Driver License Laws By State

Texas

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

Yes. The application form for an original or renewal license (DL-14A) asks whether an applicant has been diagnosed or treated for a condition that may affect his or her ability to operate a motor vehicle safely; whether he or she has insulin-treated diabetes; or whether he or she ever has experienced a seizure, convulsion, or episode of loss of consciousness. See 37 Tex. Admin. Code § 15.37 (2013) ("An applicant for an original or renewal of a Texas driver license must answer certain questions relating to their physical and mental condition prior to licensing."). A medical evaluation is required if an applicant is taking insulin or has experienced any blackout or episode of loss of consciousness in the previous three years.

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 state accepts reports of potentially unsafe drivers from "proper medical authority" after a "professional evaluation of the medical facts." See 37 Tex. Admin. Code § 15.81(4)(C)(2013). Reports may be made by any "experienced field representative" of the licensing agency, or any "law enforcement agency." See 37 Tex. Admin. Code § 15.81(4)(D) (2013). Reports from these sources must follow "thorough investigation showing clear and convincing evidence." Id. The licensing agency accepts anonymous reports, but agency personnel may investigate any reports before or after an individual is contacted for an interview to determine whether his or her medical condition is of concern. See 37 Tex. Admin. Code § 15.81(5) (2011) (providing that "reliable" report must be "verified or substantiated").

Drivers also may be required to undergo medical evaluations if they have impairments that are observed by licensing agency personnel during the licensing process, see Tex. Transp. Code Ann. § 521.163(a) (West 2013), or when involved in two or more accidents in a twelve month period where investigation suggests that a medical condition may have played a role, see 37 Tex. Admin. Code § 15.81(4)(A)-(B) (2013). See Texas Department of Public Safety, "Texas Medical Revocation," for more information.

What is the process for medical evaluations of drivers?

When the licensing agency has reason to believe that a driver may be medically unsafe to operate a motor vehicle, either because he or she gave positive answers to medical questions on the license application or because of a report from one of the other sources listed above, licensing agency personnel will investigate the situation to decide whether the case meets the criteria for referral to the state's independent Medical Advisory Board. See generally 37 Tex. Admin. Code § 15.58 (2013) (outlining the criteria for referral to the Medical Advisory Board). The investigation may include an interview of the individual to gather more information about any medical conditions. When a case is referred to the Board, the Board sends a medical evaluation form to the individual, which must be completed by his or her physician based on an examination conducted within the last 12 months. See 37 Tex. Admin. Code § 15.58(4)(A) (2013). The medical evaluation form asks questions about the individual's diagnosis, the type and dosage of insulin or oral medications administered, and any instances of coma or shock. The medical evaluation form then is returned to the licensing agency for review and a licensing decision. Periodic follow-up medical evaluations may be required yearly or at each license renewal (i.e., every five years).

Are physicians required by law to report drivers who have medical conditions that could affect their ability to drive safely?

No. There is no statutory authority requiring physicians to report drivers with medical conditions that could affect their ability to drive safely to a central state agency.

However, a physician may report any patient over 15 years old with an applicable disorder or disability. Tex. Health & Safety Code Ann. § 12.096(a) (2013).

Are physicians who report drivers with medical conditions immune from legal action by the patient?

Yes. Members of the Medical Advisory Board and physicians that make reports to the Board pursuant to Tex. Health & Safety Code Ann. § 12.096(a) (2013) are exempted from the patient-physician privilege, and are not liable for their professional opinions, recommendations, or reports. Tex. Health & Safety Code Ann. § 12.098 (2013).

Who makes decisions about whether drivers are medically qualified?

Where an individual meets the criteria for referral to the state's independent Medical Advisory Board, the Board will review the relevant medical information and make a licensing recommendation based on state medical guidelines for various medical conditions. See 37 Tex. Admin. Code § 15.58(1)-(3) (2013). The licensing agency generally follows the recommendations of the Medical Advisory Board. The Board, not licensing agency personnel, generally collects and evaluates medical information about drivers. Nevertheless, the licensing agency retains ultimate authority over all licensing determinations. See, e.g., Tex. Transp. Code Ann. § 521.292(a)(1)-(9) (2013) (authorizing the licensing agency to suspend an individual's license); Tex. Transp. Code Ann. § 521.314(1)-(2) (2013) (authorizing the licensing agency to cancel an individual's license).

What are the circumstances under which a driver may be required to undergo a medical evaluation?

An individual may be required to undergo a medical evaluation if he or she gives affirmative answers to medical questions on the license application. See 37 Tex. Admin. Code § 15.37 (2013). An individual also may be required to undergo a medical evaluation if he or she has been reported to the licensing agency as a potentially unsafe driver, see 37 Tex. Admin. Code § 15.81(4)(C)-(D), (5) (2013), or if he or she has an impairment that licensing agency personnel observe during the licensing process, see Tex. Transp. Code Ann. § 521.163(a) (2013), or if he or she has been involved in accidents where investigation suggests that a medical condition may have played a role, see 37 Tex. Admin. Code § 15.81(4)(A)-(B) (2013).

