What Do the Various U.S. States Say About Driving With Cognitive Impairment or Dementia?

As readers of this blog may know, my dad, Jim, suffered from Alzheimer’s Disease for around a decade, before he passed in 2016. (Read Jim’s story HERE.) Because his cognitive decline was progressive, he was not immediately unable to drive safely. However, as his impairments worsened, his driver’s license became a huge source of conflict and worry. In my family’s case, Jim’s doctor – at my written suggestion – ultimately initiated the chain of events that ended with my dad’s driver’s-license revocation. But for those who might find themselves (or, more likely, a loved one) in a similar situation, this guide is designed to provide a state-specific roadmap (so to speak) for the review process.

It’s apparent that the ability to drive is a pillar of personal autonomy in our culture. That said, unsafe drivers pose risks for themselves as well for everyone else on the road. Therefore, this is a pressing issue. And as the elderly population increases, it becomes more pressing yearly.

As important as the issue is, however, it is also not a little confusing. Every U.S. state has different agencies and procedures for addressing issues related to the licensing of drivers with Mild Cognitive Impairment (MCI) and Alzheimer’s Disease (AD). In many areas, it seems that the default position is to permit a person to drive unless or until her or she is demonstrably unsafe. This is just a very general statement, though. For your state’s specifics, see below.

As your read, however, keep in mind the words of attorney Brandy Duncan. “In considering these answers, please remember that each [potentially impaired] driver …must be evaluated …individual[ly] …[in order to determine] …how …[his or her] impairment effects them specifically.  So, [the] answers below are [merely] general answers.  Additionally, …answers below …[pertain mainly to] …people that drive cars …, not [to] CDL [commercial driver’s-license] holders (people that drive commercial motor vehicles, such as a tractor trailers).”[1]

No website can give you individualized legal advice. This site is no different. I am incompetent to provide advice about how the law may affect, or be modulated by, your or your loved one’s situation. For personalized advice, consult an attorney who practices in a relevant field in your state/municipality.

Finally, as one Pennsylvania government representative enjoins: “This is something you may also want to discuss with your …[loved one’s] doctor.”[2] Just as I am not a lawyer, neither am I a doctor. Tackling the issues raised by Alzheimer’s Disease will certainly require input from medical professionals, such as nurse-practitioners, physicians, and physicians’ assistants. Find doctors that you trust.

In summary: Information herein may help you better understand the legal and medical requirements. But it is not a substitute for professional guidance.

(For my write up of some safety measures you can use to prevent your loved one from accessing or operating a motor vehicle, see my article, HERE.)

ALZHEIMERSPROOF’s State-Specific Law Guide to Driving With Alzheimer’s Dementia

A few preliminary remarks are necessary.

First, this resource is presented for informational purposes only. It is intended as a guide or a map, helping you to better understand the lay of the land. It is not intended, nor should it be construed, as providing you with legal, medical, or any other sort of case-specific advice.

Second, while I have made a good-faith effort to ensure that the information contained within this resource is as accurate and complete as is feasible for me to make it, I make no guarantees about accuracy or completeness. Simply put, this is just the resource guide that I wish I had had when I was struggling with having to take my dad’s license. It’s for reference only; it’s not a replacement for professional advice that has been tailored to your family’s situation.

Third, while this guide is geared toward sketching various state laws, regulations, and rules, it is worth noting that, at the level of federal law, the National Highway Traffic Safety Administration has published recommendations on periodically re-testing dementia-afflicted drivers.[3] In some cases, these tests are supposed to be administered semiannually or even quarterly – mainly because Alzheimer’s is a progressive condition that can cause abrupt changes (usually for the worse) in driving competency. (For more on Alzheimer’s testing, see my article, HERE.)[4]

Fourth, before you read your state’s specific entry (found below), you might want to familiarize yourself with the general overview on legalities that I posted previously. It can be found under the title “Is It Legal to Drive With Alzheimer’s Disease?” That article contains information that may serve as a framework upon which to hang some of the state-specific details found further on. For instance, I summarize the licensing and medical-review processes that pertains to many, but not all, U.S. States.

What Does Alabama State Law Say About Driving With Alzheimer’s?

“The procedure at the Driver License Office is that the examiner will ask the applicant medical questions and if the answer is yes to any of those questions, the examiner will send a form to the Medical Unit to review and possibly mail medical forms to be completed by a physician.  When the forms are completed by the physician and faxed back to the Medical Unit they will be reviewed.  The physician may ask us to retest or could say the applicant does not need to be driving which in turn we would suspend the driver license or privilege.

“If the physician states that the applicant has a neurological diagnosis and marks yes that they can drive then we will send forms yearly to make sure there are no changes in the applicant’s ability to drive.  This is set forth in the Alabama Law Enforcement’s Administrative Code Chapter 760-X-20.

“Alabama does not have a benchmark where Alzheimer patients have to surrender their license, we rely on the physician to determine if the applicant should drive or not.”[5] Generally, licenses have to be renewed in person every four (4) years.

Alabama Law Enforcement Agency
(Formerly the Department of Public Safety)
Driver License Division
P.O. Box 1471
Montgomery, AL 36102
Email Link
(334) 353-1470 [Main]; (334) 242-4239 [Medical Unit][6]

What Does Alaska State Law Say About Driving With Alzheimer’s?

In “Alaska[,] state law allows [the] DMV [department of motor vehicles] to conduct a reexamination of …[a person’s] driving ability if the DMV receives a written request from law enforcement, family, physicians, or others acceptable to DMV.”

If the DMV finds the request credible, then the targeted individual will typically have to verify their safe-driving ability. According to an Alaskan government website, these may include standard “vision,” “written,” and “road-skills” tests.

Failure on one or more tests may result in license restriction or revocation. However, in certain circumstances, a person may have the option to receive “an evaluation and/or training from a certified rehabilitation center and provide the DMV with a release from the center.” To put it another way, failures, in and of themselves, may not be definitive. The final word is given to competent medical evaluators.[7]

Typically, licenses must be renewed in person every five (5) years. There may be periodic medical evaluations required for persons with early or middle-stage Alzheimer’s. Advanced Alzheimer’s is almost certainly going to result in automatic license revocation.

Department of Administration
Division of Motor Vehicles
1300 W Benson Boulevard
Anchorage AK 99503-3695
Email Link
(907) 269-5551; (855) 269-5551

What Does Arizona State Law Say About Driving With Alzheimer’s?

In general, Arizona Revised Statute 28-3153(A)(10) and 28-3164(B) prescribes that there are certain questions (called “medical-review questions”) on Arizona’s license application that, if marked “yes,” result in the activation of the state’s Medical Review Program. Once involved, administrators of this program request further information about the applicant and guide the applicant through a medical-review process. This process may end with a physician evaluation. If the evaluation reveals some severe cognitive impairment, a driver’s license could be revoked.

A medical review can be initiated in other ways as well. For example, a physician or law-enforcement officer might submit pertinent information to the transportation division. Relevant information would be anything that casts doubt on the applicant’s or licensee’s ability to safely operate a motor vehicle on the public highways/roadways.[8]

Additionally, although typical licensees only have to apply for renewal every twelve (12) years, Arizona requires “seniors” (age 60+) to be reevaluated every five (5) years.

Arizona Department of Transportation
Motor Vehicle Division
P.O. Box 2100
MD 555M
Phoenix, AZ 85001
Email Link
(602) 255-0072; (520) 629-9808; (800) 251-5866

What Does Arkansas State Law Say About Driving With Alzheimer’s?

“There is no specific Arkansas statute relating to Alzheimer’s. While some aspects of ability to drive (eyesight, for example) have specific statutory or regulatory control, overall mental health status (or, for that matter, physical health status) is not subject to such legislation, and I am not aware of any pending legislation that would address it.

“The way the issue is addressed by Arkansas is that if the licensing agency (here, the Department of Finance and Administration, specifically the Office of Driver Control – where I work!) receives notice of concern about a licensee’s ability to drive safely, we would assess that ability, and act against the driving privilege if necessary for the safety of the licensee and others on the road.

“Such notice most often comes from medical professionals interacting with the licensee, from their family, or from law enforcement or the judiciary. Once we receive such notice, we schedule a hearing for the licensee to come before a Driver Control Hearing Officer for an initial evaluation. Failure to appear at the initial evaluation will result in a revocation.

“The hearing officer will make just that, an initial evaluation of the licensee. If it is clear that this is not a person who could drive safely, the license will be revoked there.  If it seems that licensee is or may be able to drive, they will be sent with paperwork for their doctor to fill out.  The doctor has the option of choosing yes or no as to the licensee’s ability to drive safely, from a medical standpoint.  Anything less than an unambiguous ‘yes’ will be treated as a ‘no’.

“On a ‘no’, the process ends, and the license is revoked – though if there is some ambiguity at the time, or a later change in circumstance, the licensee may be offered the chance to get a second opinion from a different doctor.  If the doctor indicates that licensee is safe to drive, the licensee would then be sent to the Arkansas State Police to take the driven portion of the driving test – again on a pass/fail basis.  Retests are possible here after a failure, though that lies within the discretion of the police examiner.

“The licensee generally has 30 days from the date of the initial evaluation to complete the process, or again the result is a revocation – though one that could be relieved by later completing all the steps of the evaluation.”[9]

“Senior” drivers (age 65+), must submit to biannual vision tests, but license renewal is otherwise conducted every four (4) years.

Driver Services
1900 W 7th St, Rm 2067
Little Rock, AR 72201
Email
501-371-5581

What Does California State Law Say About Driving With Alzheimer’s?

California appears to be a mandatory-reporting state, which means that doctors are required to alert the Department of Motor Vehicles about any patient who is suffering from a condition that may impair his or her driving ability. Specifically, in this state, physicians must report anyone experiencing “[l]apses of consciousness …[or] Alzheimer’s Disease severe enough to be likely to impair a person’s ability to operate a motor vehicle.” Another list has it that conditions of possible concern include: “…stroke, …seizure disorder or diabetic condition …[or] progressive condition[s] which gradually deteriorates over time, such as Alzheimer’s disease or other form of dementia.”[10]

Furthermore, “California law (Vehicle Code Sections 13800, 13801) permits DMV to investigate and reexamine a person’s ability to safely drive a motor vehicle for a variety of reasons, including information coming to the department’s attention that a person has a physical or mental disorder that may affect his or her ability to drive safely.”[11] A person may come to DMV’s attention by way of “…many sources, including law enforcement, physicians and surgeons, judges, family members and acquaintances.”[12] The “Request for Driver Reexamination” form is available HERE.

The results of reexamination could be any of the following: nothing (in this case, the driver’s privileges remain wholly intact); “Type 1 Medical Probation” (requires the driver to periodically report to the DMV in order to demonstrate compliance with physician treatments plans, recovery progress, or further decline); “Type 2 Medical Probation” (requires the physician to periodically report on the driver’s condition); periodic reexamination (the driver is scheduled for follow-up retesting); restriction (the driver is limited to driving during certain times [e.g., during the day] or only between certain locations [e.g., to church, to the doctor, etc.]); suspension (the driver’s privileges are removed indefinitely – not necessarily permanently[13]); revocation (the driver’s privileges are terminated).[14]

Drivers are not susceptible to revocation or suspension merely because of advanced age.[15] And license renewal usually occurs every five (5) years. But, “senior” drivers (age 70+) are no longer permitted to apply for license renewal online; they must come in person. In addition, to track their decline, dementia-afflicted drivers are required to be evaluated semiannually or annually.

Department of Motor Vehicles
P.O. Box 942890
Sacramento, CA 94290
(800) 777-0133; (916) 657-6452 [Driver Safety Unit]

What Does Colorado State Law Say About Driving With Alzheimer’s?

Colorado is another “review” state. For all practical purposes, there are four types of people that can initiate an evaluation for restricting or revoking a driving privilege: a doctor or physician’s assistant, a member of law enforcement, a department of motor vehicles (DMV) staffer, or an individual driver him- or herself. Most often, the self-declaration process happens incidentally, during a periodic license-renewal attempt. For example, a driver may come into a DMV office to renew, and answers “yes” to the following question. “During the last two years, have you had any physical, mental, or emotional conditions that would interfere with your ability to operate a motor vehicle safely, including heart problems, diabetes, paralysis, epilepsy, seizures, lapses of consciousness, or dizziness?” (See Colorado Revised Statutes 42-2-112.) Obviously, a “yes,” triggers the review process.

Once a customer has been identified as needing additional medical evaluation to determine if he or she is competent to drive, that person is issued a Form DR-2401. This form must be taken to, and filled out by, the driver’s doctor. There are several possible outcomes that can happen in the doctor’s office. The doctor may recommend revoking the driving privilege entirely; the doctor may recommend temporarily suspend the driving privilege pending some sort of therapy or rehabilitation (after which, a “rehab permit” would be submitted); the doctor may recommend the imposition of restrictions (for instance, no night driving or no driving over certain distance limits); or the doctor may decide the individual is safe to drive.

The process is similar with vision, except, in the case of visual problems, the driver would take the DR-2401 form to an optometrist. In all cases, per statute, it would need to be a medical professional licensed in the state of Colorado. Whatever the doctor’s recommendation, it would be documented on the form, then returned to the DMV, where that course of action would then be implemented.

One other note on vision screenings: Licenses are usually renewed every five (5) years. Non-senior drivers (people 65 and younger) have the option of renewing online, every other renewal period. However, “seniors” are not given that option. Provided that they have evidence of having passed a vision test (within the previous half a year),[16] they are able to renew their licenses by mail.

In summary, judgments of driving competence are mostly at the discretion of various physicians, physicians’ assistants, or optometrists.[17]

Department of Revenue
Division of Motor Vehicle
Driver’s Licenses: Medical Review
P.O. Box 173350
Denver, CO 80217-3350
Email Link
(303) 205-5600

What Does Connecticut State Law Say About Driving With Alzheimer’s?

Generally, a person with Mild Cognitive Impairment or Alzheimer’s would be brought to the attention of the Driver Services Division after having been reported by a family member, doctor, law-enforcement officer, or “someone else.”

The generic Form P-244, “Affidavit to Report a Driver Who May Be Unable to Safely Operate a Motor Vehicle,” is a catch-all that allows anyone to attest to having observed a possibly incompetent driver. The form must be signed by the reporting party as well as a notary public. The actual details of the review process unfold differently depending upon who is filing the report. For instance, professional observations – such as those of physicians or police officers – made within their respective sphere of competence are treated as prima facie credible. A whole battery of secondary forms then comes into play, depending upon the issue that is affecting the target’s driving. There are forms for cardiology, diabetes, neurology, and so on.

Of these several relevant documents, a few a particularly pertinent for present purposes. These include the Initial Medical Request form (P-40), that may be filled out by a doctor. The P-40 form has boxes that can be checked for “Alzheimer’s/Dementia,” Neurological/Neuromuscular,” and “Psychiatric/Emotional Disorder,” among other diagnoses. Form P-142, the “Medical Form,” is a longer form with more space to divulge details about such conditions as neurological and substance-abuse problems. And the P-142N is the specific “Neurology Medical Report.”

The targeted individual has a right to a doctor’s review. The results of the review process could be to terminate the target’s driving privileges, restrict the target’s driving to particular places or times, or to require periodic reviews of the target’s medical condition. This latter eventuality is especially likely in early stages of Alzheimer’s, when the sufferer may not yet be experiencing sufficient diminution of his or her cognitive powers to negatively affect his or her driving, but where the expectation is that he or she will be unable to drive at some point as the disease progresses.[18]

Generally, licenses renew on six-(6-)year intervals. “Seniors” (age 65+) may have to renew as frequently as every two (2) years. This difference is not, however, medically grounded and has nothing to do with cognitive impairments (or a lack thereof). Instead, it is based on a “fee structure” and is at the driver’s discretion.

Department of Motor Vehicles
60 State Street
Wethersfield, CT 06161
Email
(860) 263-5700; (800) 842-8222

What Does Delaware State Law Say About Driving With Alzheimer’s?

Delaware laws address neither driving with Mild Cognitive Impairment (MCI) nor Alzheimer’s Disease. However, according to 25 Del C. § 1763, Delaware state law, any person who is subject to cognitive impairment (for example, due to disease of the central nervous system) must be evaluated by a physician. The doctor’s recommendations largely determine the Division of Motor Vehicle’s course of action. The driver may be asked to undergo an evaluation, or may be compelled to received rehabilitation of driver’s-education training.

According to 21 Del. C. Section 2714, Delaware state officials are able to receive medical referrals from physicians, immediate family members, law enforcement officers and drivers themselves (“self-reporting”). If the doctor of a licensed Delaware driver believes that said driver is not capable of safely operating a motor vehicle (for whatever reason – mental or physical, or both), then he or she can report it to the department of motor vehicles (DMV). The doctor can submit either a re-examination or an immediate license-suspension request or could just complete the DMV medical form stating that, from a healthcare standpoint, the driver in question is impaired in some way. The DMV would then send the driver a letter. The type of letter would depend on the actual request. If the driver fails to present a favorable medical report, either because of a refusal to comply or because no doctor will grant one, then the driver can surrender his or her license or face its suspension. Additionally, Delaware has a mandatory-reporting law. Physicians are required to report anyone experiencing “[l]oss of consciousness due to diseases of the central nervous system.”[19]

Licenses renew on a five-year (5) schedule. However, “seniors” (age 65+) must demonstrate that their vision is unimpaired.

Division of Motor Vehicles
303 Transportation Circle
P.O. Box 698
Dover, Delaware 19903
Email
(302) 744-2500

What Does Florida State Law Say About Driving With Alzheimer’s?

“Florida Statute 322.126(2), authorizes any physician, person, or agency to report an individual who may be unsafe to drive due to a medical condition to the Department of Highway Safety and Motor Vehicles (DHSMV).  Florida does not require mandatory reporting of certain medical conditions and there is currently no legislation proposed that would require a driver with Alzheimer’s disease to surrender their license at any diagnostic benchmark.

