Maine

Maine

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

Yes. The driver's license application (first-time and renewal) presents a list of conditionsand asks the applicant whether he or she has any of those conditions. See Maine BMV, "Non-Commercial Class C Application," MVE-64 (Rev. 09/08). Diabetes is one of these conditions. Id. So are blackouts and loss of consciousness. Id. If an applicant answers yes to this question, he or she is required to have a medical evaluation form completed by his or her physician or other competent treatment personnel. See 29-250-003 Me. Code R. § 2(C)(licensing agency may request a medical report upon receipt of information concerning a medication condition affecting driving ability) (2013).  

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 written reports of medical conditions of potentially unsafe drivers from family, physicians, law enforcement personnel and other government agencies, and "signed statements from citizens." See 29-250-003 Me. Code R. § 2(B) (2013). Police officers may report an incident involving a medical issue on a special form. See Maine BMV, "Law Enforcement Officer's Report Relating to Adverse Driving," MVL-10U Concerned citizens may report potentially unsafe drivers to the licensing agency by writing letters including the name, address and date of birth of the driver. The licensing agency does not accept anonymous reports and does not investigate any of the reporting sources before it initiates an evaluation. Drivers may also be required to undergo a medical evaluation if they have impairments which are observed by licensing agency personnel during the licensing process, if they are involved in three or more accidents within three years, where a license has been expired for five or more years, or when they apply for a handicapped parking permit. See 29-250-003 Me. Code R. § 2(C) (2013) (receipt of information about medical condition may lead to evaluation). For more information, see Maine Bureau of Motor Vehicles, "Medical Requirements."

What is the process for medical evaluations of drivers?

When the licensing agency learns that a driver has diabetes, it will require the individual to have a medical evaluation. See 29-250-003 Me. Code R. § 2(C) (2013). When this happens, an evaluation form is sent to the individual, which then must be completed by his or her physician based on an examination conducted within the last year and must describe the physician's diagnosis and any prescribed medications. See 29-250-003 Me. Code R. § 2(C)(1) (2013).

On the medical evaluation form, the physician must provide a rating of the individual's functional ability to drive as it is impacted by diabetes (and other medical conditions). The physician must also provide the date of the last episode of loss of consciousness, list any medications taken, and state whether the individual is reliable in taking medications and whether the medications cause any side effects that can interfere with safe driving. See Main BMV, "Medical Evaluation Form," MD-FR-24 (Rev. 02/12/2009). Medical evaluation forms must be returned to the licensing agency, where they are evaluated and a licensing decision is made. See 29-250-003 Me. Code R. § 2(D)(1)-(2) (2013). Periodic follow-up medical evaluations may be required, primarily on the recommendation of the physician.

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 the state licensing agency.

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

A physician or other person who makes a "good faith" report of an impairment that appears to be an imminent threat to driving safety is immune from "criminal or civil liability." Me. Rev. Stat. tit. 29-A, § 1258(6) (2013). The immunity for damages "applies only to the extent that this immunity is not in conflict with federal law or regulation." Me. Rev. Stat. tit. 29-A, § 1258(6) (2013); see also 29-250-003 Me. Code R. § 2(D)(2)(a)(i) (2013) (board members and other persons making examinations or reports are immune from liability).

Who makes decisions about whether drivers are medically qualified?

The licensing agency employs trained personnel (including a registered nurse) who make decisions based on their review of the information submitted and based particularly on the functional ability ratings given by physicians. See 29-250-003 Me. Code R. § 1(A) (agency determines competence to drive) (2013). Cases will be referred to the state's independent Medical Advisory Board (MAB) when it is not clear from medical reports whether a person is medically capable of driving safely. See Me. Rev. Stat. tit. 29-A, § 1258(4) (2013).

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 a neurological, cardiovascular, metabolic, musculoskeletal, visual, emotional, psychiatric, or substance abuse condition that would interfere with safe driving. 29-250-003 Me. Code R. § 2(A) (2013). A driver may be required to undergo a medical evaluation if he or she answers affirmatively on the licensing application regarding one of these conditions, or if a concerned citizen or police officer (among others) reports the driver to the state licensing agency. 29-250-003 Me. Code R. § 2(B)-(C) (2013). Furthermore, drivers 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 involved in three or more accidents within three years, if their individual licenses have been expired for five or more years, or when they apply for handicapped parking permits.

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

Yes. Maine requires that diabetes be controlled with insulin, oral medication, diet, or exercise to permit driving. See 29-250-003 Me. Code R. § 1(B) (2013). Once diabetes is diagnosed, evaluation should be undertaken by a physician to determine the degree of impairment. 29-250-003 Me. Code R. § 1(B) (2013) (Referencing detailed standards for "Diabetes and other Endocrinopathies" under "Functional Ability Profiles"). Individuals who control their diabetes without medication are not required to complete follow-up medical evaluations at any regular interval. Id. Individuals whose diabetes is controlled with medication (i.e., insulin or oral agents) must have follow-up medical evaluations every eight years. Id. Individuals whose diabetes is uncontrolled or uncontrollable and currently impairs their driving function will not be licensed. Id. Newly diagnosed people with diabetes may be reviewed "as needed." Id. Diabetic retinopathy should be evaluated under the relevant vision guidelines. Id. For more information, see Maine Bureau of Motor Vehicles, "Medical Requirements."

