California

Are applicants for a driver's license asked questions about diabetes?

Yes. All first-time and renewal applicants are required to complete a section of the licensing application that contains questions about medical conditions. This section asks whether an individual has had a condition within the last five years that affects his or her ability to operate a motor vehicle safely. One of the conditions specifically listed as part of this question is diabetes. Drivers who answer “Yes” to this question may be required to have their physician complete a medical evaluation form.

What other ways does the state have to find out about people who may not be able to drive safely because of a medical condition?

The licensing agency accepts reports of potentially unsafe drivers from: police officers, the courts, physicians, family members, friends, other citizens and hospitals. Anonymous referrals are only accepted from immediate family members who identify themselves as such. Physicians are required by law to report to the licensing agency any individual 14 years or older who has been diagnosed with a disorder characterized by lapses of consciousness. The physician reporting law lists hypoglycemia and hyperglycemia associated with diabetes as conditions which “do not always, but may progress to the level of functional severity” that would require the physician to report them. Drivers may also be required to have a medical evaluation if they have impairments which are observed by licensing agency personnel during the licensing process, or if they are involved in a crash involving a fatality or are involved in a given number of crashes in a certain time period.

What is the process for medical evaluations of drivers?

When the licensing agency becomes aware that a person has a medical condition that could impair safe driving performance, the agency will request medical information from that person and his or her physician through a medical evaluation form. In addition to providing the diagnosis, the physician is asked to indicate whether the condition is improving, stable, worsening, or subject to change; medications prescribed; whether side effects of medications may interfere with the ability to safely operate a motor vehicle; whether the medical condition affects safe driving ability; and whether the physician has advised against driving. The form also has a section specific to diabetes, which asks about the type of diabetes, the date of diagnosis, the treatment regimen and whether the individual is compliant, whether diabetes is currently controlled and how long control has been maintained, whether the individual has experienced hypoglycemic or hyperglycemic episodes during the last three years, what complications have resulted from these episodes, and whether the individual has received diabetes education from a health care professional. The doctor is also asked to provide the patient’s fasting blood glucose levels. The licensing agency uses the information along with other non-medical factors in reaching a licensing decision.

Who makes decisions about whether drivers are medically qualified?

Drivers with medical conditions or functional impairments are evaluated by non-medical administrative staff in the licensing agency's Driver Safety Branch, who have other responsibilities in addition to medical evaluation. The agency has the sole responsibility for decisions regarding the patient’s driving qualifications and licensure. While California has a medical advisory board, it is activated only when needed for formal revision of medical evaluation guidelines, and does not currently participate in assessing the medical qualifications of drivers.

Has the state adopted specific policies about whether people with diabetes are allowed to drive?

The state developed medical guidelines to assist agency personnel in evaluating individuals with conditions that may affect the ability to drive safely, such as diabetes.

What is the state's policy about episodes of altered consciousness or loss of consciousness that may be due to diabetes?

California evaluates all cases individually and considers whether any loss of consciousness was an isolated episode or a chronic impairment. An isolated episode whose cause is related to conditions that are unlikely to recur (such as allergic reactions to insect bites or adverse reactions to medications) will typically not result in any action. If the episodes are part of a chronic or recurring condition, the department evaluates the applicant based on the degree of control established after the episodes, and the probability that the individual will be able to maintain control of the condition in the future. Generally individuals who have controlled their condition and been episode free for three to six months can receive a probationary license that requires regular monitoring by their physician and submission of followup medical reports to the licensing agency. Individuals who have been under control and episode free for six or more months can be licensed without restriction if there is no significant likelihood that episodes will recur, but probation can be continued if medical factors indicate the possibility of recurrence.

What is the process for appealing a decision of the state regarding a driver's license?

There is an appeal process for drivers whose privilege is suspended, restricted, or revoked for medical or functional impairments. When a driver has received notice of an action being taken against his or her license, the driver must request a hearing within 10 days of receiving personal service or 14 days from the date the notice was mailed, or will lose the right to a hearing. Individuals have the right to be represented by an attorney at their own expense, to review and cross examine testimony of any witness for the licensing agency, present evidence and relevant witnesses, or testify on their own behalf. Individuals who disagree with the hearing officer’s decision may request a departmental review of the decision, and may appeal the decision in superior court

May an individual whose license is suspended or denied because of diabetes receive a probationary or restricted license?

Yes, in some cases. California issues two types of probationary or restricted licenses. Type 1 provisions require a driver to 1) obey all traffic laws and remain free from traffic accident responsibility; 2) remain under the care of a physician and follow prescribed treatment; 3) report any adverse change in the medical condition to the licensing agency, and to the physician; and 4) refrain from operating a vehicle after alcohol or drug use or any medicine that may interfere with the safe operation of a motor vehicle. This provision is imposed for three years, at which time a review is conducted. Type II provisions are imposed when a driver has a history of difficulty in controlling a medical condition or when he or she has established control for only a short time. The driver is required to submit periodic reports from a physician to the agency. Typically, Type II with reporting does not extend beyond one year. If the driver has been compliant and has shown success in controlling the condition, then typically the reporting requirement is deleted, thus changing it to a Type I provision.

Is an identification card available for non-drivers?

Any non-driver may receive an identification card by filing an application form and showing proper identification.

Resources

Driver licensing in California is administered by the state Department of Motor Vehicles.