Are applicants for a driver's license asked questions about diabetes?
Yes. First-time applicants are asked two medical conditions on their driver's license applications. The first question asks whether the applicant has ever experienced any medical condition that affected his or her ability to drive safely. Diabetes and altered consciousness are included in a list of these conditions. The second question asks whether the applicant is being treated for any of the listed conditions. If an applicant answers "Yes" to any of the medical questions, he or she is required to have a medical examination performed by a physician. Renewing drivers are not asked any medical questions.
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 almost everyone, including the following sources:
- police officers
- the courts
- other citizens
Ala. Admin. Code r. 760-x-20.04 (2012). The agency investigates these reports before it contacts the driver. Anonymous reports are not accepted; a sworn affidavit must be signed by all referral sources. Most decisions cannot rely on physical appearance, speculation, or generalizations. Ala. Code § 32-6-7.1(b) (2013). However, with probable cause, general conclusions about driving ability based on some physical conditions may be acceptable. Id.
A recommendation of a physician is treated with more authority. No investigation is required. The physician need not sign an affidavit. The licensing agency may restrict an individual's driving privileges based on "[a] recommendation of a physician or vision specialist" and "[t]he results of a driving examination or evaluation." Ala. Admin. Code r. 760-x-20.15 (2013).
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.
Are physicians who report drivers with medical conditions immune from legal action by the patient?
Yes. A physician licensed to practice medicine in the state is immune from civil and criminal liability medical conditions that could affect driving. Ala. Code § 32-6-45 (2013). Most non-physicians are also immune from civil liability, as long as they are "acting in good faith and without negligence or malicious intent" in making a report to the director's office. Id.
What is the process for medical evaluations of drivers?
First, a medical evaluation form may be sent to the driver. See Ala. Code § 32-6-42 (2013). The driver normally may choose his or her own Alabama-licensed physician to make the evaluation. Id. The physician completes the application. Id The form asks about episodes of altered consciousness within the last six months. It also includes a section on endocrine function which asks about usage of insulin and oral medications, hospitalizations for diabetes treatment, whether the individual has warning of impending hypoglycemic episodes, and the last three fasting blood glucose readings. The physician is asked to give a recommendation as to whether the patient can drive safely and can recommend licensing restrictions. Completed forms are sent back to the licensing agency, which then makes a decision on the driver's qualifications. See Ala. Code § 32-6-42 (2013).
What are the circumstances under which a driver may be required to undergo a medical evaluation?
The licensing agency may require an evaluation when it has reason to believe a driver has a "progressive, recurring or debilitating medical condition which may affect safe driving." Ala. Admin. Code r. 760-x-20.03 (2010); see also Ala. Code § 32-6-7.1 (2012). This may occur if driver gave positive answers to medical questions on the license application, or if a physician or any other citizen reports the condition. See Ala. Code § 32-6-42 (2013). If the evaluation finds an unsafe "progressive, recurring or debilitating condition," periodic follow-up medical examinations may be required as a condition of licensure. Ala. Admin. Code r. 760-x-20.16 (2012).
Who makes decisions about whether drivers are medically qualified?
The licensing agency has trained Medical Unit staff who make decisions in most cases, using the medical criteria and guidelines. Most decisions are made through this process.
"Individual problem cases" that require multiple opinions are referred to the state's medical advisory board for review and a recommendation. See Ala. Admin. Code r. 760-x-20.18 (2012); see also Ala. Code § 32-6-42 (2013). The Board is composed of 18 physicians, including one opthamologist, Ala. Code § 32-6-42, and usually one endocrinologist. For problem cases, the board may require an individual to undergo a physical examination by a member of the board. Ala. Code § 32-6-42 (2013). If the written records are not clear, an evaluation may include an in-person interview with members of the board. Id.
Has the state adopted specific policies about whether people with diabetes are allowed to drive?
Yes. An applicant may not be licensed if he or she has frequent or impairing episodes of hypoglycemia. Ala. Admin. Code r. 760-x-20.08 3(b) (2012). Neuropathy or other complications that could interfere with safe driving are also prohibited. Id. Evidence of alcohol or drug use sufficient to interfere with a diabetes-management program may lead to exclusion. Id. Individuals with retinopathy must have visual acuity of at least 20/60 or better in at least one eye and may not have a horizontal, temporal field of vision of 110 degrees or more from center. Ala. Admin. Code r. 760-x-20.14 3(c) (2012).
What is the state's policy about episodes of altered consciousness or loss of consciousness that may be due to diabetes?
Any episodes of loss of consciousness result in suspension of license for six months. See Ala. Admin. Code r. 760-x-20.10 (2012) (requiring for licensure that "[t]here has been no episode of altered consciousness or loss of bodily control caused by a neurological condition within the 6 months preceding application").
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. There is no statutory authority allowing for waiver of a license suspension due to altered consciousness or lack of consciousness.
What is the process for appealing a decision of the state regarding a driver's license?
The individual may request an appeal within 14 days of being notified of the department's action. An administrative hearing is held before an independent hearing officer who is an attorney or otherwise qualified person. Medical evaluations and physician recommendations are admissible without the physician being present. Ala. Admin. Code r. 760-x-20.20 (2012).
May an individual whose license is suspended or denied because of diabetes receive a probationary or restricted license?
Yes. The licensing agency may impose "restrictions suitable to the licensee's driving ability [as] appropriate to assure the safe operation of a motor vehicle by the licensee." Ala. Code § 32-6-12 (2013). The agency may provide special driver's license, or make restrictions to an ordinary driver's license. Id. It is a misdemeanor to violate these restrictions. Id.
Is an identification card available for non-drivers?
Yes. With proper identification, the licensing agency may issue a nondriver identification card to be used for identification purposes only. Ala. Code § 32-6-1(c) (2013).
Driver licensing in Alabama is administered by the State Department of Public Safety.