“If reported,[20] a driver with MCI, Alzheimer’s disease, or dementia will be required to submit a medical report from their regular treating physician.  The report must address the severity of their cognitive impairment (including the results of a Mini-Mental State Examination or its equivalent).  In addition, the physician will be asked their opinion regarding the individual’s ability to safely operate a motor vehicle.  All this information, including the initial report of disability, the individual’s driving record and any crash related incidents, will be submitted to the DHSMV’s Medical Advisory Board (Board) for its review and recommendation.

“If approved, the driver may be required by the DHSMV to submit follow-up medical reports and/or take a re-examination as a condition of licensure.  However, if a driver has a medical condition that affects their ability to drive safely and their records indicate that they pose a risk to public safety; their driving privilege will be denied.  If the driving privilege is denied, the driver may request an administrative hearing to provide additional information from his or her doctor for reconsideration by the Board.”[21]

In Florida, the renewal period is six (6) years. However, anyone who has received a moving violation will be required to renew every four (4) years, instead. “Senior” drivers (age 80+) must submit to a vision screening.

Florida Highway Safety and Motor Vehicles
2900 Apalachee Pkwy
Tallahassee, FL 32399
Email Link
(850) 617-2000

What Does Georgia State Law Say About Driving With Alzheimer’s?

In Georgia, drivers’ licenses are overseen by the Department of Driver Services (DDS). Usually, driver’s are assumed to be competent, unless they self-report otherwise. However, doctors, family members, “concerned citizen[s],” court officials, judges, and law-enforcement officers may submit what is termed a Request for Driver Review (DDS 270).

Reception of said request initiates a process whereby the DDS mails a “…Medical Form (DS-287) and/or Vision Form (DS-274) to the customer requesting a Medical Evaluation by a doctor.” Ignoring or refusing this “request” (within one month) results in automatic license suspension.

“If the Medical Evaluation signed by the doctor clears the customer, DDS clears the driving record of any notation relating to the original medical request, no action is taken and no changes are made to their driving privileges. If the customer has been advised that they must retest and they fail to do so within the allotted period of time, then they will be revoked. If the customer is revoked, but later cleared to drive, but are still required to retake the Knowledge and Road Tests, DDS sends them a letter informing them that they should visit a Customer Service Center to get retested. …

“Many doctors rely on detailed feedback from a certified driver rehabilitation specialist to help decide whether or not a person is fit to drive. They offer a clinical and behind the wheel assessment of driving skills. It includes a review of recommendations with the driver and caregivers.”[22]

License renewal procedures are a bit nuanced in Georgia. Typically, “non-senior” (age 59 or younger) drivers can select either a five-year (5) or ten-year (10) renewal period, based upon a fee schedule. “Seniors” (60+) are compelled to renew every five (5) years. Additionally, at age 64 (and following), a vision test is required. The exception is for veterans, whose licenses do not need renewal until age 65.

Department of Driver Services
P.O. Box 80447
Conyers, Georgia 30013
Email Link
(678) 413-8400

What Does Hawaii State Law Say About Driving With Alzheimer’s?

With respect to Hawaii, readers should bear in mind that each island handles things slightly differently, procedurally. In terms of renewals, however, the general rule is that for “non-seniors” (age 71 or younger) licenses must be renewed every eight (8) years. Seniors must renew every two (2) years.

According to one Department of Transportation (DOT) representative: “On the City and County of Honolulu’s Driver’s License FAQ site, there is information regarding driving with a medical condition. It states that if the person has a medical condition that would affect driving, the person is required to submit a DOT Medical Report Form completed by the person’s doctor for review by the Medical Advisory Board.”[23] At the time of writing, the relevant form could be accessed HERE.

In general: “Driver’s must [disclose] any medical condition experienced within the last two years as stated on our driver license application form.  Medical conditions include[:] Neurologic/Orthopedic/Arthritic Conditions[;] Diabetes[;] Seizure/Stroke/Blackout Spells[;] Chronic Alcoholism[;] Drug Addiction[;] Heart/Lund Condition[;] Other[.]

“Other questions include: ‘Within the last two years, have you had a loss of consciousness or physical control, which affected your functional ability to safely operate a motor vehicle?’ ‘Has your ability to drive been impaired (due to injury or illness) within the last two years?’ …

“No, [Alzheimer’s-afflicted drivers do not have to surrender their licenses at particular diagnostic benchmarks; it’s all] based on recommendation of physician. …In addition, if at the time of license application staff notices cognitive impairment, we may require a medical report to be completed by her and her physician as well as a written test.”[24]

There is no proposed legislation that would create new requirements.[25]

Drivers Licensing Offices
Email

• 349 Kapiolani Street,
  Hilo, HI 96720
  (808) 961-2222
• 67-5185 Kamamalu Street
  Kamuela, HI 96743
  (808) 887-3087
• 74-5044 Ane Keohokalole Highway,
  Suite C
  Kailua-Kona, HI 96740
  (808) 323-4800
• 95-5355 Mamalahoa Hwy,
  Na’alehu, HI 96772
  (808) 854-7214

Maui Motor Vehicle & Licensing
Maui Mall Shopping Ctr.
70 E. Kaahumanu Ave.
Suite A-17
Kahului, HI  96732
Email
(808) 270-7363

What Does Idaho State Law Say About Driving With Alzheimer’s?

“Idaho does not require surrender of a license due to medical purposes unless it is requested by an approved doctor (either an M.D. or D.O.). …We can receive requests for re-evaluation of an individual from an immediate family member, law enforcement [offer] or [doctor].  We don’t have an official form …[T]he request does have to be in writing and is not confidential.”[26]

Alzheimer’s-afflicted drivers do not have to surrender their licenses at particular diagnostic benchmarks.

That said: “Doctors are the only ones that may actually revoke driving privileges – we don’t evaluate their requests. The individual does have the right to request a hearing in regards to their revocation.”[27]

State law does not expressly require anything of drivers with diagnoses of Mild Cognitive Impairment (MCI) or Alzheimer’s Disease (or, for that matter, other forms of dementia). “Medical evaluations with respect to drivers licensing are not disease-specific. …

“Idaho Code 49-202(11)[28] states that the department and its authorized agents may request anyone to ‘…submit to medical, vision, highway, or written examinations, to protect the safety of the public upon the highways.’ The exercising of this authority may be based on observations made by the department, its agents (county DMV representatives), and direct family members of a driver. Any of these parties, the driver, or a health care professional may request that an evaluation be completed via a Certificate of Medical Examination (ITD Form 3137).  Through this, a medical professional has the authority to determine the appropriate driving conditions/restrictions for a driver and re-evaluation schedules, if needed. Departmental and physician authority is further defined in Idaho Codes 49-326(1c) and 49-326(4).”[29]

License renewal is generally required every four (4) or eight (8) years, at drivers’ discretion (and based on a fee schedule). However, “seniors” (age 63+) are required to renewal every four (4) years.

Presently, there is no proposed legislation that would create new requirements.[30]

Idaho Transportation Department
Division of Motor Vehicles
3311 W. State Street
P.O. Box 7129
Boise, ID 83707
Email Link
(208) 334-8000; (208) 334-8736

What Does Illinois State Law Say About Driving With Alzheimer’s?

“By law, you must file a Medical Report Form, completed by your physician, if: ‘…You have any medical or mental condition that may result in a loss of consciousness or any loss of ability to safely drive a vehicle’[;] or ‘…You take any medications that may impair your ability to drive.’

“Each time you renew your driver’s license you must resubmit a Medical Report Form. By law, you must notify the Secretary of State’s office within 10 days of becoming aware of any of these conditions. Failure to do so may lead to the cancellation of your driver’s license and driving privileges.

“If the particular medical condition no longer exists [obviously, this is inapplicable to Alzheimer’s and related dementias – Ed.], you must submit a final Medical Report Form completed by your physician indicating the condition no longer exists, in order to be removed from the follow-up program with this office. …

“In order to protect the rights of all persons, the Secretary of State’s office is only authorized to investigate potential medical conditions when reported by a licensed physician, member of law enforcement or member of the judicial system. These authorized reporters are not required to obtain the driver’s signature on any documents submitted to this office when it is recommended that the driver should NOT be driving. If you know someone you feel could jeopardize traffic safety as the result of a medical condition, contact the individual’s doctor or a police officer and request that the Secretary of State’s office investigate.”[31]

The standard driver’s-license renewal period is every four (4) years. However, “seniors” (age 81+) are faced with increasing scrutiny, in two waves. Seniors 81-86 have to renew every two (2) years; while those 87+ are required to do so annually. In-person renewal is also mandatory for everyone who is over the age of 73.

For further information, readers may contact:

Secretary of State
Medical Review Unit
2701 S. Dirksen Pkwy.
Springfield, IL 62723
Email Link
217-782-7246

What Does Indiana State Law Say About Driving With Alzheimer’s?

“[A]ny individual moving to Indiana wishing to obtain an operator license must pass a general knowledge test and vision screening administered at a license branch of their choosing.”[32] “The skills exam can be waived if there is proof of previous driving experience (i.e., valid driver’s license from another state). See Ind. Code 9-24-10-4. …

“Indiana Code does not require anything specific regarding persons suffering from MCI [Mild Cognitive Impairment].  However, pursuant to Ind. Code 9-24-9-2(7), the application for an Indiana Driver’s license must include information as to whether the applicant has a physical or mental disability, and if so, the nature of the disability.  During the application process, a customer service representative will ask the applicant if he/she has a medical or physical condition that would affect the applicant’s ability to safely operate a motor vehicle.  If the applicant self-reports a condition, the BMV will require a physician’s statement indicating that the applicant is either on medication to control the disability or that the disability does not affect the person’s ability to safely operate a motor vehicle.”[33]

“The BMV will also ask seizure related questions during the credential application process. In general, IC 9-24-2-3 grants the Bureau of Motor Vehicles the ability to deny the issuance of a license or permit based on individuals physical, mental disability or disease that prevents the individual from exercising reasonable and ordinary control over a motor vehicle, or when the bureau has good cause to believe that the operation of a motor vehicle by the individual would be inimical to public safety or welfare.

“Should good cause be presented, the Bureau could require the individual to complete a medical review process.  As no two cases are identical, I could not detail out exactly what would be required but an individual may be requested to provide responses to a medical questionnaire completed by their primary care physician, participate in a rehabilitation drive skills evaluation, undergo a visual acuity test or a combination dependent upon the situation. Once all information has been compiled it could undergo review by the Indiana Driver License Medical Advisory board which consists of Licensed Physicians who practice within the State of Indiana. Based on recommendation, the bureau could take no action, take action with restrictions, or revoke the driving privileges of the individual.”[34]

“In addition, the BMV can issue restrictions on a person’s license.  The BMV does have an Alzheimer’s indicator which would appear on the face of the license.  Other restrictions include day driving only, driving only within a certain distance from home, mandatory re-testing every year etc.

“Finally, pursuant to Ind. Code 9-24-2-7, the BMV may upon written notice require a licensed driver to submit to an examination if the BMV has good cause to believe that the driver is incompetent or unfit to operate a motor vehicle.  In that situation, the driver would receive a letter from the BMV’s Driver Ability Department asking that the driver’s physician fill out a form relating to the driver’s health and ability to safely operate a motor vehicle.  If the medical review board determines that the person is no longer able to safely operate a motor vehicle, the person’s license will be canceled/revoked. See Ind. Code 9-24-10-7.  There is a hearings process to dispute this determination.”[35]

“There are not specific ‘milestones’ that would trigger the automatic revocation of a license such as age or a cognitive issue as you have described below.”[36]

For most drivers, license renewal is compulsory every four (4) years. However, “seniors” (age 75+) must renew more frequently: every three (3) years for those 75-85; every two (2) years for those 86+.

Currently, there does not appear to be “…any pending or proposed legislation relating specifically to changing this process.”[37]

Indiana Bureau of Motor Vehicles
Indiana Government Center North (Central Office)
Room 402
100 North Senate Avenue
Indianapolis, IN 46204
Email Link
(888) 692-6841

What Does Iowa State Law Say About Driving With Alzheimer’s?

“Iowa Code section 321.177(7) and Iowa administrative rule 761—600.4 prohibit the department from knowingly licensing someone whom the department has good cause to believe has a mental or physical disability that would impair their ability to operate a motor vehicle safely until the person submits a medical report[38] stating the person is physically or mentally capable of operating a motor vehicle safely.  Therefore, on the application for an Iowa driver’s license, we ask the applicant to disclose any mental or physical disability that would impair their driving.

“If [an afflicted person] …is able to provide a satisfactory medical report …from [his or] her medical provider, [he or] she should be able to obtain an Iowa driver’s license, provided there is nothing else on [his or] her record that would otherwise prevent [him or] her from being licensed. Testing may be required, depending on the physician’s recommendation or an examiner’s observation.

“Regarding …progression of …[Alzheimer’s and related cognitive] disease, we do have a provision in Iowa administrative rules for special reexaminations in 761—604.50(5) recommended by certain officials for reasons including confusion, disorientation or dementia, which could affect …[Alzheimer’s sufferers] if we receive a request for a reexamination from an official listed in the rule.  A special reexamination may also be warranted if …[a dementia patient] meets the [other] criteria [enumerated] in administrative rules 761—604.50(1), (2), (3) or (4).”[39]

The Department of Transportation’s Motor Vehicle Department (driver’s license division) processes reports (that is, signed request-letters from doctors, family, or police) and restricts (if necessary) the privileges drivers who are potentially unsafe. “The most common restriction is a requirement to submit a medical report in the future. …The term of the license will be two years following any loss of consciousness.”[40] Among other things, the Iowa MVD is concerned with “…health conditions, illnesses, or diseases [that] can affect driver fitness, …[such as:] Seizure[;] Blackout/Loss of consciousness[;] Parkinson’s, Multiple Sclerosis…[;] Stroke[; and] Dementia or cognitive impairment[.]”[41]

The standard renewal interval is either two (2) or five (5) years, depending on what fee the applicant chooses to pay. However, “senior” drivers (age 70+), must renew every two (2) years.

Department of Transportation
Motor Vehicle Division
800 Lincoln Way
Ames, IA 50010
Email Link
(515) 244-8725

What Does Kansas State Law Say About Driving With Alzheimer’s?

“At this time[,] Kansas is not a mandatory reporting state.  Physicians are not currently required by law to report drivers that are at risk or should stop driving immediately.  At this time[,] there is [also] no proposed legislation to make Kansas a mandatory reporting state.

“During a visit to a Kansas exam station to acquire or renew a driver’s license, the driver is asked a series of questions.  The two questions that apply to their health and their ability to safely operate a vehicle are: [‘]DO YOU CURRENTLY HAVE ANY PHYSICAL OR MENTAL DISABILITIES THAT COULD MAKE IT DIFFICULT TO OPERATE A MOTOR VEHICLE SAFELY? WHAT ARE THEY?[‘ and ‘]HAVE YOU SUFFERED A SEIZURE IN THE LAST 6 MONTHS? CAUSE?[‘]

“If the driver answers ‘yes’ to one or both of those questions, [then] they are not issued a credential and are flagged for a medical review.  If the driver answers ‘no,’ but exhibits behavior that would indicate there is an issue or presents with limited physical mobility, they may be challenged to a drive test by the examiner.

“As Kansas is not a mandatory reporting state, reports are accepted from medical professionals, law enforcement and the public. The ‘Letter of Concern‘ and ‘Officer Referral‘ forms are filled out and submitted to our office for review. A letter is mailed to the driver with the appropriate medical and vision forms. The driver must submit current exams (that have occurred within the past 90 days) from all treating physicians within 30 days of the date requested.  If all doctors agree the driver is safe to continue driving, the driver must take and pass a drive test with a Kansas examiner. Physicians may also request full testing which would include the drive test and a written handbook test as well.  The medical exam (DV124MV), ‘Letter of Concern’ and ‘Officer Referral’ are all located on …[driver’s licensing portal on the Kansas Department of Revenue] website.”[42]

Generally, licenses are renewed every six (6) years. However, “seniors” (age 65+) must renew every four (4) years.

Driver Licensing: Medical Certifications
C/O: Kansas Department of Revenue: Division of Vehicles
P.O. Box 2188
Topeka, KS 66601-2128
Email
(785) 296-3671

What Does Kentucky State Law Say About Driving With Alzheimer’s?

​“There is no law mandating a person with a diagnosis of MCI or Alzheimer’s to relinquish their driving privilege unless they voluntarily do so. However, if the driver is reported to the Medical Review Office via affidavit then a case will be started. The …Medical Review Program webpage …links to the law and regulations[.]”[43]

Briefly summarized: Per Kentucky Revised Statutes 186.444, 601 Kentucky Administrative Regulations 13:100 and 601 KAR 13:090, the State of Kentucky has its own Medical Review Board Program, with input from “ophthalmologists, neurologists, psychiatrists, and rehabilitation specialists. …The Medical Review Board identifies drivers with physical or mental impairments [that] hamper their ability to safely operate a motor vehicle.”

The Board “provide[s] medical advice to the Division of Driver Licensing on license applicants and licensees that are reported to the Board.”

Kentucky law doesn’t address Alzheimer’s directly. It does have several things to say with respect to seizure disorders, however. In general,[44] “[a] license applicant or licensee must be seizure-free 90 days in order to obtain or maintain driving privileges. …[45]

“Drivers may be reported to the Medical Review Board for one of the following reasons​: If the driver has indicated that he has ‘blacked out,’ lost consciousness or suffered a seizure prior to a reportable motor vehicle accident; If the driver has been reported by a physician as being incapable of driving safely due to a physical or mental condition, or due to medication prescribed for an extended period of time; If the driver’s official record kept by the Transportation Cabinet indicates a possibility of a physical or mental impairment; If the driver has reported that he suffered an epileptic seizure or any type of syncopal episode; If the driver has been reported by a commonwealth attorney, county attorney, county clerk, circuit clerk, sheriff or judge as being incapable of driving due to a physical or ​mental impairment[; or] If the driver has been named in an affidavit by at least two citizens as being incapable of properly operating a motor vehicle due to a physical or mental impairment[.] …

“Once the individual has been set up under the Medical Review Board program a medical form will be mailed for completion by the treating physician. Once this information is reviewed, the individual will be notified of the Board’s decision regarding [his or her] driving privilege.​​​​​”[46]

In Kentucky, drivers’ licenses are up for renewal every four (4) years.

