Download Updated Texas Driving Rules for 2014

TEXAS LAWS REGARDING DRIVING
The laws determining safety of driving in medical conditions are extensive, but review of those pertinent to
neurology follows below:
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Syncope
o Unexplained syncope
 A single episode if unexplained precludes driving for 6 months. If cause is found and
corrected, driving may resume with physician permission.
o Neurocardiogenic syncope
 If uncontrolled and frequent and occurs while driving, precludes class A, B, and C passenger or
cargo vehicle licensure until controlled for 6 months.
o Recurrent uncontrolled syncope
 Precludes class A, B, and C passenger or cargo vehicle licensure until controlled for 1 year.
 Recurrent means 2 or more episodes in 6 months.
Transient ischemic attacks (TIA)
o If the event was caused by circumstances not likely to recur, it is permissible to drive with class A, B,
or unrestricted C license.
o If patients are treated with appropriate anticoagulant therapy, they may resume driving.
o If a patient is not on anticoagulant therapy or the underlying cause is not known, a 1 month driving
restriction should follow the last known episode of TIA.
Blackouts
o Temporary loss of consciousness, of which the person has no recall, often associated with alcohol or
drug intoxication.
o 6 month driving restriction
Stroke
o Patients should demonstrate driving ability through DPS comprehensive driving test in moderate to
severe motor, sensory, visual or language impairment.
Convulsive disorders
o For all seizures types: May obtain a class C license with P restriction after 3 months of seizure freedom
 For a class A, B, or unrestricted C license, must be seizure free OFF seizure medication for a
period of 5 years.
 For patients with simple partial sensory seizures, the 3 months of restriction is not required.
o For all of the above patients with seizures, driving is dependent upon other factors
 The patient is under a physician’s care.
 No evidence of seizures in the last 3 months.
 The patient is reliable in taking medications, avoiding sleep deprivation and fatigue, and
avoiding alcohol abuse.
 If the patient has well controlled epilepsy, but has a seizure with a change in medications,
driving may be resumed when the patient returns to the previous dose of seizure medications.
Dementia
o Diagnosis of dementia precludes driving unless the individual is judged to be safe by:
 A Neuropsychological evaluation of cognitive abilities involved in driving.
 A driving evaluation by a center or persons trained to evaluate driving ability in the setting of
cognitive impairment.
 Medical assessment by a physician with expertise in evaluating attention, memory, language,
etc in a standardized way.
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If none of the above options are available, passing the DPS written and driving evaluation will
be acceptable.
o Drivers who pass the initial evaluation should be re-evaluated every 12 months or sooner if concerns
are raised.
Head injury
o While the condition is under investigation, there should be no driving.
o Driving after head injury is dependent upon residual deficits.
 If minimal – no restrictions
 If mild – driving evaluation is required
 If moderate (significant deficits with potential for improvement) – must pass written and
driving portion of the DPS testing
 If severe (no potential for improvement) – no driving
Movement disorders
o Driving test recommended for moderate to severe cases
o Yearly medical board advisory review recommended.
Multiple Sclerosis
o Comprehensive driving evaluation by a trained driving rehabilitation specialist if warranted by
physician.
Excessive sleepiness
o It is the personal responsibility of drivers to avoid driving if they are unable to maintain alertness
while behind the wheel.
o Sleep apnea
 Severe OSA (AHI>20) precludes class A, B, and C license until the sleep disorder is treated and
the person demonstrates ongoing compliance with therapy.
 Moderate sleep apnea (AHI 10-20) may drive class C if he has EDSS<10 and the OSA is being
effectively treated.
 Mild OSA (AHI <10) may drive with any license type if EDSS is <10.
 Drivers with AHI>10 or EDS >10 must pass a Maintenance of Wakefulness Test before getting a
class A or B license.
 Ceasing therapy should be accompanied by driving cessation.
 Those with moderate to severe OSA should be recertified annually.
 Drivers with OSA should not be certified for unrestricted driving if:
 They have had a MCV associated with falling asleep
 Have not yet been treated for OSA successfully.
 Have been non-compliant with treatment.
 Drivers treated with surgery but be re-evaluated prior to return to driving.
o Narcolepsy
 Precludes driving if untreated.
 If treated, must be free of spells for 3 month period prior to medical review.
Peripheral neuropathy
o Driver proficiency test recommended for severe neuropathy.
Vertigo and dizziness
o Avoid driving while symptomatic or if the dizziness is severe.
o Unqualified for driving a commercial vehicle if the patient is on benzodiazepines or phenothiazines.