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

There are no specific guidelines related to loss of consciousness caused by diabetes. For "neurological conditions," and "unexplained episodic alteration of consciousness," including a single seizure episode, no driving is permitted for six months. 29-250-003 Me. Code R. § 1(B) (2013) (referencing "Functional Ability Profile" for "Neurological Conditions/ Seizures and Unexplained Episodic Alternations of Consciousness"). An individual who has experienced seizures because of a medication regimen, but has been seizure-free and off medication for at least two years, is not restricted in his or her driving privileges and does not require follow-up medical evaluations at any regular interval. 29-250-003 Me. Code R. § 1(B) (2013). An individual who has experienced seizures because of a medication regimen, but has been seizure-free for at least two years and off medication for at least three months, is required to have follow-up medical evaluations at four-year intervals. 29-250-003 Me. Code R. § 1(B) (2013). If the medication is being tapered, the individual is not permitted to drive until three months after the medication has been discontinued. 29-250-003 Me. Code R. § 1(B) (2013). An individual with a longstanding seizure disorder (i.e., present greater than five years), who is on a medication regimen and has been seizure-free for at least three months, is also required to have follow-up medical evaluations at four-year intervals. 29-250-003 Me. Code R. § 1(B) (2013). An individual with any other seizure disorder (i.e., present less than five years), who is on a medication regimen and has been seizure-free for at least three months, is required to have follow-up medical evaluations at two-year intervals. 29-250-003 Me. Code R. § 1(B) (2013). "Breakthrough" seizures in a known seizure disorder due to reduction in medication are not subject to this three-month rule. 29-250-003 Me. Code R. § 1(B) (LexisNexis 2011). Furthermore, an individual whose seizures are not controlled, whose medication regimen is not adjusted, who has with an uncontrolled seizure disorder, who chronically fails to comply with his or her medication regimen, or whose medication regimen interferes with safe driving is not permitted to drive. 29-250-003 Me. Code R. § 1(B) (2013). Finally, an individual with a newly diagnosed seizure disorder is subject to periodic follow-up medical evaluations as necessary. 29-250-003 Me. Code R. § 1(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. If an individual with a known seizure disorder (whether present for less than or greater than five years) experiences a "breakthrough" seizure due to reduction in medication, this episode will not be held to violate the three-month rule as regards the interval at which follow-up medical evaluations are required. 29-250-003 Me. Code R. § 1(B) (2013) (referencing “Functional Ability Profile" for "Neurological Conditions/ Seizures and Unexplained Episodic Alternations of Consciousness"). However, there is no statutorily provided exception to the rule that an individual who experiences any unexplained episodic alteration of consciousness including a single seizure episode is not permitted to drive for six months. Id.

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

An applicant may request an administrative hearing, in writing, within 10 days of the effective date of the suspension. Me. Rev. Stat. tit. 29-A, § 2483(1) (2013). The licensing agency then will conduct a hearing and issue a decision within 30 days of the original request. Me. Rev. Stat. tit. 29-A, § 2483(2) (2013). Any suspension or restriction imposed by the licensing agency remains in effect while the appeal is pending, unless reversed by the licensing agency itself. Me. Rev. Stat. tit. 29-A, § 2483(5) (2013). The Medical Advisory Board considers any medical information submitted whenever an individual challenges a licensing agency action. Me. Rev. Stat. tit. 29-A, § 1258(4) (2013). Within 30 days of receipt of the decision from the administrative hearing, an individual may appeal to Superior Court.  Me. Rev. Stat. tit. 29-A, § 2485(5) (2013). If an individual has voluntarily cancelled his or her license for physical, mental, or emotional reasons, he or she may ask the licensing agency to reinstate it after (1) demonstrating that he or she is physically, mentally, or emotionally competent to operate a motor vehicle and (2) successfully completing the operator's examination. Me. Rev. Stat. tit. 29-A, § 1259(4)(A)-(B) (2013).

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

No. However, the licensing agency may issue licenses with "any…restriction[s] or condition[s] that [it] determines is in the interest of highway safety." Me. Rev. Stat. tit. 29-A, § 1257(4) (2013).

Is an identification card available for non-drivers?

Yes, with proper identification and payment of $5 fee. Me. Rev. Stat. tit. 29-A, § 1410(1)-(2) (2013). Identification cards are valid for periods of six years. Me. Rev. Stat. tit. 29-A, § 1410(4) (2013). For more information, see Maine Burea of Motor Vehicles, "Maine State Identification Cards."

Resources

Driver licensing in Maine is administered by the Bureau of Motor Vehicles.