Driver’s License Bureau
501 High Street
Frankfort, KY 40601
Email Link
(502) 564-6800
Medical Review Board
Email
(502) 564-1257

What Does Louisiana State Law Say About Driving With Alzheimer’s?

[Under Construction][47]

In general, drivers’ licenses require renewal every four (4) years. For “seniors” (age 70+), this renewal must be conducted in person – no email or postal mail is allowed.

Louisiana Department of Public Safety and Corrections
Office of Motor Vehicles
P.O. Box 64886
Baton Rouge, LA 70896
Email Link
(225) 925-6146

What Does Maine State Law Say About Driving With Alzheimer’s?

According to “Maine Motor Vehicle Statutes, 29-A[,] …’The [Medical Advisory B]oard shall advise the Secretary of State on written medical and vision standards related to operator’s licensing. Standards may only be adopted as rules.’[48]

“The rules that describe the standards to be used in determining physical, emotional and mental competence to drive can [viewed HERE].

“Maine does require drivers to report certain conditions. We do not require reporting of [Mild Cognitive Impairment] MCI, because statistically, it carries no increased crash risk. Dementia is a reportable condition, and the privilege of continuing to drive is based on the severity of the condition. For example, if a person has diagnosed dementia that poses low risk to safe operation they may be allowed to continue to drive, but they would have to submit an updated medical form again in 2 years. A person with potential risk to safe operation would be required to take a road test before being allowed to continue to drive. If there is severe risk to safe operation, the license would be suspended for an adverse medical condition.

“Drivers are responsible to report their conditions. When a person comes in to apply, renew, get a duplicate license or waiver in from out of state they are asked about conditions they may have. Concerned citizens, law enforcement or health care providers may also tell BMV if they are concerned about a driver’s ability to safely to operate.

“When BMV becomes aware that a person has or may have a certain condition, the person is given a medical or vision form to take to their health care provider to be completed and returned to BMV.  Action is taken on the basis of that information and the rules listed above.”[49]

Licenses general renew every six (6) years in Maine. However, “seniors” (age 65+) must renew every four (4) years. Additionally, seniors must undergo a vision test at each renewal. (For other drivers, vision tests are conducted every other renewal period.)

Secretary of State
Bureau of Motor Vehicles
29 State House Station
Augusta, Maine 04333-0029
Email Link
(207) 624-9000

What Does Maryland State Law Say About Driving With Alzheimer’s?

“The short answer is that yes, dementia is a reportable medical disorder under Maryland law.[50]  Code of Maryland Regulations (COMAR) 11.17.03.02-1 requires each licensee or applicant for a driver’s license to notify Maryland Department of Transportation Motor Vehicle Administration (MDOT MVA) if the licensee or applicant is diagnosed with a reportable condition.  These reportable conditions are listed in COMAR as well; there are sixteen of them,[51] and dementia is one of the sixteen.  …

“MDOT MVA has a medical review process for Maryland drivers that are referred [whether by doctors, police[52] or regular citizens] with potential medical conditions that could affect their driving safely.  When a driver has been diagnosed with a type of dementia such as Alzheimer’s disease, the issue is not whether the person will have to stop driving, but when that must happen.  So, it’s a great idea to plan ahead and made a formal agreement about driving with a caregiver and then this person will also agree to help with the transition from driving. [For information on planning ahead, see HERE. – Ed.] …

“When all the necessary information is received from a referral, the case is thoroughly reviewed by the Medical Advisory Board, and then a recommendation is made concerning the individual’s medical fitness to drive. Examples of possible recommendations are:

• “Approves applicant or driver and recommends the case be closed[;]
• “Recommends retention/return of driving privilege, but requires periodic medical reports to the MVA[;]
• “Allows driving with certain restrictions placed on the license. An example would be daylight driving only[;]
• “Suspen[ds]/continue[s] suspension of the driver’s license until the medical condition is corrected or brought under control to permit safe driving[;]
• “[Requires r]eexamination (which may include a functional capacity test screening, vision test, law test, and/or a driving test)[.]”[53]

Additionally, all drivers age 40+ are required to pass a vision time at each license renewal, every five (5) years.

Maryland Department of Transportation
Motor Vehicle Administration
6601 Ritchie Highway NE
Glen Burnie, MD 21062
Email
(410) 768-7000

What Does Massachusetts State Law Say About Driving With Alzheimer’s?

“Massachusetts is a self-reporting state. It is a licensee’s responsibility to report any medical condition that may affect his/her ability to operate a motor vehicle. If a licensee has a medical condition which he/she believes may affect his/her ability to operate a motor vehicle, he/she must report the condition to the RMV (Registry of Motor Vehicles) and not operate a motor vehicle until the condition is resolved. A licensee is legally responsible for his/her actions behind the wheel.

“Often, family members become concerned enough to report an unsafe driver. …[M]ost of the referrals come from medical practitioners. There are no mandatory reporting laws for health care providers to report patients with a driver license to the RMV who may be unable to operate a motor vehicle safely. The RMV does receive information from members of the medical community regarding their concern over a particular patient’s ability to operate a motor vehicle. The RMV can take limited action depending on the input received. We may notify the identified driver of the concerns that are raised and the driver may choose to surrender the license. We may also schedule him or her for a ‘Competency Road Exam’ (basically a driving test) to evaluate the person’s capabilities to operate a motor vehicle. We may request a voluntary surrender if the individual’s medical condition renders them unsafe to operate. If we determine a person is incapable of operating a motor vehicle safely and they refuse to surrender the license we may refer them to our Driver Control Unit which may suspend or revoke the license.

“In terms of these medical referrals, there are no benchmarks that the RMV imposes. It is strictly left to the medical community to assess an individual’s particular situation as it evolves.”[54]

As far as general license renewals go, the state requirement is every five (5) years. However, “seniors” (age 75+) are not permitted to renew via mail or online; they must come into an office in person.

Massachusetts Department of Transportation
Registry of Motor Vehicles[55]
P.O. Box 55889
Boston, MA 02205-5889
Email Link
(857) 368-8000; (800) 858-3926; (857) 368-8020 [Medical Affairs][56]

What Does Michigan State Law Say About Driving With Alzheimer’s?

“Michigan law does not expressly require a person to self-report a medical condition, and we are not aware of any pending legislation requiring mandatory self-reporting. People obtaining a driver’s license are asked whether they lost consciousness in the previous six months.

“If you believe [that a relative] should not be driving …, you may wish to submit a Referral for Driver Examination: [HERE].[57]

“The department has the authority to evaluate a person’s physical and mental ability to drive safely under state law, and restrict or suspend driving privileges as appropriate. A driver re-examination may require a favorable statement from a physician, an on-the-road driving evaluation and other tests.”[58]

“The Department has in place standards called the ‘Physical and Mental Standards for Michigan Drivers.’ The standards allow the Department to review any driver with a health condition that could affect their ability to operate a motor vehicle safely, including Alzheimer’s Disease or any cognitive impairment. …

“When the Department is made aware of concerns for the driver, either through the driver notifying the Department at time of license application or through others with firsthand knowledge of the driver’s health concerns, the Department will require the driver to obtain an updated medical statement from their treating physician in regards to any physical/mental ailment that could affect their driving ability.   See MCL 257.320 of the Michigan Motor Vehicle Code for the authority to conduct a reexamination.

“In most cases, following receipt of the completed statement, the Department will require the driver to appear for driver reexamination. A Department driver analyst will review the medical documentation to determine if it is safe for the driver to operate a motor vehicle. This includes such conditions as Alzheimer’s Disease, cognitive impairment, uncontrolled diabetes and seizures. The Physical standards do allow for a license suspension based on the driver’s condition and doctor’s recommendation.

“While there is nothing specific in the law pertaining to Alzheimer’s Disease, it is a condition that could progress to the point where the individual can no longer operate a motor vehicle. Should the driver pass the medical review and testing at a reexamination (i.e. vision screening, written examination, and on-road driving evaluation) the Department will monitor the driver’s health with periodic reviews requiring a medical document from the driver as completed by their treating physician.

“At present, I am not aware of any proposed legislation concerning this condition.”[59]

In general, there are five (5) documents required “to obtain a [Michigan] driver’s license or state ID card …: one each to verify her Social Security number, identity and legal presence, and two to prove Michigan residency.”[60]

In Michigan, drivers renew their licenses every four (4) years. But “seniors” (age 65+) must do so in person; they have no option to renew online or via the postal service.

Michigan Department of State
Lansing, MI 48918
Email Link
(888) 767-6424; (517) 335-7051

What Does Minnesota State Law Say About Driving With Alzheimer’s?

“There are no state laws specifically addressing cognitive impairment/Alzheimer’s Disease in relation to driving privileges. …[T]here is no legislation requiring tracking of progression of cognitive deficiency in relation to driving privileges. …[However:] You may wish to check with your elected state officials regarding this question.

“Driver and Vehicle Services can and will take action to withdraw driving privileges when appropriate and necessary for public safety. If you have concerns regarding a family member, you may write to us [at]:  Minnesota Driver and Vehicle Services, 445 Minnesota St., Suite 170, St. Paul, MN 55101-5170.  You may provide us with your signed statement describing your safety concerns, and your relationship to the person. We can then interview the person and determine whether or not a medical statement and/or driving test is necessary. …[Additionally,] if we receive a letter from a physician recommending that driving privileges be cancelled, the person’s driving privileges will be withdrawn.”[61]

Drivers’ licenses must be renewed every four (4) years.

Minnesota Department of Public Safety
Division of Driver and Vehicle Services
445 Minnesota Street Suite 190
Saint Paul MN, 55101
Driving Handbook for “Seniors” (Age 65+)
Email
(651) 297-3298

What Does Mississippi State Law Say About Driving With Alzheimer’s?

“[I]f there are any concerns that you may feel that your …[loved one] shouldn’t be driving, you will have to write a letter of concern. In your letter, …state that person’s name, social security number/driver license number, and mailing address. In your letter [also briefly] state your concern or issue that is going on with that person.

“Once our department receives that letter, we will mail two forms[:] one for medical doctor and the other one is for the eye doctor. After the doctor fills out the forms, we will then set up an appointment to have that driver tested. If the medical doctor feels the need that the individual should lose his/her driving privileges based on their medical conditions, [then] there is a box for him to check to say that he feels that that person should not be driving.

“We do not have a statue that states that a person with Alzheimer’s should not be driving. …[T]hat decision comes from their primary doctor if they feel that he/she should not be or still capable of operating a motor vehicle and we will take further actions to suspend the license if necessary.”[62]

Drivers’ licenses must be renewed every four (4) years.

Department of Public Safety
1900 East Woodrow Wilson Ave.
Jackson, MS 39216
Email[63]
(601) 987-1212

What Does Missouri State Law Say About Driving With Alzheimer’s?

In general, §302.291, Revised Statutes of Missouri (RSMo), addresses incompetent or otherwise unqualified drivers. For present purposes, the most relevant bit is that this statute defines the processes available when a licensee is alleged to be mentally incompetent or unqualified to drive an automobile.

Certain individuals identified in the statute (e.g., physicians and police officers) may provide a report to the department concerning a particular driver. If the Department of Transportation judges that the report articulates a good cause, then the department may require that the relevant driver obtain a medical evaluation or retake his or her driving examination. Additionally, the department may suspend, deny, or revoke the driver’s license – where deemed appropriate.

The department also asks drivers and prospective drivers, at the time of their application or renewal of their license, if they have any medical conditions. If the driver self-reports any of pertinent medical issues, then the license office staff file a report and action steps may be taken, pursuant to the description given above.

Moreover, the department administers a road sign test which is intended, in part, to identify cognitive impairment. If a driver cannot pass the road sign test, they will not be issued a license.[64]

As far as license renewal goes, “seniors” (age 70+) must renew every three (3) years, while non-seniors renew every six (6).

Department of Revenue
Harry S. Truman Building
301 West High St.
Jefferson City, MO 65101
Email
(573) 526-2407

What Does Montana State Law Say About Driving With Alzheimer’s?

“First, Montana is not a mandatory reporting state, meaning [that] medical professionals are not required to report to [the Motor Vehicle Division] MVD if a driver suffers from a condition which may affect their ability to safely operate a motor vehicle. Second, when drivers apply for a license, they are required to answer and certify questions pertaining to if they have any physical or mental condition that may impair ability or if they have a condition(s) that may cause loss of consciousness or control.”[65]

According to Montana State Law,[66] a person “is required by law to disclose …[relevant] medical condition[s like Alzheimer’s] on the[ir license] application[s.] …[A]t that point[, the person] …may be asked to have a 20-1900 medical evaluation completed by her primary physician.[67] …[T]he medical evaluation will determine whether [the person in question] could be required to do further testing[,] such as the driv[ing] or written test.”[68]

“In addition, at the time of licensing, if an examiner observes or had evidence that a driver may not be safe to operate a motor vehicle, MVD may require testing that is separate from a medical professional’s recommendation.

“For class D (passenger vehicle) drivers, Montana law does not list specific conditions.[69] Therefore, there are no particular benchmarks for individuals with cognitive impairment at specific diagnostic benchmarks.”[70]

A person with no license at all “will be required to take do all of the testing. If a medical evaluation [is] completed[, the results might lead the motor-vehicle department to] …require [the subject] to submit future medical evaluations[.] …[I]f [at any point] a non-favorable medical [report] is received[,] then the possibility of [driver’s-license] surrender may …[arise].”

As of this writing, there doesn’t seem to be any pending legislation that would substantially affect the process just sketched.[71]

Moreover, for the most part, drivers’ licenses must be renewed every eight (8) years. However, there are two caveats. Number one, everyone’s license expires at age 75, regardless of how many years it has been in force. And number two, “seniors” (75+) must renew every four (4) years.

Department of Justice
Motor Vehicle Division: Driver Services Bureau
P.O. Box 201430
302 N. Roberts
Helena, MT 59620
Email
(406) 444-3933

What Does Nebraska State Law Say About Driving With Alzheimer’s?

“There are no laws that are specific to any medical condition.”[72] However, the general application for driver’s licenses (for new licenses, as well as for replacements and renewals) inquires about “…diabetes, epilepsy, mental illness, head injury, stroke, heart condition, neurological diseases, etc.”

Nagengast refers interested readers to the Nebraska Department of Motor Vehicles’s “policy and procedure manual – Section 13 – ‘Medical Requirements’: ‘No applicant shall be issued a license or permit to operate a motor vehicle on the streets and highways of the State of Nebraska until such person has satisfied staff and/or the Director that they possess a sufficient physical and mental capacity to operate a motor vehicle with a reasonable degree of safety.

“‘If the applicant marks yes to any medical questions or staff marks yes to the medical questions due to observing conditions that may question the applicant’s capability to safely operate a motor vehicle, a Statement of Physician and/or testing may be required. If a Statement of Physician is issued, please make sure the applicant is also given a copy of the Nebraska Driver’s Manual so they can be prepared for any testing that may be required. …

“‘All individuals applying for a Nebraska license or permit, …are required to meet the Department’s minimum medical requirements. …

“‘The information listed below are guidelines on when staff shall issue a Statement of Physician and administer a drive test to applicants.  They are not intended to be all inclusive.  …Loss of Consciousness or Voluntary Control[;] …Vertigo, Dizziness or Fainting Spells[;] Disorientation, Impairment of Memory or Memory Loss[– this requires a Statement of Physician form; ] Epilepsy/Seizure Disorders & Etc.[; and] Loss of or Impairment of Foot/Leg, Upper Body Strength, Range of Motion/Mobility, Hand/Arm[.] …

“‘If a Statement of Physician is required, the applicant must submit a current statement (completed within the last 90 days). …If a doctor marks Only if appropriate tests as determined by DMV are passed to question #1 a written test will be required or to #2, a drive test will be required. When the applicant returns, if the applicant seems to have cognitive problems where staff is concerned that the person may not be able to safely operate a motor vehicle, …[then the staff member] should notate the concerns they have with applicant on history and then contact the home office to request that the person take a written test. The written test will serve as a screening device in these instances before staff administers the drive test.

“‘All Statement of Physician forms must be reviewed by the home office. …Statement of Physician – this statement must be completed by doctors of medicine, doctors of osteopathy, physician assistants, advanced practice nurses and doctors of chiropractic. If the Statement of Physician indicates that the applicant meets minimum medical requirements, …[then] the license document [will be issued]. …If the physician indicates on the Statement of Physician that the applicant should operate a motor vehicle only under certain restrictions, [then] staff may consider this recommendation along with the results of other parts of the examination in deciding whether to issue a license or permit subject to such limitation.”[73]

Licenses must be renewed every five (5) years. However, “seniors” (age 72+) are constrained to in-person renewals.

Department of Motor Vehicles
301 Centennial Mall South
P.O. Box 94789
Lincoln, Nebraska 68509
Email Link
(402) 471-3861

What Does Nevada State Law Say About Driving With Alzheimer’s?

