Hand controls: Mechanical or Electronic?

Getting back on the road with hand controls is a bit of a process, but so worthwhile. These steps will guide you through the process (bearing in mind the licencing process may vary from state to state – this is the QLD flavour)

1. Referral / intake

• Get a referral and QLD Transport Medical Certificate from your GP
• QTMC must state: “medically stable for purpose of OT driving assessment / lessons with driving instructor only”, and tick “M” medical condition and “V” vehicle modifications boxes
• take the completed QTMC to the QLD Transport office for processing – you will get an updated licence with these conditions according to the QTMC; you MUST check the expiry date and gain an updated QTMC when this expires!

2) OT driving assessment: clinical and practical assessment, to trial various hand controls.
At intake, your OT driver assessor should be able to work out with you which type of hand controls you will be most suited to, and book a specialised driving instructor with these type of controls in their vehicle.

If we haven’t nailed the hand control choice, we will do further drives in the same vehicle/hand controls to get a bit more practice and confirm, or we may do further drives with different hand controls (same instructor/vehicle or different instructor/vehicle).

If we’ve worked out the right hand controls for you, we’ll discuss the recommended number of lessons – this will vary between 5 to 10 lessons, right through to 15 to 20, or even 30 to 40 for high level electronic gear, dependent on previous driver experience (some clients are teens / learners and have never driven before) and your progress.

3) Recommendations and paperwork
Once a decision on the hand controls is made, the OT driver assessor completes report/s and obtains quote for driving lessons from the chosen driving instructor, which is submitted to the insurer for approval.

NDIS information:
When lessons are recommended, the OTDA 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).

Once you have written approval from the NDIA, you are able to book your lessons directly with the driving instructor. (Note – as at February 2022, this is taking months to gain approval).

4) On-road re-assessment to review progress
For some clients, an OT on-road re-assessment will be completed part-way through their lessons, to check that everything is progressing as it should be, and gain the evidence to confirm that the modifications will enable the person to be a safe driver in the long term.

5) OT Driver Assessor to submit vehicle mods application
A vehicle modifications application is then completed and submitted to the insurer. This will typically include a suite of documents including:

• copy of driver’s licence
• copy of QLD Transport Medical Certificate
• the vehicle modifications application and signed consent forms
• OT driving assessment report/s
• letter from the client indicating that they consent to their vehicle being modified
• copy of vehicle registration and insurance
• vehicle Safety Certificate / Roadworthy may be required (at client’s expense)

NB: 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.

6) Wait!
Await approval of the vehicle modifications. (again, there may be lengthy wait times for NDIS Participants).

7) Installation, lessons, license/medical certificate review

• Following approval, modifications are installed into the vehicle.
• Driving lessons should be occurring at this time.
• License/medical certificate will also be reviewed – the OT driver assessor will liaise with the driving instructor, and determine when it will be appropriate to provide an updated report to the GP to recommend an upgrade to the medical certificate – to remove the restriction of “driving with driving instructor only”. So it is off to the GP again to upgrade the medical certificate and this has to be taken to QLD Transport for processing, and provide copies to the OT Driver Assessor and insurer.

8) Handover assessment

• When the vehicle modifications are completed, our process at Driving Well Occupational Therapy is to complete a handover assessment at the modifier, with the client, OT Driver Assessor and Driving Instructor, to take the modified car for a test drive, and ensure everything is set up and working as it should be for the client.
• The OT will review the compliance documents of the modifications.
• Some clients will be able to drive their vehicle home, however sometimes this is not possible if the client is not yet competent or if there are tweaks needed to the mods.

Note: in QLD, a Transport driving test is not required, however this is a requirement in other states. In QLD, we need to be confident that the client is driving at the QLD Transport driving test standard, and that if they did have to complete a test, that they are at passing level.

9) Further lessons as needed
Some clients will have another few lessons in their own modified vehicle to gain experience and confidence.

10) Sign-off
OT driver assessor will complete final on-road report and post-modification evaluation report – these will be sent to QLD Transport and the insurer.

A celebration is definitely in order after all this! And for Driving Well, the handover days are the absolute highlight for us, our “WHY FACTOR” – this is why we do what we do!