Driving assessment and vehicle modifications process

Driving Well Occupational Therapy aims to guide you through what can be a daunting and complex process. There are many steps required, with governance by QLD Transport and Australian Competency Standards for OT Driver Assessors, and working with funding bodies including NDIS, NIISQ and Workcover.

Driving with a medical condition or disability 

The law in Queensland states that "any person with a medical condition or disability that may affect their ability to drive, must have medical clearance from their doctor. In cases where there is concern regarding learning ability or a physical impairment, the person will need to have an Occupational Therapy driving assessment."

This law is called Jet's Law", named for Jet Rowland who in 2004 was 2 years old and involved in an accident, where the driver of the other vehicle had epilepsy and shouldn't have been driving. Jet was killed, his older brother had a catastrophic spinal cord injury and uses a wheelchair, and their mother Anita (a Police Officer) sustained serious orthopaedic injuries.

When a GP is unsure about the person’s ability to drive or the functional impact of the medical condition or disability on driving, they can refer for an Occupational Therapy Driving Assessment. This must be completed by an Occupational Therapist with the additional post-graduate driver assessor qualification. All our occupational therapists at Driving Well have this qualification; director Jenny also has an additional qualification to assess heavy vehicle drivers.

After an OT driving assessment, the OT will make a recommendation back to the GP in a formal report, and then the GP makes the final decision about the persons medical fitness for driving. To continue driving, the GP writes a new QLD Transport Medical Certificate for the person to take to the QLD Transport office for processing; an updated licence is then provided. 
 

There are extremely serious consequences of driving with a medical condition when the proper clearance and reporting is not completed:
-    In the case of an accident, insurance is voided
-    Significant fine (in excess of $10000)
-    Potential criminal charges – prosecution
-    Putting themselves and others in danger

 

For further information:

https://www.qld.gov.au/transport/licensing/update/medical

If you are over the age of 75 years: https://www.qld.gov.au/seniors/transport/senior-drivers/safe-driving

- Jet's Law brochure

press to zoom
press to zoom
press to zoom
press to zoom
press to zoom
press to zoom
press to zoom
press to zoom
press to zoom
press to zoom
press to zoom
press to zoom
press to zoom
press to zoom
press to zoom
1/1
OT driving assessment process

Intake / Referral 

You have a medical condition / injury / disability / are an older driver and discussed driving with your GP. Your GP has requested that you complete the occupational therapy driving assessment to help them determine whether they can provide medical clearance for you to continue driving or return to driving.

Paperwork required

Please ensure you have returned copies of the following documents to Zeta, Practice Manager (admin@drivingwell.com.au) and have them available on the day:

 

1) current driver's licence:

  • Please check the expiry date on your driving licence.

  • If your driving licence is not current, take your medical certificate to the Transport Department to get a temporary licence - this will cost about $87 for 12 months.

  • You cannot drive in the driving assessment without a valid licence.

 

2) current QLD Transport Medical Certificate (QTMC):

  • This is a QLD Transport requirement

  • obtain this from your GP, stating "medically stable for purpose of OT driving assessment / driving lessons only".

  • You will need to take this QTMC for processing to QLD Transport prior to your appointment.

 

3) GP referral / medical history

 

4) Optometrist report if required by doctor

 

5) If relevant: hospital discharge summary / other medical/allied health reports

Assessment

What is involved in an occupational therapy driving assessment?

1.5 hour clinical assessment:

  • medical /disability history and medications

  • driving history

  • physical, cognitive and vision function screen

  • road law knowledge screen

1 hour practical assessment:

  • The practical assessment is a drive in the specialised driving instructor's car, with the driving instructor in the front passenger seat, and the OT Driver Assessor in the rear left seat. The drive usually commences from your home.

  • An open or local area licence can be considered.

  • The practical drive is a test of driving performance in the following areas:

    • observation skills

    • speed control

    • planning and judgement

    • vehicle positioning

    • physical control and reaction time

    • insight into driving performance

  • The OT Driver Assessor will talk with the Driving Instructor at the end of the drive, to determine the outcome of the assessment.

  • The assessment CANNOT be completed in the client's own vehicle, as it does not have dual controlled brakes and this may not be safe for the client, OT Driver Assessor, Driving Instructor or the community. Every OT driving assessment will be completed in the driving instructor's car with dual controls, so the driving instructor can intervene if there is an emergency situation.

Possible outcomes

For every OT driving assessment, there are three possible outcomes:

"Pass”: medical condition is not impacting on driving and therefore safe to continue driving

“Driving program”: client has not yet passed

  • requires lessons / refresher sessions with the specialised Driving Instructor to attempt to address concerns seen in the initial on-road assessment or learn to drive with vehicle modifications.

  • An on-road re-assessment is usually required after the lessons.

  • Lessons and re-assessment are at additional cost.


"Fail”: medical condition is impacting on driving and no longer safe, and recommendation that the licence will be cancelled and the person is recommended to retire from driving.

