Massachusetts

Massachusetts

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

The driver's license application (first-time and renewal) asks an applicant whether he or she has any medical condition that may affect his or her ability to safely operate a motor vehicle and if he or she is taking any medications that could affect his or her ability to safely operate a motor vehicle. If an applicant answers yes to either question, he or she may be required to submit a Medical Evaluation Form. See Mass. Code Regs. 24.03(1)-(2) (applicant who does not meet qualifications standards must report medical condition to the Medical Affairs Branch of the Registry).

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 health care providers and law enforcement officers. Mass. Ann. Laws ch. 90, § 22I(b) (2013). Family members and interested third parties including, but not limited to, members of an individual's community (such as neighbors), and private driving schools may submit a request for evaluation form to the medical affairs division of the licensing agency. Mass. Dept. of Trans., "Request for Medical Evaluation," Form T21788 (Rev. 07- 12). For health care providers and police officers, the report must be filed in good faith, from a belief based on personal observation or physical evidence. Mass. Ann. Laws ch. 90, § 22I(b) (2013). Simple diagnosis of a medical condition or impairment is not enough—there must be actual observations or evidences that the condition affects safe driving. Id. A police officer must conduct an investigation Id. The licensing agency does not accept anonymous reports and the driver may make a written request to examine the reports. Mass. Ann. Laws ch. 90, § 22I(d) (2013). Drivers also may be required to provide medical certification if they have impairments which are observed by licensing agency personnel during the licensing process, if they are found to have caused at-fault accidents involving a fatality, or when they apply for handicapped parking permits. For more information, see Massachusetts Registry of Motor Vehicles, "Reporting Requirements."

What is the process for medical evaluations of drivers?

If a physician or law-enforcement officer reports to the licensing agency that an individual is not able to safely operate a motor vehicle, the licensing agency will conduct a review of the driver's capacity. Mass. Ann. Laws ch. 90, § 22I(c) (2013). The agency must conduct this review within 30 days of receiving the report, and must consider the contents of the report. Id. It does not need to request additional medical evaluation before making licensing decisions. In other circumstances not involving a physician or police officer report, the licensing agency may request a medical evaluation. See, e.g., 540 Mass. Code Regs. 24.06(1) (2013) (requiring persons subject to seizures or losses of consciousness to undergo examination by a physician as a condition of licensure).

On the Medical Evaluation Form, the physician must document the extent, frequency, and control of the symptoms of the individual's condition which may affect ability to operate a motor vehicle. Mass. Dept. of Transp., Med. Affairs Branch, "Medical Evaluation Form," Form T20221 (Rev. 07 – 12). The physician must indicate whether the condition is likely to interfere with the individual's mental or physical ability to operate a motor vehicle safely; the type and date of the individual's last episode of loss of consciousness; the types and dosages of medications prescribed; and whether the medications are likely to affect the individual's ability to safely operate a motor vehicle. Id. The physician is also asked to give a professional opinion on whether the individual is capable of safely operating a motor vehicle and is asked whether periodic follow-up evaluations should be required. Id. Medical Evaluation Forms must be returned to the licensing agency, where they are evaluated based on the physician's recommendations and the state's minimum medical criteria and a licensing decision is made.

If the licensing agency determines that a suspension of a current license is necessary, the driver is first asked to voluntarily surrender the license. See 540 Mass. Code Regs. 24.03(1)(2013). If the driver does so, the license is placed on Medical Hold. See 540 Mass. Code Regs. 24.03(3) (2013). To regain the license, the individual must submit appropriate medical documentation and may be required to complete a behind-the-wheel driving examination. Id. Periodic follow-up medical evaluations may be required, usually on the recommendation of the physician. For more information, see Massachusetts Registry of Motor Vehicles, "Reporting Requirements."

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

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 voluntarily make a report to the licensing agency if he or she has a "reasonable cause to believe that an operator is not physically or medically capable of safely operating a motor vehicle or has a cognitive or functional impairment that will affect that person's ability to safely operate a motor vehicle." Mass. Ann. Laws ch. 90, § 22I(b) (2013). The report must be filed in good faith, from a belief based on personal observation or physical evidence. Mass. Ann. Laws ch. 90, § 22I(b) (2013). Simple diagnosis of a medical condition or impairment is not enough—there must be actual observations or evidences that the condition affects safe driving. Id. For more information, see Massachusetts Registry of Motor Vehicles, "Reporting Requirements."

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

Physicians treating drivers with medical conditions that could interfere with their ability to drive safely are immune from any civil liability that might result from either making or not making reports to the licensing agency. Mass. Ann. Laws ch. 90, § 22I(b) (2013). So are law enforcement officers. Id. There is no statutory authority similarly providing immunity from any criminal liability.

Who makes decisions about whether drivers are medically qualified?

Most decisions are made by licensing agency staff based on the state's minimum medical criteria and the recommendations of an individual's treating physician. See 540 Mass. Code Regs. 24.01 (2013) (stating that the licensing agency develops standards of fitness for the safe operation of a motor vehicle). Great weight is given to a physician's opinion although the minimum medical criteria will override a physician's opinion when the two conflict. The state also has an independent Medical Advisory Board and cases can be referred to the board for recommendations. See Mass. Ann. Laws ch. 90, § 8C (2013). However, this is rarely done, as the primary function of the Medical Advisory Board is to assist in developing medical criteria. See 540 Mass. Code Regs. 24.01 (2013) (stating that the licensing agency promulgates minimum medical criteria based on recommendations from the Medical Advisory Board).