In Nevada, physicians are required to report patients who are suffering from epilepsy. Per Administrative Code 483.280ff, in the state of Nevada: “Medical restrictions or the cancellation of a license due to a medical condition would be at the discretion of a primary care physician with the documentation being provided to the DMV.” The relevant document is termed a “Confidential Physician’s Report” (Form DLD-7).[74]

Nevada Department of Motor Vehicle employees “can recommend that a senior or any person that appears to be suffering from a medical condition while driving be re-tested or medically evaluated and signed off on by a physician.”[75]

“If one or more of the following physical or mental conditions exist and there is documented evidence through medical examinations or reports in addition to appropriate departmental evaluations and examinations which indicate the disorder would severely impair the person’s ability to operate safely a motor vehicle, the Department will not issue or renew the license, permit or privilege. The existence of one of these conditions does not automatically preclude the person from obtaining a license if the condition is not severe enough to impair driving ability:

“…Lapses of consciousness, severe dizziness, fainting spells, head injuries, seizures or any other injuries or ailments resulting in lapses of consciousness, including, without limitation, epilepsy or disorders related to or associated with diabetes. …

“Any physical or mental condition which impairs the ability of the person to operate a motor vehicle safely and which: …Affects perception; …Affects consciousness, including, without limitation, epilepsy; …Alters judgment, including, without limitation, dementia or mental illness; or …Limits motion, including, without limitation, arthritis, paralysis or amputation…”[76]

On renewals: For most drivers, this occurs every four (4) years. However, for “seniors” (age 70+), medical and vision reports must be supplied by a physician.

Nevada Department of Motor Vehicles
555 Wright Way
Carson City, NV 89711
Email Link
(702) 486-4368; (775) 684-4368; (877) 368-7828

What Does New Hampshire State Law Say About Driving With Alzheimer’s?

According to New Hampshire law (Title 21, Chapter 263, section 59) governing driver’s-license License “Suspension and Revocation,” a license can be taken away “…for Incompetency or Improper Driving. …[T]he director may order the suspension of the license of any driver …without a hearing …whenever he has reason to believe that the holder thereof is physically or mentally an improper or incompetent person to drive motor vehicles, or is driving improperly or so as to endanger the public, …or has made a material false statement in his application; and the license shall not be reissued unless, upon examination or investigation, or after hearing, the director determines that the person should again be permitted to drive.”[77]

There is no legal reporting requirement in New Hampshire; though, one may argue that there is an ethical requirement. (Doctors do have legal immunity from repercussions for reporting people.) However, the law allows for restriction / suspension / revocation if a reported driver is found to be incompetent or severely impaired. Family members, law-enforcement officers, physicians (or other healthcare providers) may all report drivers. (Even reports from neighbors may sometimes be acceptable.) A report prompts a medical evaluation or medical hearing. This is all pursuant to New Hampshire state law 263.59.[78] It is possible for a person to be suspended without a hearing (particularly for “incompetency or improper driving” – whether the problem is physical or mental). However, the recommendation from DMV might just call for retesting (eye, knowledge, driving mechanics, etc.).[79]

Licenses renew every five (5) years. “Seniors” (age 75+), though, must renew in-person and must pass a driving test.

Department of Safety
Division of Motor Vehicles: Driver Licensing Office
23 Hazen Drive
Concord, NH 03305
Email
(603) 227-4000

What Does New Jersey State Law Say About Driving With Alzheimer’s?

New Jersey is one of six states that have mandatory physician-reporting laws. In this state, doctors are compelled to disclose “[r]ecurrent convulsive seizures, recurrent periods of unconsciousness, or recurrent impairment or loss of motor coordination due to conditions such as epilepsy.”[Under Construction.[80]] In general, drivers’ licenses must be renewed every four (4) years. However, this may be modified by the New Jersey Motor Vehicle Commission’s “medical review” process.[81]

New Jersey Motor Vehicle Commission
199 E Broadway
Salem, NJ 08079
Website

P.O. Box 160
Trenton, NJ  08666
Email Link
(609) 292-6500; (609) 292-7500 ext. 5032 [Medical Review Unit]

What Does New Mexico State Law Say About Driving With Alzheimer’s?

Driving with Alzheimer’s in New Mexico “…will depend on …[a] doctor’s approval. …[Any afflicted individual] will need to have a medical report …completed[,] and if the doctor …[finds him or] her [too] impaired …to drive[,] then a license will not be issued. This is not MVD’s [Motor Vehicle Division’s] decision.”[82] In a nutshell, the decision about whether to preserve or revoke driving privileges “…is completely based on the medical report from her doctor.” The doctor’s “Medical Report” form is HERE.

“When issuing a driver’s license, the state of New Mexico relies upon applicants to disclose any medical conditions. There are specific questions the answers to which an applicant must attest to their truthfulness.

“Once an applicant has identified a medical condition, depending on what that condition is, the applicant will be asked to complete a medical report form on which a medical professional must attest to the applicant’s ability to safely operate a vehicle. The medical profession has the option of recommending that the applicant not be licensed to drive.  Other options include issuance of a limited term driver’s license.  Certain medical conditions are then referred to a medical review board for review of the applicant’s application.  At that time, the appropriate medical professional can provide guidance on whether or not the MVD should take the recommendation of the applicant’s medical professional.

“The statutory citation for the health standards advisory board can be found at 66-5-6 NMSA 1978.”[83]

In general, driver’s licenses need to be renewed in eight- (8) or four- (4) year intervals. Non-senior drivers may select their preferred interval, based on the fee that that are willing to pay. However, “senior” drivers (75+) must renew every year, beginning at their 75^th birthdays.

Taxation and Revenue Department
Motor Vehicle Division
P.O. Box 1028
1100 South St. Francis Drive
Santa Fe, NM 87504
Email Link
(888) 683-4636; (505) 827-2269

What Does New York State Law Say About Driving With Alzheimer’s?

“There are not specific laws governing these issues, however there are regulatory processes established within the DMV.”[84] In other words, New York state law does not expressly require anything of drivers with diagnoses of Mild Cognitive Impairment (MCI) or Alzheimer’s Disease (or other forms of dementia). However, “motorists should refrain from driving if they are not fit to drive.

“Physicians in New York are not required by law to report drivers with medical conditions to the DMV, but they may voluntarily report drivers. They may report drivers by writing a letter on their own letterhead, or by using the Licensing Agency reporting form DS-6, Physicians Reporting Form.

“Original and renewal permit/license applicants must answer questions about medical conditions when they complete the application. For original transactions for Permit, License or Non-Driver ID Card, they use form MV-44 or for renewal transactions they use ‘Driver License Renewal Application’ form (MV-2L) The applications asks the following questions:

“‘Since you last received a license, have you had, or been treated for, any condition listed below, or has a condition gotten worse?’

“‘Any condition that causes unconsciousness or unawareness including convulsive disorder, epilepsy, fainting or dizzy spells, or heart ailment?’

“If the motorist answers ‘yes’ to [these] question[s], then they and their physician are required to complete a medical form MV80U.1, ‘Medical Statement For Medical Review Unit,’ available from any issuing office or online at dmv.ny.gov.[85] The information provided by the physician must be based on an examination performed within 120 days from the date the form is submitted to the Medical Review Unit. …

“Alzheimer’s affected drivers do not have to surrender their license[s] at a particular diagnostic benchmark[s]. However, if the department receives a medical statement from a physician indicating that the motorist has a medical condition that interferes with the safe operation of a motor vehicle then the license would be suspended until an acceptable medical statement is received and reviewed by the department.

“To our knowledge there is no proposed legislation regarding this topic.”[86]

Incidentally, the New York Department of Motor Vehicles (DMV) “can learn about a medical condition by[:] answers on an Application for Permit, Driver License or Non-Driver ID Card[; a] form (MV-44)[;] an accident report[;] a report from a doctor or a police officer[; or] a report from a member of family of the driver or other citizen[.]”[87]

DMV-requirements may include mandatory evaluations to discover “how your medical condition affects your driving ability …[; requests to] provide medical documentation[; and instructions to] take a vision test, written test or road test[.]”

Possible outcomes include: restriction and suspension of driving privileges. “The DMV has a variety of information regarding the issue on the DMV Website at: https://dmv.ny.gov/driver-license/driver-medical-conditions.”[88]

License renewals in New York occur every eight (8) or five (5) years. However, if a person has a medical restriction, then a medical report may need to be submitted with each renewal attempt.

New York State Department of Motor Vehicles
224-260 S. Pearl Street
Albany, NY 12202
Email Link
(518) 486-9786; (518) 473-5595; (518) 474-0774

What Does North Carolina State Law Say About Driving With Alzheimer’s?

“There is no state law requiring customers to disclose their medical conditions. …We have no pre-defined conditions for surrendering a license. Each case is individual and we evaluate a customer’s driving record and information received from the healthcare provider and/or other concerned citizens. …If the Division is made aware of these conditions, by observation or by report of a physician or other concerned citizen, a road test and/or a medical evaluation may be necessary in order to evaluate fitness to operate a motor vehicle. …The Medical Review Program evaluates customers’ health conditions in order to decrease negative effects said conditions may have on the safety of the customer and others.” “The NCDMV Medical Review Unit follows the operational structure outline by General Statute 20-9.1, which is attached. …[T]he NCDMV Medical Review Unit recommends …[that possibly impaired drivers] to go to a local driver license office when …[they are up for renewal or are] ready to change …[their] license[s.] …[B]ased on the observation of a driver license examiner, [he or] she might be referred to the medical program. [He or s]he can also be referred through a medical provider, family or other concerned citizen in writing. To our knowledge, there is no law requiring a disclosure but while in the local driver license office, an examiner may deem it necessary to generate a medical report form.  There is no benchmark to surrender one’s license unless indicated by a medical provider. Restrictions may be added in order to maintain driving privilege keeping safety in mind. [More i]nformation on the NCDMV Medical Review Program can be found …[HERE.]”[89]

North Carolina’s Division of Motor Vehicles has established a Medical Review Unit that “gathers and evaluates medical information of drivers who have medical conditions that could affect safety on the state’s roads. A staff of licensed physicians and nurses conducts thorough reviews of medical records and statements in conjunction with driving records and provides a decision as to what, if any, restrictions should be placed on a driver’s license. …

“The Medical Review Unit evaluates a driver when there is concern that a medical condition might have an impact on his or her driving ability and safety. These include: Seizures[;] Heart conditions (e.g., irregular heart rhythms, uncontrolled high blood pressure, etc.)[;] Diabetes[;] Sleep disorders[;] Black outs or loss of consciousness[;] Impairment of limbs, back or neck (e.g., stroke, injury, etc.)[;] Cognitive disorders (e.g., stroke, head injury, dementia, etc.)[;] Vision disorders[;] Psychiatric disorders[;] Neurological disorders (Parkinson’s disease, dementia, alcoholic dementia, various neurodegenerative disorders)[; and] Substance abuse disorders[.]

“Not all medical conditions prevent motorists from driving.”[90]

However, when restrictions are instituted, these might include requiring contacts or eyeglasses. Forbidding nighttime driving, or limited distance and speeds. Of course, these limitations presume a certain amount of cognitive function functionality (i.e., the ability to comply with an order, the capacity to remember the restrictions, the reasoning ability to apply adhere to the restrictions in real-life situations). “If you do not comply with the Medical Review Unit’s decision in a timely manner, your driver license will be canceled until you comply.”[91]

Who is allowed to request a medical evaluation? Technically, anyone call request a medical evaluation in the state of North Carolina.[92] However, the most common requests are received from division-of-motor-vehicle workers, family members, law-enforcement officials (via accident or observational reports), and physicians.

Anyone requesting that a driver be medically evaluated by the DMV must fill out and sign the Request for Medical Evaluation form. Anonymous requests are NOT accepted.

Sometimes, periodic reviews are mandated. “The frequency of reviews varies, depending on the medical condition, but in most cases, these updates are as often as every three months or as infrequent as once every three years.”[93] But, there is an appeals process, for people who believe that they have been treated unfairly. For more on these appellate hearings, see HERE.

As usual, drivers are entitled to receive copies of their medical records.

It’s also possible for certain drivers to be eligible for removal from the medical-review program. Obviously, though, this is exceedingly unlikely in cases of dementia, since, once it is properly diagnosed, it signals the inevitable decline of the patient. “Submitting a removal request does not guarantee that a driver will be removed from the Medical Review Program”[94] The removal decision is predicated upon many factors, including the driver’s current medical condition – and removal assumes that said condition is an improvement (again, a highly implausible scenario in cases of Alzheimer’s).

Generally, licenses must be renewed every eight (8) years. But, for “seniors” (age 54+), the renewal period is every five (5) years. One of my sources (see end note #89) was “…not aware of any proposed legislation that would create new requirements.”

Department of Transportation
Division of Motor Vehicles
3114 Mail Service Center
Raleigh, NC 27697
Email Link
(919) 715-7000

Medical Review Program
3112 Mail Service Center
Raleigh, NC 27697
(919) 861-3809

What Does North Dakota State Law Say About Driving With Alzheimer’s?

North Dakota state law prescribes that applicants “need to disclose [any relevant medical] condition on their application [–] as [the application] specifically asks about medical conditions. If the condition is recently diagnosed a medical report would be required. If the examiner notices memory lapses or confusion in their interaction with the individual a medical report and/or retesting may be required.

“There are no specific timeframes or benchmarks [for license surrender]. It is up to the physician’s discretion if they feel it necessary to submit a report to Driver License recommending the individual no longer drive. At that point, we would suspend the license. They may also suggest retesting, which we would then require in that case.”

As far as is known, there is no pending legislation that would meaningfully alter this process. However, as always, “[f]or [more] comprehensive answers to these questions, …the source should be an attorney.”

Still: “This is what is in century code: ‘Medical Qualifications for All Drivers (North Dakota Century Code 39-06-03) A person does not qualify for driving privileges if that person has had: 1. Convulsions, seizures, blackouts or fainting spells (must be episode free for 6 months for full privileges; must be episode free for 3 months for restricted privileges); 2. A mental illness that has not been restored to competency for the safe operation of a motor vehicle; 3. Habitual use of alcohol or narcotic drugs that would affect the safe operation of a motor vehicle; 4. Loss of use of a hand, arm, foot, or leg that would affect the safe operation of a motor vehicle.”[95]

In North Dakota, licenses must be renewed every four (4) years.

Department of Transportation
Driver License Division
608 East Boulevard Ave.
Bismarck, ND  58505
Email Link
(701) 328-2600; (701) 328-2500

What Does Ohio State Law Say About Driving With Alzheimer’s?

Ohio drivers are “required[96] to disclose [any] medical …conditions that may impair their ability to operator a motor vehicle safely.  The driver may disclose this information in response to the status questions when applying for an Ohio driver license.

“Upon disclosure of the medical condition or conditions, the Ohio [Bureau of Motor Vehicles] BMV exam station will provide a BMV 2310 Statement of Physician for the driver to complete and present to the physician for completion and return to the exam station to complete the application for an Ohio driver license.

“Any concerns for driving with any medical condition, including Alzheimer’s, will be in the hands of the attending physician who will decide and mark the BMV 2310 Statement of Physician appropriately to allow or disallow the patient to drive.

“Currently, the Ohio BMV does not require a re-test upon disclosure of any medical condition.  The attending physician may request retest on the BMV 2310 Statement of Physician and the BMV will follow the recommendations of the physician.  If a physician would like to inform the BMV of a driver’s driving ability, they are able to send in a letter of concern on their office letterhead.  Once the BMV receives that letter, a case will be created and a BMV 2310 Statement of Physician form will be mailed to the driver’s address to be completed by their physician.”[97]

According to the Ohio BMV’s website,[98] medically (or specifically visually) afflicted drivers may be issued a “two-part license.” Basically, this is a traditional driver’s license (“part 1”) in conjunction with “[a] medical restriction card indicating the driver’s requirements that must be carried with the license.”

“There are several codes in the Ohio Revised Code (O.R.C.) and the Ohio Administrative Code (O.A.C) that pertain to licensing in Ohio for those who may suffer from a condition that may impair their ability to safely operate a motor vehicle.  The one that I usually guide customers to is the following …

“4507.20 Examination of licensee’s competency. The registrar of motor vehicles, when the registrar has good cause to believe that the holder of a driver’s or commercial driver’s license is incompetent or otherwise not qualified to be licensed, shall send a written notice to the licensee’s last known address, requiring the licensee to submit to a driver’s license examination, a physical examination, or both, or a commercial driver’s license examination within the time indicated on the notice. The physical examination may be conducted by any individual authorized by the Revised Code to do so, including a physician assistant, a clinical nurse specialist, a certified nurse practitioner, or a certified nurse-midwife. Any written documentation of the physical examination shall be completed by the individual who conducted the examination.

“Upon the conclusion of the examination, the registrar may suspend the license of the person, may permit the licensee to retain the license, or may issue the licensee a restricted license. Refusal or neglect of the licensee to submit to the examination is ground for suspension of the licensee’s license.

“A physician licensed under Chapter 4731. of the Revised Code may submit a report to the registrar stating that in the physician’s professional opinion the holder of a driver’s or commercial driver’s license may be incompetent or otherwise not qualified to operate safely a motor vehicle due to medical reasons. Any such report submitted to the registrar is confidential, is not a public record, and is not subject to disclosure under section 149.43 of the Revised Code.”[99]

In general, license renewals occur every four (4) years. If the Bureau of Motor Vehicles has received a report (from a court, family member, law enforcement officer, medical doctor, neighbor, or other concerned citizen) that a particular driver might be unsafe, then the BMV can levy additional requirements.

Bureau of Motor Vehicles
P.O. Box 16520
Columbus, Ohio 43216-6520
Email link
(844) 644-6268; (614) 752-4464 [Medical Division]

What Does Oklahoma State Law Say About Driving With Alzheimer’s?

