26: Intracranial TumoursBAC
Page 345 and 346: Some examples of compensatory mecha
Page 347 and 348: Re-assessmentguidelinesPolicy ratio
Page 349 and 350: i. aphasia (language disturbance)ii
Page 351 and 352: 27.2 Prevalence and incidence of co
Page 353 and 354: 27.4 Effect of cognitive impairment
Page 355 and 356: Chapter 28: Sleep DisordersBACKGROU
Page 357 and 358: An immediate reduction in daytime s
Page 359 and 360: 28.5 CompensationIndividuals with s
Page 361: OSMV determinationguidelines cont
Page 365 and 366: Policy rationaleThe general approac
Page 367 and 368: Chapter 29: Prescription and Over-T
Page 369 and 370: Examples of newer antihistamines in
Page 371 and 372: Stimulants (for ADHD)Examples of st
Page 373 and 374: AntiepilepticsIn general, individua
Page 375 and 376: Sedating EffectLowModerateHighTCAsd
Page 377 and 378: dizziness, andblurred or double vis
Page 379 and 380: Re-assessmentguidelinesPolicy ratio
Page 381 and 382: 30.2 Effect of general debility and
Page 383 and 384: 30.5 Private and commercial drivers
Page 385 and 386: Appendix 1: Glossary of TermsCommer
Page 387 and 388: Medical assessmentis any kind of as
Page 389 and 390: Transient impairmentmeans a tempora
Page 391 and 392: must cause to be issued to the appl
Page 393 and 394: (ii) cancel the person's driver's l
Page 395 and 396: Appendix 3: Aging DriversAbout agin
Page 397 and 398: Percentadults. The survey also foun
Page 399 and 400: Appendix 4: Licence ClassesThe tabl
Page 401 and 402: Appendix 5: Drafting and Approval P
Page 403: drivers, this means that BC commerc
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2010 BC Guide in Determining Fitness to Drive

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