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

Yes. An individual with diabetes will be referred to the Medical Advisory Board if he or she experiences hyperglycemia or hypoglycemia severe enough to cause "neurological dysfunction." 37 Tex. Admin. Code § 15.58(1)(C)(i)(I) (2013). This can include confusion, motor dysfunction, or loss of consciousness. Id. If any of these blood glucose problems have caused an accident any time within the last two years, the driver will be referred to the Board. Id. at (1)(C)(i)(II) (2013).

Furthermore, an individual with chronic renal failure must control his or her uremia through regular dialysis. 37 Tex. Admin. Code § 15.58(1)(C)(ii) (2013). An individual with retinopathy, who is under the care of a physician for an "eye disease" may be referred to the Medical Advisory Board. Id. at (1)(A)(i).

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

As mentioned above, an individual experiencing hypo- or hyper-glycemia severe enough to cause "loss of consciousness" will be referred to the Medical Advisory Board. 37 Tex. Admin. Code § 15.58(1)(C)(i)(2013).

The same may be true for other conditions. An individual with hypertension or syncope due to cardiovascular problems will be referred to the Medical Advisory Board if he or she has experienced any loss or alteration of consciousness within the past year. 37 Tex. Admin. Code § 15.58(1)(B)(iii)(II), (v) (2013). An individual that has experienced a stroke will be referred to the Medical Advisory Board if he or she experiences any degree of persistent neurological deficit (in which case he or she must take and pass a qualifying road test prior to referral) or if he or she has lost consciousness, blacked out, or fainted within the past year. 37 Tex. Admin. Code § 15.58(1)(E)(ii) (2013). Also, an individual will be referred to the Medical Advisory Board if he or she has experienced seizures or epileptic or convulsive attacks within the past year. 37 Tex. Admin. Code § 15.58(1)(E)(iii)(II) (2013).

Does the state allow for waivers of this policy, e.g., a waiver for a one-time episode of severe hypoglycemia that has mitigating factors (e.g., recent change in medication, illness, etc.) or that has been addressed with a physician?

No. However, episodes of hypoglycemia or hyperglycemia that did not lead to loss of consciousness, confusion, motor dysfunction, or an accident do not necessarily need to be reviewed by the Board. 37 Tex. Admin. Code § 15.58(1)(C)(i)(2013).

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

A notice of revocation advises a driver regarding, among other things, the right to a hearing, how to request a hearing, and the period in which he or she must request a hearing. Tex. Transp. Code Ann. § 521.296(3)-(5) (2013); 37 Tex. Admin. Code § 15.82(b) (2013). If a person desires a hearing, a written request must be made and received by the licensing agency no later than 15 days after the notice of revocation is presumed to have been received by the individual (i.e., five days following the date of the licensing agency's letter of intent). Tex. Transp. Code Ann. § 521.298 (West 2010); 37 Tex. Admin. Code § 15.83(a) (2013). A hearing will be scheduled no earlier than the eleventh day after the requester is notified of the hearing. Tex. Transp. Code Ann. § 521.299(a) (2013); see 37 Tex. Admin. Code § 15.83(g) (2013). It will be held in a municipal court or a justice court in the county in which the requester resides. Tex. Transp. Code Ann. § 521.300(a) (2013); see 37 Tex. Admin. Code § 15.84(a) (2013). If an adverse licensing decision is sustained following a hearing, the aggrieved individual may appeal to the county court at law or county court by filing a petition no later than 30 days after the licensing agency order was entered. Tex. Transp. Code Ann. § 521.308(a)-(b) (West 2013); 37 Tex. Admin. Code § 15.85(a)-(b) (2013). Appealing to the county court at law or county court stays the licensing decision until the earlier of 91 days following the date of the appeal petition or entry of a final judgment. Tex. Transp. Code Ann. § 521.308(f) (West 2013); 37 Tex. Admin. Code § 15.85(d) (2013).

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

The licensing agency may impose restrictions on an individual's license "appropriate to ensure the safe operation of a motor vehicle by the holder." Tex. Transp. Code Ann. § 521.221(a)(6) (2013). Furthermore, the licensing agency "may issue a special restricted license or state the applicable restriction on the regular license." Tex. Transp. Code Ann. § 521.221(b) (2013).

Is an identification card available for non-drivers?

Yes, with proper identification and payment of a fee. 37 Tex. Admin. Code § 15.24(1)-(4) (2013); see generally Tex. Transp. Code Ann. § 521.101 (2013) (providing for the issuance of identification certificates). An individual may obtain an identification certificate only if he or she is domiciled in Texas. Tex. Transp. Code Ann. § 521.1426(a) (West 2013); 37 Tex. Admin. Code § 15.49 (2013). A fee of $15.00 is required for applicants under 60 years of age, and a fee of $5.00 is required for applicants 60 years of age or older. Tex. Transp. Code Ann. § 521.422(a)(1)-(2)(2013). Texas imposes no age restriction for obtaining an identification certificate. See Texas Department of Public Safety, "Apply for an Identification (ID) Card," for more information.

Resources

Driver licensing in Texas is administered by the state Department of Public Safety.



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