After the assessment

1) OT driving assessment report
Your OT Driver Assessor will complete a medicolegal report regarding the outcome of the assessment and recommendations - this will be sent to your referring doctor (usually your GP), Medical Conditions Reporting Unit at QLD Transport, the driving instructor and any other relevant parties determined during the assessment (eg Support Coordinator, NDIS, other insurer).

We aim to complete the report within 5 BUSINESS DAYS and we usually send the report to the GP/Doctor through the "Medical Objects" portal or via email.

2) See your GP

  • Book an appointment to see your GP/Specialist for at least 5 BUSINESS DAYS following the driving assessment.

  • Make arrangements (family/friend/taxi/public transport) to attend your GP/Specialist appointment.

  • The GP/Specialist will review the report, and if they are in agreement with the recommendations (in pass and rehab outcomes), they will provide you an updated QLD Transport Medical Certificate.


3) Go to QLD Transport
Make arrangements to go to QLD Transport (family/friend/taxi/public transport) and take your updated QLD Transport Medical Certificate for processing.

4) Next steps
If you have passed the assessment and been to the Transport office, you can now drive.
If you are recommended lessons and been to the Transport office, you can commence the lessons.

5) Re-assessment

  • When a driving program (lessons) is required, the OT driver assessor will talk with the Driving Instructor and book the re-assessment at the end of the driving program (or earlier if the client is ready).

  • The on-road re-assessment follows the same process as the first on-road assessment. 

  • The "three possible outcomes" of a driving assessment remain.

  • There are no guarantees that a client will pass following a driving program.

  • The OT driver assessor will complete another report and send this with recommendations to the GP.

  • If you have passed, you will need to see your GP again, for the GP to review the report and if they agree, they will provide an upgraded QLD Transport Medical Certificate.

  • You must then take the upgraded QLD Transport Medical Certificate to QLD Transport for processing - then you can drive.

NDIS and insurers Information 

Approval for driving training program

  • When a driving program (lessons) are recommended, the OT driver assessor will submit the OT driving assessment report and quote for the number of recommended lessons from the driving instructor provider, to the NDIA

  • "specialised driving training" is a quote required item, which needs to be approved by NDIA and added as a line item to your NDIA plan under Capacity Building: improved daily living (Specialised driver training 15_046_0129_1_3)

  • this applies even if you have a goal regarding driving / community access, and even if you have sufficient budget in improved daily living.

  • Once you have written approval from the NDIA (and the line item is added to your NDIS plan), you are able to book your lessons directly with the driving instructor. (Note - as at February 2022, this is taking months to gain approval).

  • If you are with another insurer, a quote and report is provided, and the insurer must approve the quote to commence lessons.

Vehicle criteria - "suitable to modify"

Insurers have varying criteria about age and kilometres of the vehicle, which is considered to be "suitable" to modify. NDIS require no older than 5 years and no more than 80,000km - however, when minor modifications are being completed (including hand controls) which can be transferred to the next vehicle, they will usually accept this as long as the Safety Certificate is also provided.

For structural conversions of vehicles (for example, lowering the floor for wheelchair access), it is best to have as new a car as possible, so that it is sustainable and reliable for you - you'll have it for about 10 years!

"Future proofed"

  • Vehicle modifications for driving and/or vehicle access must be "sustainable for you over the lifetime of the vehicle" (considered to be 8 to 10 years in Australia).

  • The OT driver assessor will talk with you about the nature of your medical condition / disability, prognosis, and consider whether the modifications will be suitable for you over the next 8 to 10 years - this may mean planning for the need for a wheelchair accessible vehicle and electric wheelchair.

  • The OT driver assessor may require supporting letters from Specialist doctors (eg Neurologist) and physiotherapist to help determine the best vehicle set-up for you, and to support the application for the modifications.

"Whole of task completion"

For drivers: the modifications recommended must achieve independence with "whole of task completion" 

  • independence with driving

  • independence with access / transfer into driver's seat/position

  • independence with stowing / securing wheeled mobility device (eg scooter, manual wheelchair or electric wheelchair)

  • independence with many tasks in the community eg going to physio, cafes, doctor, bank, post office, movies, seeing friends, leisure activities, light shopping

  • NDIS will likely reduce support worker hours for community access and transport allowances.

Vehicle modifications

There are many options for vehicle modifications for driving including:

  • spinner knobs

  • hand controls

  • left foot accelerators

  • high level electronic hand controls

  • transfer aids

  • wheelchair stowage hoists

  • wheelchair access

Your OT driver assessor will guide you in what further steps are required - this may include appointment/s to trial various vehicle modifications. If vehicle modifications are needed for driving, you will also likely have on-road re-assessments to review progress and confirm that the driving controls will be suitable for you long term.

You will be advised what further documentation is required.

  • vehicle registration

  • vehicle insurance

  • Safety certificate


Your OT driver assessor will commence the vehicle modifications application and submit to NDIS.
We will assist in case management of your modification.


An OT handover assessment is completed with the OT driver assessor and driving instructor on completion of the modifications, to ensure that everything is working the way it should for you.