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

A driver may be required to undergo a medical evaluation if he or she has experienced an episode of loss of consciousness within the preceding six months, see 540 Mass. Code Regs. 24.06(1) (2013), or if he or she has given positive answers to medical questions on the license application. See Mass. Code Regs. 24.03(1), (3) (applicant who does not meet qualifications standards must report medical condition to the Medical Affairs Branch of the Registry). Drivers also may be required to undergo medical evaluations if they have impairments which are observed by licensing agency personnel during the licensing process, if they are found to have caused at-fault accidents involving a fatality, or when they apply for handicapped parking permits. Further, a driver may be required to undergo a medical evaluation if he or she has been reported as a potentially unsafe driver through the submission of a Request for Medical Evaluation Form. Mass. Ann. Laws ch. 90, § 22I(b) (2013).

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

No. Massachusetts has adopted no specific medical guidelines related to diabetes, except for its guidelines related to episodes of loss of consciousness.

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

To be licensed, an applicant must be episode-free for six or more months and must obtain a statement from his or her treating physician that he or she has been free from episodes for the required period. 540 Mass. Code Regs. 24.06(1) (2013). The physician statement (Loss of Consciousness Evaluation Form) must specify (1) the cause of the episode (i.e., type of disorder suffered); (2) the means by which the condition is controlled (including any medications and dosages); (3) the degree of impairment or disability suffered during the episode (i.e., extent of episode); (4) the probability of recurrence of the episode (including frequency of occurrence, degree of assurance that the event will not reoccur, and basis for estimate of probability); (5) the date of the most recent episode; and (6) a certification, to a reasonable degree of medical certainty, that the individual's medical condition and medications will not interfere with the safe operation of a motor vehicle. 540 Mass. Code Regs. 24.05(1)(a)-(f) (2013); Mass. Dept. of Transp., Med. Affairs Branch, "Loss of Consciousness Evaluation Form," Form T21618 (Rev. 11-12). An applicant may be required to submit periodic follow-up medical evaluations. The licensing agency has the authority to require than an individual be episode-free for longer than six months. 540 Mass. Code Regs. 24.05(2) (2013). Furthermore, the licensing agency may request whatever additional evidence of medical qualification criteria that it deems appropriate, and it may modify the regulatory standards on a case-by-case basis. 540 Mass. Code Regs. 24.05(3) (2013). An individual must be given written notice that his or her license will be suspended or revoked at least fourteen days prior to the effective date of the suspension or revocation. Mass. Ann. Laws ch. 90, § 22(b) (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?

Yes. The licensing agency may exempt an individual from the six-month seizure-free period upon receipt of a certification from his or her physician containing all of the information specified in 540 Mass. Code Regs. 24.05(1)(a)-(f) (2013) and requesting that the individual be granted an exemption from the six-month episode-free policy because the physician has determined that the individual's medical condition and medications will not interfere with the safe operation of a motor vehicle, with specific reasons provided for such determination. 540 Mass. Code Regs. 24.05(2) (2013).

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

If an individual's license is denied, suspended, or revoked, he or she may appeal the decision before the Board of Appeals on Motor Vehicle Liability Policies and Bonds within 10 days, where, after a hearing, the licensing agency's decision will be affirmed, modified, or annulled. Mass. Ann. Laws ch. 90, § 28 (2013). The licensing agency's decision remains in effect while the appeal is pending. Id. At the hearing, both the aggrieved individual and the licensing agency may introduce evidence and testimony. Id.

In addition, if an individual's license is suspended or revoked for medical reasons, he or she may effectively appeal the decision by failing to surrender his or her license, at which point the licensing agency will schedule a hearing on the matter at which the individual may be accompanied by a lawyer and at which evidence and testimony may be introduced. 540 Mass. Code Regs. 24.03(2)(b) (2013); see also Mass. Ann. Laws ch. 90, § 22(b) (2013) (describing the hearing process). A decision will be issued within 10 days, and if the individual does not attend the hearing, he or she will have waived his or her right and his or her license will be revoked within 10 days. 540 Mass. Code Regs. 24.03(2)(b)(1)-(2) (2013). The individual may appeal this outcome to the Board of Appeals on Motor Vehicle Liability Policies and Bonds, as described above. 540 Mass. Code Regs. 24.03(2)(b)(3) (2013).

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

There are no specific statutory or regulatory provisions for issuing a probationary or restricted license.

Is an identification card available for non-drivers?

Yes. Any individual fourteen years of age or older, who does not possess a valid driver's license, may obtain an identification card with proof of identity and payment of a $25.00 fee. Mass. Ann. Laws ch. 90, § 8E (2013). An identification card is valid for a five-year period. The application process is the same as that to obtain a driver's license. Id. If an applicant voluntarily surrenders his or her driver's license due to medical reasons, he or she may receive an identification card free of charge. 540 Mass. Code Regs. 24.03(3) (2013). If an individual wishes to reinstate his or her driver's license, he or she must comply with any relevant medical clearance procedures by submitting medical clearance documents and completing a road examination, and the license will be reinstated free of charge. 540 Mass. Code Regs. 24.03(3) (2013).

Resources

A Driver licensing in Massachusetts is administered by the Registry of Motor Vehicles.