According to “…Oklahoma Administrative Code 595:10-5-1 et al., and 47 O.S. Sections 6-207 and 6-119[, if you] know someone who shouldn’t be driving because of health reasons[,] …[y]ou will …need to complete [and sign] a Request For Driver Review form.[100] This will permit us to conduct an investigation concerning the driver’s driving and health issues. Please see the bottom of the form for the mailing address and make sure to mark the envelope ‘Attention Medical Desk.’ …

“The Department CANNOT guarantee that the person submitting the Request for Driver Review form will remain anonymous throughout any review process which may be initiated by the Department as a result of a request for driver review. …”[101]

The Department has a set of rules or regulations called the ‘Medical Aspects of Driver Licensing’ …” that govern the DMV-run “Medical Advisory Board.” For purposes of this article, the most relevant conditions that concern the Medical Advisory Board include: “…Disorientation[;] …Any Condition which would cause Loss of Control/ Partial Control of a Motor Vehicle[;] Impaired Balance Recovery[;] Neurological Disorders[;] Behavioral Changes[;] Impaired Reflexes[;] …Lapses of Attention[;] Parkinson’s Disease[;] Cerebral Palsy[;] Mental [Dis-]Ability[;] Progressive Neuromuscular Disorders[;] Mental Confusion[;] Senility[;] …Multiple Sclerosis[; and] Visual Problems.”[102]

Synopsis: “The law requiring the Department to review a licensee with a progressive medical condition would be cited in state law at: The ‘Medical Aspects of Driver Licensing,’ specifically Oklahoma Administrative Code 595:10-5-1 et al., and 47 O.S. Sections 6-207 and 6-119. Once a request for driving review (…form), is made to the Department the licensee will be required to undergo a medical evaluation. If the license is competent to safely operate based on the recommendations of the primary care physician and has successfully completed a driver review/examination[, then] they would be allowed to maintain driving privileges. As time marches on[,] and the condition worsens[,] there would be ongoing periodic medical examinations to determine what type of restrictions are necessary to allow the licensee to keep the driving privilege until they are no longer medically able to meet the minimum medical standard. Each case will vary depending on the overall medical condition and comorbidities and the Departmental review is based on those factors.”[103]

“The Oklahoma Administrative Code of Medical Aspects is a reference in dealing with a driver that has a compromised or chronic medical condition. …[The aforementioned] request for action form …would be available in the event the family wanted to open a medical file to begin the testing process. A specific reference to address the issues …[of dementia] have mentioned would be: OAC:595:10-5-13. Requests for review of driving ability [have to do with the following:]

“‘(a) Behavior indices. A person licensed to drive in this state coming to the attention of the Department because the person has developed disorientation, mental confusion, senility, lapses of attention, behavioral changes, impaired reflexes, impaired balance recovery, or orthostatic hypotension, or has developed any condition which would cause loss of control or partial control of a motor vehicle, shall be reviewed.

“‘(b) Evaluation. When the Department has good cause to believe the person may be afflicted with any physical or mental ailment, or when the person’s driving record indicates the person may be a hazard to public safety, the person may be required to submit to a physical examination, mental examination, and/or be examined as provided by Oklahoma Statutes. [47 O.S. § 6-110 and 6-119]’

“Once a request for a driver review has been submitted the driver will be requested to appear for an informal interview to speak with a Driver Compliance Hearing Officer. The Hearing Officer will make an initial assessment and a recommendation to have a medical evaluation by a physician that is most familiar with the medical condition to provide the assessment [–] …[i]f deemed necessary[,] either now or at a later time[,] to require a review driver examination. Each case is evaluated on its own merits and the Department has a Medical Doctor on staff to review medical cases that are comprehensive in nature, throughout each step of the review process the driver is given clear instructions to make the review process as easily understandable as possible for the driver as well as the family.”[104]

Licenses must be renewed every four (4) years. “Seniors” have waived (age 65+) or reduced (62+) renewal fees.

Department of Public Safety
Driver Compliance Division – Medical Desk
P.O. Box 11415
Oklahoma City, OK 73136

Department of Public Safety
3600 N. Martin Luther King Avenue
Oklahoma City, Oklahoma 73111
Email Link ; Email Link
(405) 425-2083; (405) 425-2059; (405) 425-2424

What Does Oregon State Law Say About Driving With Alzheimer’s?

Oregon has a mandatory-reporting law. Physicians must report any patients who are suffering from “[l]oss of consciousness or control.” “While …[Oregon has] no compulsory age-based or diagnosis-based mandatory actions for driving privileges, we do have a medically at-risk driver program [and HERE] that is based on how a person is affected by conditions or impairments that affect driving ability. Drivers come into our at-risk program through mandatory and non-mandatory referrals primarily from doctors, law enforcement, and family members.  However, DMV employees may also refer customers into the program if they see something that concerns them.

“After referral into the program, our Driver Safety Unit and our Medical Determination Officers (MDOs) review each individual case to determine whether a driver needs to provide medical information regarding the status of their condition or successfully pass all DMV tests to demonstrate they can safely operate a motor vehicle.

“If a driver is unable to establish medical clearance or pass tests after being required to do so by our MDOs, the driving privileges are denied, suspended, or cancelled.  As an alternative to having a license denied, suspended, or cancelled, a driver can voluntarily surrender their driving privileges.

“Nearly every legislative session, some attempt is made by a few legislators to make changes to our current program.  While I’m not aware of anything yet planned for next session in 2019, there certainly could be a bill introduced.”[105]

Under Oregon Administrative Rules 735-074-0090 and 735-074-0120, “Severe and Uncontrollable Impairments …must be Reported to DMV[.]” These include various physical enfeeblements and conditions, but also: “(3) Cognitive impairments affecting the following areas: (a) Attention, including but not limited to: (A) Decreased awareness; (B) Reduction in the ability to efficiently switch attention between multiple objects; or (C) Reduced processing speed. (b) Judgment and problem solving, including but not limited to: (A) Reduced processing speed; (B) An inability to understand a cause and effect relationship; or (C) A deficit in decision making ability. (c) Reaction time, including but not limited to a delayed reaction time. (d) Planning and sequencing, including but not limited to: (A) A deficit in the ability to anticipate or react to changes in the environment; or (B) Problems with sequencing activities. (e) Impulsivity, including but not limited to: (A) Lack of emotional control; or (B) Lack of decision making skills. (f) Visuospatial, including but not limited to problems determining spatial relationships. (g) Memory, including but not limited to: (A) Problems with confusion or memory loss; or (B) A decreased working memory capacity. (h) Loss of consciousness or control.”[106]

Licenses renew every eight (8) years. Vision tests are required each renewal for drivers age 50+.

Oregon Department of Transportation
Driver and Motor Vehicle Services Division
1905 Lana Ave NE
Salem, OR  97314
Email Link
(503) 945-5000

What Does Pennsylvania State Law Say About Driving With Alzheimer’s?

Pennsylvania is a state that has mandatory physician reporting. Doctors must report patients who have “[l]apses of consciousness or other mental or physical disabilities affecting …their abilities …to drive safely.” “According to Section 1518 of the Pennsylvania Vehicle Code[107] all health care personnel, i.e. all physicians, podiatrists, chiropractors, physician assistants, certified registered nurse practitioners and other persons authorized to diagnose or treat disorders and disabilities defined by PennDOT’s Medical Advisory Board, must report [e.g., HERE or HERE – Ed.] to PennDOT within 10 days, in writing, the full name, address, and date of birth of any patient 15 years of age or older, who has been diagnosed as having a condition that could impair his or her ability to safely operate a motor vehicle. However, reports[108] are not required if the condition is expected to last less than 90 days; for example, a broken leg would not need to be reported to PennDOT.”[109]

Per Pennsylvania Code (Title 67, Chapter 82 and Title 67, Chapter 83) The Pennsylvania Department of Transportation (PennDOT) “has a Medical Advisory Board that is responsible for the formulation of physical and mental criteria, including vision standards, for the licensing of drivers. The board consists of a neurologist, a cardiologist, an internist, a general practitioner, an ophthalmologist, a psychiatrist, an orthopedic surgeon, an optometrist, and members from PennDOT, General Counsel, Department of Health and the Pennsylvania State Police. …”

The board is concerned with both physical (e.g., arthritic conditions, cardiovascular and heart troubles, diabetes, hearing difficulties, joint and mobility impairments, seizure disorders, vision problems, and so on) as well as mental factors. For present purposes, this is the most relevant category and includes: “Cognitive Impairments. Inattentiveness to the task of driving because of, for example, preoccupation, hallucination or delusion. Contemplation of suicide, as may be present in acute or chronic depression or in other disorders. Excessive aggressiveness or disregard for the safety of self or others or both, presenting a clear and present danger.”[110]

Finally: “If at some point …[a driver] does surrender [his or] her driver’s license, you can obtain a PA Photo ID for [him or] her free of charge with the surrender of her license.”[111] See HERE.

Generally, drivers’ licenses must be renewed every four (4) years. “Seniors” (age 65+) may renew every two (2). Additionally, randomly selected drivers (age 45+) are required to submit medical and vision documentation at the time of renewal.

Pennsylvania Department of Transportation
Driver and Vehicle Services
1101 South Front St.
Harrisburg, PA 17104
Email Link
(717) 412-5300; (800) 932-4600 [Customer Care Center]

Pennsylvania Department of Transportation
Bureau of Driver Licensing
P.O. Box 68682
Harrisburg, PA 17106
(717) 787-9662

What Does Rhode Island State Law Say About Driving With Alzheimer’s?

In general, a department of motor vehicle “reexamination” occurs when a driver is reported to the relevant governmental body by a concerned citizen.[112] Usually, reporting persons are doctors or medical personnel, immediate family members, or law-enforcement officials. If the DMV deems the report credible, then the reported individual will undergo an interview process and, in all likelihood, driver’s license retesting.[113]

Rhode Island has instituted a Medical Advisory Board, “in accordance with Chapter 31-10-44 of the Rhode Island General Laws. …When a person’s physical and mental fitness to operate a motor vehicle is called into question, the Administrator may consult relevant specialists who are members of the Medical Advisory Board in order to determine a person’s qualifications to operate a motor vehicle.”[114]

One government representative writes that she is “unaware of specific existing or pending laws however I am forwarding what I was able to find on RI DMV site.  For questions about the actual laws you may want to contact The DMV directly.”[115]

General license renewal every five (5) years. But, it’s every two (2) years for “seniors” (age 68+).

Department of Revenue
Division of Motor Vehicles
600 New London Avenue
Cranston, RI 02920
Email Link
(401) 462-4368

What Does South Carolina State Law Say About Driving With Alzheimer’s?

“‘Must MCI diagnosed drivers disclose their conditions?’ – When drivers apply (or reapply) for a driver’s license in South Carolina they complete …a Form 447-NC …This form asks several questions [on page 2] about physical fitness to continue driving (see questions 7-12).  These questions must be answered honestly, as the answers are given under penalty of perjury, i.e. the person can be criminally prosecuted for perjury if they lie on this form.[116]  Having said that, in between issuance of a driver’s license and/or reissuance of a driver’s license, the driver has no statutory requirement to notify SCDMV if they develop a permanent or temporary medical condition that makes them unsafe to drive.  Please note that just because there may not be a statutory requirement to notify SCDMV of such a change, the person could still be found civilly liable if they drive when they suffer from a medical condition that makes them unsafe to drive and cause some sort of collision or other injury to another person.

“‘Must MCI-diagnosed drivers be re-tested for licensing’ – Possibly.  If SCDMV is notified by a law enforcement officer or medical professional that a person should be retested or may have a medical condition that impairs their ability to drive safely, then SCDMV may require that person to submit to the skills test again (the driving portion of the test).  Additionally, if a person is present in an SCDMV office and an SCDMV staff member has reason to believe that person may suffer from a medical condition that impairs the person’s ability to drive safely, then SCDMV field office staff may also initiate a skills test for that person.  Additionally, in general, anytime a driver’s license or privilege to drive is suspended, revoked, or cancelled (or expired for more than 9 months), then the person must undergo both the knowledge and skills tests (written & driving tests).

“‘Must MCI-diagnosed drivers submit to medical evaluation’ – Possibly.  If SCDMV is notified by a medical professional that a person may be unsafe to drive due to a medical condition, then SCDMV can require that person to submit to a medical evaluation.  Additionally, if a person is retested (as described above) and SCDMV staff note the person engages in maneuvers that are unsafe during the skills test, then SCDMV can require that person to submit to a medical evaluation.

“Also, please be aware that any person that is involved in 4 or more collisions within a 2-year period (whether they are found at fault for the collision or not) may also be required to submit to a skills retest and/or a medical evaluation.

“Do Alzheimer’s-afflicted drivers have to surrender their licenses at particular diagnostic benchmarks? Etc. No.

“Is there (to your knowledge) any proposed legislation that would create new requirements? No.”[117]

Additionally, most drivers have the option to renew licenses for periods of ten (10) or five (5) years, depending upon fees selected. However, “seniors” (age 65+) have to renew every five (5) years, and their renewals must be in person – not online or via postal mail.

Department of Motor Vehicles
P.O. Box 1498
Blythewood, SC 29016
Email ; Email Link
(803) 896-5000

What Does South Dakota State Law Say About Driving With Alzheimer’s?

“Driver’s Licensing requirements and licensing is under the direction of the South Dakota Department of Public Safety.”[118] “There are no specific South Dakota statutes regulating drivers with MCI or Alzheimer’s. The re-evaluation of drivers or cancellation of a license is based on requests from doctors, law enforcement, family or the general public.”[119]

To put it another way: “Nothing in South Dakota Codified Law specifically addresses MCI or Alzheimer’s. An individual with these impairments is not required to surrender their license. There are no specific statutes that …can [be] cite[d] …and there is no proposed legislation on these topics.

“If …[a person] will be transferring an out of state driver’s license, it is up to the South Dakota driver license examiner who will be helping her. If he detects any impairment at the counter, …[then the prospective licensee] will be asked to go through a series of cognitive tests. The examiner also has the discretion to take …[the applicant] on a drive test if he deems it is necessary.

“Any physician, family member, or law enforcement may request the re-evaluation of an individual’s driving skills. If this office receives a request for evaluation, the individual is required to submit a medical statement and vision statement. Provided the submitted statements are satisfactory, a knowledge test, interview, and drive test will be administered. I have attached the evaluation request form if you are interested.”[120]

“In South Dakota, mandatory reporting is not required regarding those who are believed to no longer have the ability to drive safely. However, it is highly encouraged that medical professionals voluntarily submit a Medical Statement [Driver Medical Evaluation – Ed.][121] detailing any medical issues that may interfere with safe driving… Alternatively, a medical professional, family member or member of law enforcement may submit a Driver Evaluation Request to the Driver Licensing Program if they are concerned about a person’s ability to safely operate a motor vehicle and would like to have his or her driving skills re-evaluated by a Driver Licensing examiner. …The medical information contained in the reports required by Driver Licensing is confidential and shall only be used to determine the ability of a person to safely operate a motor vehicle, and for taking any action deemed necessary by Driver Licensing.”[122]

Drivers’ licenses in South Dakota must be renewed every five (5) years. For general information on licensing drivers in South Dakota, see HERE.

Department of Public Safety
Driver Licensing
118 West Capitol Ave.
Pierre, SD  57501
Email Link
(605) 773-3178 [main]; (605) 773-6883 [licensing]

What Does Tennessee State Law Say About Driving With Alzheimer’s?

Tennessee “does not [appear to] have a statute that requires that individuals with [Mild Cognitive Impairment or Alzheimer’s to] disclose that fact to the TN DMV.”[123] However, “T.C.A. §55-50-505 (2)(b) The department may, upon receiving evidence sufficient to establish that a licensed driver is incompetent or otherwise not qualified to be licensed, upon written notice of at least twenty (20) days to the licensee, require the driver to submit to a driver license examination and/or submit any other information deemed appropriate by the commissioner. The department shall take action as may be appropriate and may suspend the license of the person or permit the driver to retain the license, or may issue a license subject to restrictions as permitted under § 55-50-331(d) and (e). Refusal or neglect of the licensee to submit to the examination shall be grounds for suspension of the driver license.”[124]

“When the Department receives information about the ability of a driver to safely operate a motor vehicle, that driver shall be sent notice stating that the Department received information regarding his/her ability to safely operate a motor vehicle. The notice shall state the driver’s driving privileges may be suspended. …The Department shall provide the medical report forms to the driver to be completed by the appropriate licensed medical professional.

“In all cases where medical reports are needed, the complaint/data must first be reviewed by the Department. Drivers who may be physically or mentally unfit to operate a motor vehicle upon the streets or highways of Tennessee may be identified in the following manner, and the review process invoked: 1. A written complaint from law enforcement or driver license examiner; 2. Data contained in a crash report; 3. Data provided by any reliable individual or person within the medical profession as determined by the Department obtained through the receipt of a signed letter by that individual; 4. Drivers previously suspended and requesting a re-evaluation of their record due to a purported change in the status of mental or physical health; 5. Data obtained from courts, private citizens, newspaper stories, or information that would appear to be reliably obtained through other sources; 6. Information from a person who has witnessed the driver’s inability to drive because of a seizure or other condition through the receipt of a signed letter from that person; or 7. Information from friends or relatives who know the driver’s condition who submit information that a driver has a condition through the receipt of a signed letter.

“The medical report forms must be completed by a licensed physician, physician assistant, or nurse practitioner (herein referred to as licensed medical professional) and should contain sufficient information regarding the driver’s medical condition to enable the Department to determine whether the driver should be permitted to retain or obtain driving privileges. …The Department may use independent medical review boards to review and make recommendations if a driver is reported to have a mental or physical condition. …

The medical report forms completed by the licensed medical professional will be reviewed and one or more of the following actions shall take place: 1. If the licensed medical professional documents that the driver does not have a medical problem relating to the operation of a motor vehicle, the case may be closed. …2. If the licensed medical professional determines that the person should not be allowed to drive because of a medical condition, the driver shall have his/her driving privileges suspended. …3. The medical review board may recommend that the case be closed or it may recommend the suspension of the driver’s driving privileges and state the conditions for the suspension. …”[125]

“The Department may use independent medical review boards to review and make recommendations if a driver is reported to have a mental or physical condition. The review boards will consist of licensed physicians in fields of specialized or general medicine. Physicians may serve on the medical review board in a voluntary capacity, or they may be paid by the Department if the Department deems such payment appropriate. The recommendations of the medical review board shall not be binding upon the Department.”[126]

“If you have been diagnosed with dementia or Alzheimer’s disease but are in the early stages, you may not need to stop driving immediately. A comprehensive evaluation can determine whether you can continue to drive safely for the time being – and can help you make plans for a time in the future when you will not be able to drive. …Because dementia affects each person differently, a comprehensive driving evaluation can be an objective indicator of whether your loved one currently is safe to continue driving.”[127]

Additionally: “Tennessee does not really have any regulations based on age alone (for senior drivers).   There are driving programs for seniors offered through AAA that might be helpful. Tennessee does require drivers to drive safely and if someone is unable to do that, then it may be time for that individual to stop driving.   The ability to drive a vehicle on a public highway or road is a privilege that can be revoked by the state.

