2010 BC Guide in Determining Fitness to Drive

Persistent and episodic impairmentsWhether or not a functional assessment is appropriate depends upon thetype of impairment. Because persistent impairments are measurable,testable and observable, it is possible to assess an individual’s functionalability to drive through observation by a physician or other health carepractitioner or an OT or driver rehabilitation specialist. Because episodicimpairments are not measurable or testable, OSMV cannot functionallyassess how the impairment impacts an individual’s ability to drive.Multiple functional impairmentsSome individuals may have impairments to more than one of the functionsnecessary for driving. In this situation, a case manager or adjudicatorprioritizes requests for functional assessments based on the functions thatmay be impaired. Because there are assessment tools available tospecifically measure cognitive impairment as it relates to driving, if anindividual’s cognitive function may be impaired a case manager oradjudicator will assess that function first. Sensory functions are assessednext, followed by motor functions. If an assessment indicates that afunction is impaired, a driver is not fit to drive and there is no need tocontinue with further assessments of the other functions that may beimpaired.Multiple medical conditionsThe impact of multiple medical conditions on functional ability to drive isvery important when making determinations about fitness to drive.Research results indicate that drivers with multiple medical conditions are,in general, at higher risk for crashes and at-fault crashes than those with asingle medical condition.The medical condition chapters in Part 3 of this Manual each focus on asingle medical condition, e.g. cardiovascular disease, and the guidelinesare written as if an individual only had one medical condition. This isbecause the number of combinations of illnesses and medications issimply too large to make reliable and valid driving guidelines that couldsupport making decisions about driving fitness for specific individuals.This means that the medical condition guidelines cannot always be reliedupon in order to make a driver fitness determination for an individual withmore than one medical condition. While the guidelines for each individualmedical condition may indicate that the driver is fit to drive, if the medicalconditions have a cumulative effect on the functional ability to drive, theindividual may, in fact, not be fit. Therefore, OSMV always requestsfunctional assessments of individuals with multiple medical conditions45