“TCA 55-50-303(4) mentions that a license shall not be issued to: ‘(4) To any person who has previously been adjudged to be afflicted with or suffering from any mental disability or disease and who has not at the time of application been restored to competency by the methods provided by law…’.”[128]

Finally, license renewal must occur every five (5) years. However, “senior” drivers (age 60+) may have reduced renewal rates, if they elect a non-photo license.

Tennessee Department of Safety
P.O. Box 945
Nashville, TN 37202
Email

Tennessee Department of Safety and Homeland Security
Driver License Services
William R. Snodgrass Building, 3rd Floor
312 Rosa Parks Ave.
Nashville, TN 37243
Online Services
(615) 253-2062; (615) 251-5235

What Does Texas State Law Say About Driving With Alzheimer’s?

Texas “State law does not require drivers with diagnoses of MCI or Alzheimer’s disclose their conditions. It may be to …[a person’s] advantage to disclose this to DPS when [he or] she goes in for [his or] her license. [However,] Texas is a voluntary reporting state so it is not required that something be reported.

“[Whether a driver has to surrender his or her license at a particular diagnostic benchmarks] …would depend on how severe the diagnosis is on the Alzheimer’s. …

“There is no statute that governs these requirements just a guide for driving that the board doctors use.

“…All of our cases come from DPS [the Department of Public Safety] so once …[a person] report[s] the MCI [or Alzheimer’s] to DPS they will send the case over to …[the Department of State Health Services].”[129]

Possibly unsafe drivers may be reported by family, medical personnel, and police officers by writing (in print or electronically), to: Texas Department of Public Safety: Enforcement and Compliance Service, P.O. Box 4087, Austin, TX 78773, (512) 424-5311 [Fax]. The driver’s license application is available HERE.

“We then send out a letter telling the customer where to find the form to take to their doctor to get filled out. Once the paperwork comes back it goes to the board and the three board doctors give a recommendation back to DPS. They make the final decision.[130]

“As far as I know there is no proposed legislation that would create new requirements.”[131]

According to the Texas Transportation Code 521.274 and 521.2711: Licenses come up for renewal every six (6) years in Texas. However, for “seniors” (85+), they must be renewed every two (2) years. Per the Texas Transportation Code §§521.1425(a), 521.142(e): “In addition to the regular driver license renewal requirements, if you are 79 years of age or older you will be required to renew your driver license in-person at your local driver license office. During your renewal: (1) You will be required to successfully pass a vision test, and (2) A driver license office representative (CSR) will evaluate your responses provided at the time of your renewal regarding your medical history to determine if any additional testing is required.”[132]

Licenses must be renewed every six (6) years. However, “seniors” (age 85+) must renew in person every two (2) years. They may not renew via mail or online.

Department of Public Safety
Texas Department of Motor Vehicles
4000 Jackson Avenue
Austin, Texas 78731
Email Link; Email Link
(512) 424-2600; (512) 465-3000; (888) 368-4689

Department of Public Safety
Enforcement and Compliance Service
P.O. Box 4087
Austin, TX 78773
Email; Email

Texas Department of State Health Services
Medical Advisory Board (MC 2835)
P.O. Box 149347
Austin, Texas 78714
Email
(512) 834-6738; (512) 834-6739

What Does Utah State Law Say About Driving With Alzheimer’s?

Utah Code 53-3-303.5[133] governs the “Medical Advisory Board and medical standards…”.[134] Briefly summarized, the guidelines[135] are as follows.

Driver’s-license applicants are asked questions about their medical condition and history. Some of the categories of medical condition with which the Driver’s License Division (DLD) is especially concerned include “Category D – Neurologic” and “Category F – Learning and Memory.”[136] For example, according to paragraph 8 of the description for Category F: “Alzheimer’s dementia and other dementia results in progressively impaired cognitive function and may require frequent review of driving abilities.”[137]

A driver who discloses his or her own dementia, would therefore be subject to additional DLD scrutiny, beyond the standard driving and written tests. At that point, “…further information may need to be collected from …[the relevant driver’s] healthcare provider. The Driver License Division collects this information by sending the Functional Ability Evaluation [Medical Report] form, or the [Certificate of] Visual Examination form… [The afflicted driver, or his or her caretaker,] will need to take these forms to …[the appropriate] healthcare provider, who will profile the category for the condition indicated. Based upon a completed Functional Ability Evaluation/Visual Examination, the Driver License Division may issue a license with or without limitations.”[138] In some cases, suspension or revocation may be warranted.

A more complete picture may be gleaned from the pamphlet, available online, titled Functional Ability in Driving: Guidelines and Standards for Health-Care Professionals.[139]

Utah’s driver’s-license application is viewable HERE. Licenses must be renewed every five (5) years.[140] “Senior” drivers (age 64½+) are required to present evidence of adequate vision.

Family members and other concerned parties may alert the Driver’s License Division to possibly unsafe drivers by submitting a REPORT.

Note: Utah “…Adult Protective Services refer questions pertaining to a family member’s ability to drive to either their physician or to the Utah Department of Public Safety, Driver’s License Division.”[141]

Utah Department of Public Safety
Driver License Division
P.O. Box 144501
Salt Lake City, Utah 84114
Email Link
(801) 965-4437

What Does Vermont State Law Say About Driving With Alzheimer’s?

“What typically happens is Vermont DMV receives a note/letter from a doctor, police officer or concerned family member or friend and then the person will have to retest meaning do a road test if the person doesn’t pass then they get rescheduled for another appointment but if they do then they get their license.

“Here is the medical condition question[142] on our VT driver’s license form: ‘Do you have a history of a physical or mental condition including diabetes, epilepsy, seizures or blackouts (other than properly corrected eyesight) that could affect your ability to safely operate a motor vehicle? If ‘Yes’ indicate condition(s)/medication(s)…’”[143]

“This question is asked at each license renewal.  If [a driver] answers this question as ‘no,’ we will issue a license. We do not retest unless it is requested by the doctor, law enforcement, and/or family member or friend, however each notification would grant your grandmother rights to a hearing to disclose the reporter and dispute the issue.

“We currently have no statutes for a law of disclosure.  Should there be a medical issue with a driver after the issuance, the state refers to the driver’s disclosure of ‘no’ to the above question.”[144]

Drivers’ licenses must be renewed every four (4) years.

Vermont Agency of Transportation
Department of Motor Vehicles
120 State St.
Montpelier, VT 05603
Website
Email Link
(802) 828-2000; (888) 998-3766

What Does Virginia State Law Say About Driving With Alzheimer’s?

“If you have a mental or physical condition that may impair your ability to safely operate a motor vehicle, even temporarily, you must provide DMV with a medical statement from your physician, physician’s assistant, or nurse practitioner. Some of these conditions include: …Impairment of judgment [and] Loss of motor functions[.] … DMV will evaluate the medical information to determine if a driver’s license may be issued or restricted.”[145]

The review process typically requires the submission of a “Customer Medical Report” (MED 2) from your physician or other medical practitioner. Depending on the overall health picture, it may also be necessary to submit a “Customer Vision Report” (MED 4). Additionally, Virginia maintains a list of what they term “Driver Rehabilitation Specialists.”

As with most states, the general process for licensing is to fill out a renewal application. If the individual discloses a medical impairment, then he or she will have to be evaluated. If the individual does not disclose any impairment, then – provided that the person can pass the driving-knowledge and road-skills tests – a license will be (re-)issued.

Medical reviewers can require re-testing as well as periodic reporting. Outcomes of the medical-review process include: license suspension or revocation, restriction of privileges, or unconditional renewal.

According to Virginia law, Code of Virginia § 46.2-322: “Examination of licensee believed incompetent; suspension or restriction of license; license application to include questions as to physical or mental conditions of applicant; false answers; examination of applicant; physicians, nurse practitioners, or physician assistant’s statement.

“A. If the Department has good cause to believe that a driver is incapacitated and therefore unable to drive a motor vehicle safely, after written notice of at least 15 days to the person, it may require him to submit to an examination to determine his fitness to drive a motor vehicle. If the driver so requests in writing, the Department shall give the Department’s reasons for the examination, including the identity of all persons who have supplied information to the Department regarding the driver’s fitness to drive a motor vehicle. However, the Department shall not supply the reasons or information if its source is a relative of the driver or a physician, physician assistant, nurse practitioner, pharmacist, or other licensed medical professional as defined in § 38.2-602 treating, or prescribing medications for, the driver.

“B. As a part of its examination, the Department may require a physical examination by a licensed physician, licensed nurse practitioner, or licensed physician assistant and a report on the results thereof. When it has completed its examination, the Department shall take whatever action may be appropriate and may suspend the license or privilege to drive a motor vehicle in the Commonwealth of the person or permit him to retain his license or privilege to drive a motor vehicle in the Commonwealth, or may issue a license subject to the restrictions authorized by § 46.2-329. Refusal or neglect of the person to submit to the examination or comply with restrictions imposed by the Department shall be grounds for suspension of his license or privilege to drive a motor vehicle in the Commonwealth.

“C. The Commissioner shall include, as a part of the application for an original driver’s license, or renewal thereof, questions as to the existence of physical or mental conditions that impair the ability of the applicant to drive a motor vehicle safely. Any person knowingly giving a false answer to any such question shall be guilty of a Class 2 misdemeanor. If the answer to any such question indicates the existence of such condition, the Commissioner shall require an examination of the applicant by a licensed physician, licensed physician assistant, or licensed nurse practitioner as a prerequisite to the issuance of the driver’s license. The report of the examination shall contain a statement that, in the opinion of the physician, physician assistant, or nurse practitioner, the applicant’s physical or mental condition at the time of the examination does or does not preclude his safe driving of motor vehicles.

And, again, § 46.2-315: “Disabled persons. The Department shall not issue a driver’s license to any person when, in the opinion of the Department, the person is suffering from a physical or mental disability or disease which will prevent his exercising reasonable and ordinary control over a motor vehicle while driving it on the highways, nor shall a license be issued to any person who is unable to understand highway warning or direction signs.

“The words ‘disability or disease’ shall not mean inability of a person to hear or to speak, or both, when he has good vision and can satisfactorily demonstrate his ability to drive a motor vehicle and has sufficient knowledge of traffic rules and regulations.”[146]

As far as license renewal goes: the usual period is every eight (8) years. “Seniors” (age 80+) must submit to a vision test for each renewal.

Virginia Department of Motor Vehicles
P.O. Box 27412
Richmond, VA 23269
Email Link
(804) 497-7100

What Does Washington (State) Law Say About Driving With Alzheimer’s?

“In Washington state we are very serious about the safety of the drivers on the road[.]”[147] That said, it turns out: “There is nothing currently regarding Alzheimer’s specifically regarding driving privileges.  …

“However, when persons are applying for a driver license they are asked if they have any physical or mental condition or are taking any medications that would impair their driving abilities.  If they answer ‘yes,’ they are required to submit a Physical Examination Report.

“Also, if our department has reason to believe that a person is suffering from a physical or mental disability or disease that may affect that person’s ability to drive a motor vehicle, the department must evaluate whether the person is able to safely drive a motor vehicle per RCW 46.20.041.[148]

“In addition[,] healthcare providers, law enforcement or individuals are able to report unsafe drivers by submitting a Driver Evaluation request.”[149]

Fundamentally, “Washington state rel[ies] on an individual’s doctor to let us know if a driver is able to drive safely or not. They [i.e., the doctors] perform specific test’s on patients with MCI or Alzheimer’s and send those evaluations to us.”[150]

Alzheimer’s-afflicted drivers do not have to surrender their licenses at particular diagnostic benchmarks. Whether said drivers may retain driving privileges follows “what the doctor recommends.”

In terms of license renewal, the standard period is every five (5) years. “Senior” drivers (age 65+) must renew in person, as opposed to by postal service or the state website.

Driver Services
Department of Licensing
P.O. Box 9030
Olympia, WA 98507-9030
Email [main]; Email [online services help]; Email [hearings]
(360) 902-3900 [main]; (360) 570-4950 [hearings]; (360) 570-7893 [medical forms]

What Does Washington D.C. Law Say About Driving With Alzheimer’s?

“While there is no statute or regulation pertaining specifically to MCI or Alzheimer’s Disease, the director has the authority to deny a credential to drive pursuant to DC Official Code Section 50-1401.01(a)(1) in order to protect the public. In addition, if applicable, at age seventy or over, an individual must furnish a statement from a licensed medical practitioner that the person has been found to be physically and mentally competent to operate a motor vehicle before a credential will be issued or renewed.

“The DMV does have a confidential online medical referral process though which law enforcement, medical practitioner and concerned relatives can report drivers who they think are no longer able to safely operate a motor vehicle due to a medical condition. If the referral is not from a medical practitioner, once the DMV confirms the validity of the referral, it will send the driver a Medical/Eye Report and require that the form be completed by a medical practitioner and returned to the DMV.  If the driver fails to return the form timely, or the medical practitioner does not sign off on their ability to drive, the DMV will revoke their license. If the medical practitioner believes there should be limitations on the driving, then generally those limitations will be followed.

“There is no pending legislation that would impose new requirements on drivers with dementia or Alzheimer’s.”[151]

“If you have a medical condition that may impair your ability to safely operate a motor vehicle, even temporarily, you must provide DC DMV a Medical/Eye Report form that has been completed by your physician. …Alzheimer’s Disease [r]equires a Medical Report and the completion of the knowledge and road skills tests[.] …

“DC DMV also requires you to submit a Medical Report when a law enforcement officer suspects you may have a medical condition that led to a traffic citation or accident. If DC DMV receives a detailed, written statement from a family member, law enforcement officer, or physician related to the unsafe driving of a District resident, we will require that resident to complete a Medical Report. Driving tests may also be required in any of these situations, depending on the circumstances.

“DC DMV will use the medical information provided by your physician to determine if a driver license may be issued or issued with restrictions. We may also issue a driver license that will be valid for less time, based on your physician’s information. Also, if your doctor recommends follow-up Medical/ Eye Reports, we will track this information to ensure compliance. If we do not receive the follow-up reports within the timeframe specified by your physician, your license will be subject to suspension. …

“DC DMV may determine that you must undergo a medical or vision review to maintain your driving privileges, if you are reported as an unsafe driver, for instance. As part of the driver license medical review process, DC DMV may require you to submit …a Medical Report from your physician.

“If you are 70 years old or older, when you renew your driver license, you must: Have your physician complete …[a medical] certification …”[152]

Possible outcomes of the review process include: application denial, license suspension/revocation, restriction (including necessitating periodic review), and mandatory enrollment in a “Defensive Driving Course.”[153]

The standard license-renewal interval is every five (5) years. However, for “senior” drivers (here defined as those age 70+), “reaction” and vision tests may be needed. Additionally, the renewal applicant’s physician has to “clear” the senior as being mentally and physically fit.

District of Columbia Department of Motor Vehicles
L’Enfant Plaza
Washington, DC
Email ; Email Link [director]
(202) 737-4404

What Does West Virginia State Law Say About Driving With Alzheimer’s?

“West Virginia does not have a mandatory reporting requirement for certain diagnoses like some other states do, so the doctor does not have to report that …[a person] has MCI or even Alzheimer’s. …[The patient’s] right to drive will not be rescinded because of the diagnosis, and there are no specific benchmarks that would trigger revocation of her license. What we have in WV is the following process by which a doctor, a family member or any other concerned person may ask DMV to rescind an individual’s driver’s license[.]”[154]

To put it another way: “There is nothing specific in the law that pertains to a diagnosis of MCI or Alzheimer’s Disease. However, the Division has policies in place for reporting unsafe drivers.”[155]

“The Division of Motor Vehicles relies on Title 91, Code of State Rules, Series 5, when reviewing applications for driver licensing from individuals who are subject to mental, emotional or physical illness.”[156]

According to one West Virginia Division of Motor Vehicle publication: “Who Can Be Denied a Driver’s License? Any person who the Commissioner of Motor Vehicles has good cause to believe would be hazardous to public safety or welfare when operating a motor vehicle[.]

“How to Refer an Unsafe Driver: If you are concerned about an immediate family member who can no longer safely operate a motor vehicle, you may write a detailed explanation to the DMV at the address listed below. You should provide us with the person’s name, address, date of birth, and driver’s license number, if possible. Law enforcement may submit this information if they have had personal observation or contact with an unsafe driver. You may also wish to seek the advice of the family member’s personal physician or the physician may submit information directly to:

“Division of Motor Vehicles, Medical Section
“PO Box 17030
Charleston, WV 25317
“Telephone: (304) 926‑0729

“Based on the submitted information, the DMV will reexamine the person’s driving skills or ask for updated medical information from the person’s doctor. After reexamination, the DMV may issue the person a restricted driver’s license or revoke his or her driving privilege, not only for the safety of that individual but for the safety of other motorists.

“Re-examination of Driver: You may be required to take a medical, written, or driving examination if the Commissioner of Motor Vehicles has good cause to believe you are incompetent or otherwise not qualified to be licensed.  After you have taken the examination, your driver’s license may be suspended or revoked, or you may be issued a restricted driver’s license. Refusal to submit to this test is grounds for suspension or revocation of your driver’s license.”[157]

“If it’s necessary to contact DMV to ask that her license be suspended, …[it may be] better if that letter is from the doctor. That way, family doesn’t have to take the blame, and your …[loved one] may be more likely to adhere to instructions from the doctor than she would from any of you.”[158]

Regarding doctor’s reports, the department requires “an explanation as to why the patient should not be driving. Physicians have the option of denying driving privileges or having a patient retested. The physician should include some general information about their patient (name and date of birth) so they can be found in …[the DMV] system. This must be on letterhead or a prescription.

“[The division of motor vehicles] will review their file to determine whether the circumstances warrant a driver re-examination, or a suspension of driving privileges. If more information is needed on the medical condition, the Division may require a medical report form completed by their attending physician(s).”[159]

“Lastly, to my knowledge, there is no proposed legislation that would change the current rules or create new requirements.”[160]

For the purposes of reporting possibly unsafe drivers, the Division utilizes a Form DMV-50-CD, titled “Medical Review Request.”

Drivers must renew their licenses every five (5) years.

Department of Transportation
Division of Motor Vehicles
5707 MacCorkle Avenue, SE
Charleston, WV 25317
Email
(304) 558-3900; (800) 642-9066

What Does Wisconsin State Law Say About Driving With Alzheimer’s?

“There is no expressed ‘requirement’ for drivers with MCI, Alzheimer’s or any other form of dementia.”[161] “Having MCI or Alzheimer’s does not completely disqualify a person from holding a license in Wisconsin.”[162]

“These conditions vary quite a bit from person to person and from the point of diagnosis onward.  In other words, when someone has one of these diagnoses, the progression and/or severity can vary vastly.  In the mild/early form, there may be no issues with driving safety; in the latter stages, there may be significant potential problems. …”[163]

“Both MCI and Alzheimer’s are progressive diseases, so if we were made aware of the condition, we would follow up with the driver and their chosen Health Care Professional.

“The Health Care Professional can make licensing recommendations. These may include saying that the driver is not safe to drive due to their medical condition, reevaluation of the driver’s driving abilities, and how frequently we should follow up with the driver.”[164]

“Each driver’s situation is different. The way …[that the Division of Motor Vehicles is] made aware of concerning situations is when someone informs us about their concerns.[165] This information comes to us from healthcare providers, law enforcement and regular citizens (family members, friends, neighbors, etc.) Drivers are also sometimes required to submit medical information if they go to a DMV service center to get a license and the person behind the counter talks to the driver or observes behavior that causes concern. …

“[L]ook at the Wisconsin DMV web page …[for] clear instructions on what to do if you want to report an unsafe driver. Essentially, we ask that the informant to complete a very simple form called the ‘Driver Condition or Behavior Report’ (form MV3141). This is a 2-sided form, but 1 side is completed if the informant is law enforcement or a citizen; the 2nd side is completed if the informant is a healthcare provider.  If a citizen completes the form, we require a 2nd signer to attest to the information being submitted.  Once we get this information, we will require medical information typically within 30 days…. or, if they do not have a license in WI, we will prevent licensing until they give us a medical report giving us information that indicates that their medical provider feels that they are safe to drive.”[166]

Physicians also complete a “Medical Examination Report” (Form MV3644), in order to give the DMV status updates on neurological problems, among other conditions. (See, also, the related “Certificate of Vision Examination by Competent Authority [Form MV3030V/T579].)[167]

The Division of Motor Vehicles cares about conditions – like Alzheimer’s and related dementias – that cause or involve: “Loss of consciousness[;] Confusion, memory loss, inability to concentrate[;] Impaired judgment and insight[;] …Impaired response/reaction time[;] Adverse effects or side effects of medications[;] Impulsive behaviors[; and] Inadequate vision…”[168]

“Per the above explanation, our legislature has given us broad authority to investigate drivers with potentially concerning medical conditions to try [to] ensure that our drivers are deemed safe to functionally operate a motor vehicle.  The administrative code that covers this is Trans 112.03. [Wisconsin Administrative Rules, Administrative Code, Department of Transportation, Chapter 112, Section 03. – Ed.]  That said, there is nothing specific to diminished cognitive capacity spelled out in the statutes or administrative codes.[169] …

“I am not aware of any legislation to create any new requirements around this particular group of conditions. This would be a question for you to ask your WI legislators. They create the statutes and administrative codes that guide us in what we do.  You ‘guide’ the legislators in understanding what is important for them to create statutes and administrative codes for.”[170]

Drivers’ licenses renew every eight (8) years.

Department of Transportation
Division of Motor Vehicles: Medical Review & Fitness Unit
P.O. Box 7918
Madison, WI 53707
Email Link
(608) 266-2327

​​What Does Wyoming State Law Say About Driving With Alzheimer’s?

There does not appear to be a specific law governing driving with Alzheimer’s in Wyoming. “There are no specific regulations regarding MCI. Our Rules & Regulations allow for cancellation or denial of a license ‘upon receipt by the Department of a written medical statement from a qualified medical professional that the person is not medically, physically, or mentally capable of safely operating a motor vehicle.’ Also, Section 11 (i) provides for ‘any applicant may be required to demonstrate his or her ability to operate a motor vehicle safely as required by W.S. 31-7-122.’”[171]

“Furthermore, there does not seem to be “any current proposed legislation requiring these things. …[I]f doctors are concerned about their patients driving, they can refer them for a review with the DMV.”[172]

Medical conditions may be brought to the attention of the DMV when a person applies for, or renews, a license, or when a driver is reported to the department. In such cases, the DMV may require a Driver Medical Evaluation or license retesting.

Among the relevant conditions are: “…epilepsy, seizure disorder, loss of muscular control, loss of consciousness, loss or impairment of a limb.” Any of these may necessitate “a medical evaluation completed by your health provider …before the driver license is issued. …

“A re-exam may be required for the following reasons: Drivers who have had, or are developing problem driving records[]; …Drivers who have experienced a major physical change that could affect their ability to safely operate a motor vehicle. These people are usually referred by doctors, law enforcement, or by examiner observation. Accident reports – law enforcement requests that we re-examine a driver because they have either caused an accident or demonstrated to the officer at the time of the accident that they may have a medical or visual condition[.]

“W.S. 31-7-122[173] grants the Department authority to require any licensee to undergo a re-evaluation of his/her qualification to maintain a driver license, if there is reason to believe a person might not be qualified to drive.”[174]

Drivers’ licenses have to be renewed every four (4) years.[175]

Additional Resources:

Assessing and Counseling Older Drivers by DB Carr National. Highway Traffic and Safety Administration (NHTSA)

Clinician’s Guide to Assessing and Counseling Older Drivers, 3^rd Ed. U.S. Department of Transportation, National Highway Traffic Safety Administration.

Physician’s Guide to Assessing and Counseling Older Drivers, Sept. 2003, (DOT HS 809 647).

Medical Review Practices For Driver Licensing

Traffic Tech: Driver Medical Review Practices Across the United States

Medical Review Practices For Driver Licensing, Vol. 3

Your Road Ahead: A Guide to Comprehensive Driving Evaluations

Talking With Older Drivers: A Guide for Family and Friends.

Notes and Sources:

[1] Additionally, the following information may apply to, but is not geared specifically toward, learner’s or other driving permits, as opposed to “regular” driving licenses.

[2] Source: “Jodi,” Pennsylvania Long-Term Care Ombudsman program. New York State Trooper Terence McDonnell concurs, writing: “These are very sensitive issues which should be discussed with …[loved one’s] physician …[and family members]. While [his or] her ability to drive represents independence, it also may jeopardize her safety and that of every other user of the public roads.”

[3] See the “Additional Resources” section at the end of this webpage. But, see also, e.g., “Assessment of Driving-Related Skills For Older Drivers: Traffic Safety Facts,” Traffic Tech – Technology Transfer Series, no. 389, U.S. Department of Transportation, Washington, DC: National Highway Traffic Safety Administration, Apr. 2010.

[4] These tests include, without limitation, visual tests (esp. the computerized “Useful Field of View” or UFOV test and the Snellen “E” chart), functional and physical tests (such as those that gauge the ability to walk, the patient’s range of motion, and motor strength), as well as cognitive tests (for instance, the so-called “Trail-Making” tests – which have Parts A and B – and the clock-drawing test), culminating with the well-known “Mini Mental Status Exam,” more fully described HERE.

[5] Jeannie Eastman, Driver License Supervisor, Alabama Law Enforcement Agency. She adds: “If [a driver] has a current driver license in another state, [he or] she will be able to go to one of our Driver License Exam Offices and transfer the license.”

[6] Other contact information may be gleaned from HERE.

[7] Source: http://doa.alaska.gov/dmv/akol/mature_driver.htm.

[8] Source: Troy Walters, Arizona Motor Vehicles Department Ombudsman, via email.

[9] Source: Aaron Gimblet, Hearing Officer, Little Rock Driver Control, Office of Driver Services.

[10] Medical Oversight of Noncommercial Drivers, Highway Special Investigation Report, Washington, D.C.: National Transportation Safety Board, 2004, Appendix E, p. 69; and “Driver Safety Information Medical Conditions and Traffic Safety,” <https://www.dmv.ca.gov/portal/dmv/?1dmy&urile=wcm:path:/dmv_content_en/dmv/dl/driversafety/dsmedcontraffic>.

[11] Source: Customer Communications Section, Communication Programs Division, Department of Motor Vehicles.

[12] “Driver Safety Information Medical Conditions and Traffic Safety,” op. cit.

[13] Though, in the case of Alzheimer’s Disease or related dementias, the chance of reinstatement is slim indeed.

[14] “DMV’s Reexamination Process,” California Department of Motor Vehicles, <https://www.dmv.ca.gov/portal/dmv/detail/pubs/brochures/fast_facts/ffdl27/!ut/p/a1/nZFPb4JAEMU_Sw8eyQwLuMtx21oRam1Co7AXsvxTGllQV9L003exSXsyTZ3Tm8Pv5c0bEJCAUHJotlI3nZL7cRfTLFo8zuxgjtHce-bIoyBYrWdrMvcd2IAAUSjd6x2kZTtkRad0pXRWqQmafYL9OT9NMD92xe58rIys5UlntSz0qOtyT-jo0RdNCamXF3buo7RIVbqW69XUktTOrQp9whxCK1YySCEVNPMXyGwWY7SKXyhyHgZ26L6i_2RDfJPhtSu96b8Nw79qSyBt3g8HwU15Y2EfGpKb2zNm5Lh8WG5NRql3VqPqDpKRhOSHhOSXNPqbvHzPJMUrwxH6tmWO1w-fb3W7Yad7f8HvvgBqqllC/>.

[15] Ibid.

[16] Said exam has to be signed off on by a properly crtified ophthalmologist or optometrist.

[17] Source: Driver’s License Admin, Driver-License Communications, Department of Revenue, email.

[18] Source: Ernie Bertothy, Assistant Director of Communications, Connecticut Department of Motor Vehicles, Driver Services Division.

[19] Source: Rosanna Mena, Medical Section, Delaware Department of Transportation (DelDOT), Public Relations. On the mandatory-reporting law, see Medical Oversight of Noncommercial Drivers, Highway Special Investigation Report, Washington, D.C.: National Transportation Safety Board, 2004, Appendix E, p. 69.

[20] Apparently, reports remain confidential in Florida.

[21] Source: Bill Henderson, Medical Review Program, Bureau of Motorist Compliance, Division of Motorist Services.

[22] “Medical Review Process,” Georgia Department of Driver Services, <https://dds.georgia.gov/medical-review-process>.

[23] Source: Meghan Small, Information Specialist, Hawaii Department of Transportation. For further reading, see HERE.

[24] Naomi O’Dell, Vehicle Registration & Licensing Administrator, Department of Finance, Vehicle Registration & Licensing Division.

[25] Ibid. She writes: “Not that I am aware of.”

[26] Source: Cindy Francke, Idaho Transportation Department. Another form is available HERE.

[27] Ibid.

[28] “The department or its authorized agents have the authority to request any person to submit to medical, vision, highway, or written examinations, to protect the safety of the public upon the highways. The department or its authorized agents may exercise such authority based upon evidence which may include, but is not limited to, observations made.”

[29] Source: Brendan Floyd, DMV Policy & Program Management, Idaho Transportation Department.

[30] According to Floyd, op. cit.

[31] Source: Driver Services Department, Illinois Secretary of State.

[32] Source: Mark Dehn, Executive Director, Driver Operations, Indiana Bureau of Motor Vehicles.

[33] Source: Lori Schein, Deputy General Counsel, Indiana Bureau of Motor Vehicles.

[34] Source: Dehn, op. cit.

[35] Source: Schein, op. cit.,

[36] Source: Dehn, op. cit.

[37] Source: Schein, op. cit.

[38] The cited codes reference a “Medical Report” designated Form 430031. The Iowa Department of Transportation has a web portal set up for the purpose of accessing forms online. At the time of this writing, no “Form 430031” shows up on relevant searches on the portal, which can be conducted HERE. However, interested readers may download it HERE instead.

[39] Source: Sara Siedsma, Compliance Officer, Department of Transportation, Motor Vehicle Division.

[40] Your Health and Driving Safely: Information for Iowa Drivers, <https://iowadot.gov/mvd/driverslicense/Driver%20Fitness_WEB.pdf>.

[41] Ibid.

[42] Source: Michele Chavez, Driver Solutions & Medical/Vision Unit PSA, Kansas Department of Revenue, Kansas Division of Vehicles.

[43] Drivers’ License Services, via Melissa Case, Program Assistance Section, Department of Vehicle Regulation.

[44] KRS 186.411.

[45] Kentucky, like other states, has additional requirements – such as those having to do with vision. See HERE.

[46] “Kentucky Medical Review Board Program,” <https://drive.ky.gov/driver-licensing/Pages/Kentucky-Medical-Review-Board-Program.aspx>.

[47] Place Holder.

[48] Motor Vehicles and Traffic Statutes, Title 29-A, Chapter 11, Subchapter 1, Section 1258, Paragraph 2.B., <http://legislature.maine.gov/statutes/29-A/title29-Asec1258.html>.

[49] Source: Thea Fickett, Medical Review Coordinator, Bureau of Motor Vehicles.

[50] Emphasis supplied.

[51] They are: diabetes (if prone to losing consciousness); epilepsy; seizure disorders of other sorts; heart conditions (causing loss of consciousness); stroke; conditions causing dizziness, fainting, or blackouts; sleep apnea or narcolepsy; traumatic brain injuries; conditions that affect driving abilities (e.g., causing weakness, shaking, or numbness in appendages); amputated limbs; severe vision/eye problems; alcoholism; drug addiction; other mental-health conditions that decrease driving abilities; schizophrenia; or dementia.

[52] Law enforcement officers conduct a brief (nine question) interview when a “senior” driver (age 65+) is pulled over for a traffic stop.

[53] Source: Nanette Schieke, Chief, Driver Safety Division, Maryland Department of Transportation, Motor Vehicle Administration. For more information, Ms. Schieke recommends: “The local Alzheimer’s Association chapter and support groups also have great information and caring people with expertise in helping families and caregivers deal with the transition from driving; you can reach [the Alzheimer’s Association] at 1-800-272-3900 or email at info.maryland@alz.org.”

[54] William McVey, Deputy General Counsel, MassDOT, Registry of Motor Vehicles Division; citing information obtained from the Medical Affairs Branch. For more information, McVey recommends that readers visit HERE and: “Click on: Disability Plates and Placards and then scroll down to Contact Information and click on ‘Medical Affairs Division,’ and then, click on: Medical Standards Related to Driving. Click on it and go down to ‘Report a Medically Impaired Driver’ to see a schematic of the various options available to the RMV.”

[55] Different departments have different post-office box numbers. For a directory, click HERE.

[56] The Ombudsman’s office number is (857) 368-9455.

[57] Instructions for completing the form are HERE.

[58] Source: Fred Woodhams, Communications Director, Michigan Department of State.

[59] Source: John Gregurich, Driver Analyst, Traffic Safety Division, Michigan Department of State.

[60] Ibid. For more information, see HERE and HERE. Additional resources can be obtained from “the Aging Driver’s website …[as well as] ‘Driving and Alzheimer’s Disease’ …,” according to Sara Palmateer, student assistant, Office of Communications, Michigan Department of Transportation.

[61] Source: T. Nierengarten, Driver Improvement Specialist, Minnesota Driver and Vehicle Services.

[62] Source: Martine Gray, Administrative Assist/Driver Records Department, Dept. of Public Safety/Hwy Patrol.

[63] Under Construction.

[64] Source: Ann Marie Moy, Director of Strategy and Communication, Missouri Department of Revenue.

[65] Source: Tammy Stefanik, Deputy Bureau Chief, Department of Justice, Motor Vehicle Division (MVD), Driver Services Bureau.

[66] Montana Code Annotated 61-5-120 (on medical reassessment), 61-5-113 (on restricted licenses), 61-5-105 (on who may not be licensed), 61-5-103, 61-5-206 (on suspensions), 61-5-207 (on medical evaluations), 61-5-111 (on renewals), 61-5-110 (on records checks). Medical Evaluation forms can be obtained HERE (see the Medical and Vision Forms section).

[67] See also HERE.

[68] Source: Jayne McLuaghlin, Licensing Permit Tech, Montana Department of Justice, MVD. Stefanik echoes this by stating: “If a driver indicates they may have a condition of that nature, MVD requires the driver to submit a completed medical evaluation.  MVD will use the medical evaluation to determine license eligibility and testing requirements, including periodic testing.”

[69] However, the Administrative Rules of Montana, 23.3.504, states (2)(g)-(h): “A person is physically qualified to hold a type 1 endorsement if he/she: …has no established medical history or clinical diagnosis of epilepsy or any other condition which is likely to cause loss of consciousness or any loss of ability to control a motor vehicle; [and] has no mental, nervous, organic, or functional disease or psychiatric disorder likely to interfere with his/her ability to drive a motor vehicle safely…”.

[70] Stefanik, op. cit.

[71] Stefanik: “I am not aware of any knowledge of proposed legislation creating new requirements.” As a side note, licensees from other states wishing to obtain driving licenses in Montana “need to take the[ir existing] license[s] to the local exam station and surrender [them] to get a Montana license,” according to McLaughlin.

[72] Source: Julie Nagengast, Nebraska Department of Motor Vehicles.

[73] Via Julie Nagengast.

[74] Source: Trooper Matt McLaughlin #267, Nevada Highway Patrol, Public Information Officer. On the mandatory-reporting requirement, see Medical Oversight of Noncommercial Drivers, Highway Special Investigation Report, Washington, D.C.: National Transportation Safety Board, 2004, Appendix E, p. 69.

[75] For additional information, contact the Alzheimer’s Association at (800) 272-3900 or (775) 786-8061.

[76] “Denial of License: Physical or Mental Conditions,” NAC 483.370, <https://www.leg.state.nv.us/NAC/NAC-483.html#NAC483Sec370>.

[77] “Suspension for Incompetency or Improper Driving,” 2015 New Hampshire Revised Statutes, Title 21 (“Motor Vehicles”), Chapter 263 (Drivers’ Licenses), Section 263:59; NH Rev Stat § 263:59 (2015).

[78] Title 21 (“Motor Vehicles”), chapter 263 (“Drivers’ Licenses), Section 59 (“License Suspension and Revocation”).

[79] Source: Maria Buckman, Director’s Office, Division of Motor Vehicles.

[80] Medical Oversight of Noncommercial Drivers, Highway Special Investigation Report, Washington, D.C.: National Transportation Safety Board, 2004, Appendix E, p. 69.

[81] Place holder.

[82] Source: Leanna Velasquez, Licensed Municipal Court Clerk. Just a note on agency structure. As engineer Kenneth Murphy (New Mexico Department of Transportation) put it: “In New Mexico[,] the Department of Transportation designs, constructs and maintains the transportation system. It does not regulate driver’s licenses and the statutes related to them. The Taxation and Revenue Department has a Motor Vehicle Division that performs these functions.” Additional resources are available from the Lawyer Referral for the Elderly Program (LREP) at (800) 876-6657 …[email]. Another great resource to contact would be the Alzheimer’s Association at (800) 272-3900 website is” HERE. Source: April M. Ortega, New Mexico Aging and Long-Term Services Department.

[83] Source: Alicia Ortiz, Acting Director, New Mexico Motor Vehicle Division.

[84] Source: Terence McDonnell, Traffic Services, New York State Police.

[85] This was reiterated by C. Rouse (Driver Improvement Examiner, Medical Review Unit), who wrote that when a person from out of state moves to New York, that person “…could have [his or] her physician fill out form MV-80U. 1 which can be found on our public website: www.dmv.ny.gov.”

[86] Source: Linda Briggs, Head Driver Improvement Examiner, New York State Department of Motor Vehicles, Medical Review Unit.

[87] “Driver Medical Conditions,” New York Department of Motor Vehicles, <https://dmv.ny.gov/driver-license/driver-medical-conditions>.

[88] McDonnell, op. cit.

[89] Sources: John Brockwell, Communications Officer, Division of Motor Vehicles, North Carolina Department of Transportation; and Medical Advisor, Medical Review Unit, North Carolina Department of Transportation. On the General Statutes, see also: “General Statute 20-7(e) provides authority to place restrictions on a driver license when the individual has a physical or mental disability that affects his/her operation of a motor vehicle. General Statute 20-9 provides the authority to refuse to issue a license to an individual who is unable to exercise ordinary and reasonable control of a motor vehicle; and provides the authority to request medical information from customers at intervals in the discretion of the Division when doing so is in the interest of public safety. General Statute 20-15(a) provides the authority to cancel a driver license if an individual suffers from a physical or mental disability that affects his/her ability to safely operate a motor vehicle or if he/she fails to submit the required medical information.” Ibid. An anonymous medical adviser from the North Carolina Medical Review Unit concurs, writing: “There is no state law requiring customers to disclose their medical conditions. If the Division is made aware of these conditions, by observation or by report of a physician or other concerned citizen, a road test and/or a medical evaluation may be necessary in order to evaluate fitness to operate a motor vehicle. We have no pre-defined conditions for surrendering a license. Each case is individual and we evaluate a customer’s driving record and information received from the healthcare provider and/or other concerned citizens. There is no applicable statute. I am not aware of any proposed legislation that would create new requirements. The Medical Review Program evaluates customers’ health conditions in order to decrease negative effects said conditions may have on the safety of the customer and others. General Statute 20-7(e) provides authority to place restrictions on a driver license when the individual has a physical or mental disability that affects his/her operation of a motor vehicle. General Statute 20-9 provides the authority to refuse to issue a license to an individual who is unable to exercise ordinary and reasonable control of a motor vehicle; and provides the authority to request medical information from customers at intervals in the discretion of the Division when doing so is in the interest of public safety. General Statute 20-15(a) provides the authority to cancel a driver license if an individual suffers from a physical or mental disability that affects his/her ability to safely operate a motor vehicle or if he/she fails to submit the required medical information.” Medical Advisor [sic], Medical Review Unit, North Carolina.

[90] “Medical Review Program,” North Carolina, Division of Motor Vehicles, <https://www.ncdot.gov/dmv/driver/medical/>.

[91] Ibid.

[92] However, the requests can never be anonymous and they cannot merely be made because of old age. See, also, HERE.

[93] Ibid.

[94] Ibid.

[95] Nikki Wegner, WND Program Manager, Alzheimer’s Association Minnesota-North Dakota via Nicole Cook, Human Services Program Administrator, Vulnerable Adult Protective Services.

[96] See Ohio Revised Code: 4507.081, 4507.20.

[97] Source: Melody McDougle, Ohio Department of Public Safety, Ohio Bureau of Motor Vehicles, Driver License Suspension Section; relayed via Erica Hawkins, Director of Communication, Ohio Department of Transportation.

[98] “Medical Restriction,” Ohio BMV, n.d., <http://bmv.ohio.gov/dl-restriction-medical.aspx>.

[99] Source: Gary Cuckler, Driver License Suspensions, Special Case/Medical Unit.

[100] Compare the comments of Scott Harding (Ombudsman Supervisor, EODD Area Agency on Aging): “It is my understanding that a doctor can send a letter of concern to the Department of Public Safety, which regulates drivers’ license requirements.  If they deem it to be a credible concern, it’s my understanding that they can contact the license holder and require additional tests and or information.”

[101] “Driving and Health Issues,” Oklahoma Department of Public Health, <https://www.ok.gov/dps/FAQs/Driving_and_Health_FAQ.html>.

[102] Ibid. For more information, contact the Oklahoma City Office of the Alzheimer’s Association at (405) 319-0780. Additional resources may be available at the Oklahoma Department of Public Safety and at the Legal Aid Services of Oklahoma, according to Tim Nicholson, Ombudsman Supervisor, Eastern Oklahoma Development District.

[103] Source: Mike Bailey, Senior Medical Officer, Driver Compliance.

[104] Ibid.

[105] Source: Email from Driver Programs policy manager for Oregon DMV. “For more detailed information on the laws and rules for our at-risk program, you can go to the following links.  For the statutes …, you’ll want to pay particular attention to [Oregon Revised Statutes] ORS 807.340, .350, .710, and 809.419. On mandatory reporting, see Medical Oversight of Noncommercial Drivers, Highway Special Investigation Report, Washington, D.C.: National Transportation Safety Board, 2004, Appendix E, p. 69.

[106] See, again, HERE. Ann Fade (Deputy State Long-Term Care Ombudsman) adds: “You can also access all Oregon administrative rules and Oregon revised statutes through the Oregon Secretary of State website…”.

[107] Title 75, Chapter 15, Section 1518, <https://law.justia.com/codes/pennsylvania/2010/title-75/chapter-15/1518/>.

[108] On the mandatory-reporting law, see Medical Oversight of Noncommercial Drivers, Highway Special Investigation Report, Washington, D.C.: National Transportation Safety Board, 2004, Appendix E, p. 69. For other medical report types, see HERE.

[109] Source: “Medically Impaired Driver Law,” Pennsylvania Department of Transportation, <http://www.dmv.pa.gov/Information-Centers/Medical-Reporting/Pages/Medically-Impaired-Driver-Law.aspx>.

[110] “Medical Criteria and Regulations,” <http://www.dmv.pa.gov/Information-Centers/Medical-Reporting/Pages/Medical-Criteria.aspx>.

[111] Source: “Jodi,” Pennsylvania Long-Term Care Ombudsman program.

[112] One website suggests that Rhode Island has an office and hotline established for reporting, at: Administrative Adjunction Court, Officer of Operator Control, 345 Harris Ave., Providence, RI 02909, (401) 462 462-0802

[113] “Senior Drivers in Rhode Island,”

[114] “Medical Advisory Board,” Rhode Island Department of Revenue, Division of Motor Vehicles, <http://www.dmv.ri.gov/adjudication/medical/index.php>.

[115] Source: Donna Lonschein, Clinical Director, Alliance for Better Long Term Care.

[116] The reasons for these requirements are fairly intuitive. However, cognitive deficits present peculiar difficulties. Presumably, not all failures of truthful self-reporting can be chalked up to dishonesty. Objectively false reports may result from a lack of self-awareness, for instance.

[117] Source: Brandy A. Duncan, Asst. General Counsel, South Carolina Department of Motor Vehicles.

[118] Source: Greg Fuller, South Dakota Department of Transportation.

[119] Source: Jane Schrank, Director, South Dakota Department of Public Safety, Driver Licensing Program.

[120] Source: N.n., Driver Licensing Program, Department of Public Safety.

[121] There’s also a “Driver’s Licensing Vision Statement.”

[122] “For Physicians,” <https://dps.sd.gov/driver-licensing/south-dakota-licensing-information/physicians>.

[123] Source: Laura E. Brown, General Counsel, State Legal Assistance Developer, Tennessee Commission on Aging and Disability, TN.gov. See, also, the remarks of Gerry Crownover (Staff Attorney, Legal Division, Driver Improvement): “Tennessee law does not expressly require drivers to disclose their conditions.  The law does however allow the state to suspend the driver license of a person when we receive written information that the person is suffering from a medical condition that makes them unsafe to drive. The statute for this law is T.C.A. 55-50-505. The process is governed specifically by Regulation 1340-01-04-.06.  This regulation and other information can be found at our website…”.

[124] Source: Theresa D. Bean Hill, Assistant to the Director, Driver Services Division/Administrative Office.

[125] Tennessee Driver Improvement Program, Rule 1340-01-04-.06(2)(a.)-(e.), Rev. 18, Aug., 2014.

[126] Tennessee Driver Improvement Program, Rule 1340-01-04-.06(d).

[127] Your Road Ahead: A Guide to Comprehensive Driving Evaluations, Hartford, Conn.: Hartford Financial Services, 2010, pp. 6 and 21. For more information, see the online documents “Driver Improvement Medical Disabilities” and “Rules and Regulations – Driver Improvement – Physical or Mental Disabilities.”

[128] Laura E. Brown, General Counsel, State Legal Assistance Developer, Tennessee Commission on Aging and Disability. For more information, see HERE.

[129] Source: Patricia Bryars, Public Health & Prevention Technician III, Office of EMS/Trauma Systems/Medical Advisory Board, Texas Department of State Health Services.

[130] The main source of information is, of course, the Texas Department of Motor Vehicles. But here is senior social worker Lynda Taylor’s list of additional resources (with her commentary in quotations): The Medical Advisory Board; the Alzheimer’s Association (Texas chapter) (800) 272-3900 – “The Alzheimer’s Association 24/7 Helpline provides reliable information and support to people with memory loss, caregivers, health care professionals and the public. Call them toll-free anytime day or night.” In Central Texas: Alzheimer’s Texas (800) 367-2132 – “They have a phone line open all day, every day, for you to talk with someone about your questions and concerns.” Ms. Taylor also recommends that families confer with the Texas Area Agency on Aging at (800) 252-9240. (Information sent via Patrice Kennemer, DHSH Press Office.)

[131] Bryars, op. cit.

[132] “Drivers Age 79 or Older,” Texas Department of Public Safety, <https://www.dps.texas.gov/DriverLicense/elderlydrivers.htm>. See also HERE, HERE, HERE, and HERE.

[133] The relevant statute is: Utah Code, title 53 (“Public Safety Code”), chapter 3 (“Uniform Driver License Act”), part 3 (“Impaired Persons Licensing Act”), section 303.5 (“Driver License Medical Advisory Board – Medical waivers).

[134] According to “Mary Ann,” Utah Driver License Division, Medical Section.

[135] Esp., HERE.

[136] Ibid.

[137] Category D, on the other hand, ranges over: “A wide variety of neurological conditions …includ[ing]: Strokes; Head injuries; …Parkinson’s disease, Progressive conditions such as muscular atrophies and dystrophies, myasthenia gravis and various spinal cord and brain diseases; …,” etc.

[138] “Drivers,” Driver’s License Division, Utah Department of Public Safety, <https://dld.utah.gov/drivers/>.

[139] Christopher Caras, dir., publication DLD 321, Jan. 2015 Ed., Salt Lake City, UT: Utah Department of Public Safety, Driver License Division, Medical Advisory Board.

[140] Sex-offenders must renew yearly.

[141] Source: Nan Mendenhall, Assistant Division Director, Office of Adult Protective Services Director, Division of Aging and Adult Services.

[142] #2.

[143] Source: James Clark, Vermont Transportation Agency.

[144] Source: Mayer Thayer, Vermont Transportation Agency.

[145] “Medical Review Process,” Virginia Department of Motor Vehicles, <https://www.dmv.virginia.gov/drivers/#medical/spec_restrict.asp>.

[146] Cited by Gail Thompson, Assistant State Long-Term Care Ombudsman, Office of the State Long-Term Care Ombudsman, Virginia Department for Aging & Rehabilitative Services.

[147] Source: Rachael, Customer Relations Email Team, Washington State Department of Licensing.

[148] Revised Code of Washington. The relevant legal basis rests atop such statutes as: RCW 46.20.041, RCW 46.20.120, and RCW 46.20.130.

[149] Source: Donna, Customer Relations Email Team, Washington Department of Licensing. Rachael echoes Donna’s synopsis, writing that “private citizens, law enforcement and medical professionals have the ability to request that a driver be reevaluated for licensure. Additionally, upon application we will ask if the applicant has any ‘mental or physical condition that may interfere with driving.’ If the customer says ‘yes’ to having a condition that may interfere with driving, they will be referred to a physician for examination before they can continue with the process to be licensed in Washington.”

[150] Source: Ed OConnell, Restricted License Supervisor, Washington State Department of Licensing, Alcohol and Medical Units.

[151] Source: Ariel W. Reed, Assistant General Counsel, Department of Motor Vehicles.

[152] “Medical Requirements,” Washington, D.C. Department of Motor Vehicles, <https://dmv.dc.gov/service/dmv-medical-requirements>.

[153] Ibid.

[154] Source: Nancy Cipoletti, Director, Alzheimer’s Programs, West Virginia Bureau of Senior Services.

[155] Source: Roxana Dove Medical Coordinator, Driver Services.

[156] Ibid.

[157] Stae of West Virginia Driver’s Licensing Handbook, Charleston, VW: West Virginia DMV publication, n.d., p. 16, <https://transportation.wv.gov/DMV/DMVFormSearch/Drivers_Licensing_Handbook_web.pdf>; quoted by Cipoletti.

[158] Cipoletti, op. cit.

[159] “Medical Review Unit,” West Virginia Department of Transportation, Division of Motor Vehicles, <https://transportation.wv.gov/DMV/Drivers/Pages/Medical-Review-Unit.aspx>.

[160] Cipoletti, op. cit. She adds this food for thought: “If your …[loved one] moves to WV, would [he or] she be driving on roads that are familiar or unfamiliar? That might play a big part in her ability to navigate them safely.” Cipoletti also recommends the following recommendation for readers that would like more information: “One resource that might be helpful to you if driving is a big issue is a free publication from The Hartford Financial Services Group, At the Crossroads: Family Conversations about Alzheimer’s Disease, Dementia and Driving. You can download or order it from their website, www.thehartford.com/lifetime.”

[161] Source: Gail, MVPS – Senior, DMV Medical Review team, Wisconsin Department of Transportation, Medical Review & Fitness unit.

[162] Source: Stephanie, DOTSKA, Wisconsin Department of Motor Vehicles, DMV Medical unit.

[163] Gail, op. cit.

[164] Stephanie, op. cit.,

[165] See HERE.

[166] Gail, op. cit.

[167] Stephanie, op. cit. Other forms include: “Pledge of Confidentiality” (MV3454), “Release of Medical Information Authorization Form” (MV3510), and “Voluntary Temporary Surrender” (MV3581). For additional information, see Public Guide for Reporting Medically-Impaired Drivers, Law-Enforcement Guide for Reporting Drivers, Medical Professional Guide for Reporting Drivers, Older Driver Workbook. Additional source: “Driver Medical Concerns – Overview,” Wisconsin Department of Transportation, Division of Motor Vehicles, <http://wisconsindot.gov/Pages/dmv/license-drvs/mdcl-cncrns/med-concerns.aspx>.

[168] “Medical Condition,” Wisconsin Department of Transportation, Division of Motor Vehicles, <http://wisconsindot.gov/Pages/dmv/license-drvs/mdcl-cncrns/medicalcondition.aspx>.

[169] Though, the relevant code, loc. cit., does mention “cognitive skill” and “functional ability.”

[170] Gail, op. cit. For more information, see HERE.

[171] Source: Dani Galluzzo, Driver Services Supervisor, Hearings/Driver Review, Wyoming Department of Transportation; via Analyn Reader, Regional Ombudsman, Wyoming long-term care.

[172] Source: Lindsay Hruby, State Long Term Care Ombudsman.

[173] “The division, having good cause to believe that a licensed driver is unsafe or otherwise not qualified to be licensed, may upon written notice of not less than ten (10) days to the licensee require him to submit to an appropriate examination.”

[174] “Medical and Vision Screening,” Wyoming Department of Transportation, <http://www.dot.state.wy.us/home/driver_license_records/driver_Review.html>.

[175] For more information, see HERE.