Returning to driving
For many people, one of the first things they focus on after their initial recovery from their brain injury, is when they can get back to driving. However, as we know, driving uses many complex thinking and physical skills which may have been affected by a brain injury.
Brain Injury and driving
You may be safe to drive now or sometime in the future. This will depend on how your brain injury has affected you. Some people will need to have their cars adapted or change to driving an automatic. Other people may have to accept that they are no longer able to drive safely.
In this material, we provide you with the current facts regarding returning to driving, along with tips and advice based on research and people’s own experiences. We hope you will find this useful — whatever your situation.
At the time of publication, the current guidelines for drivers with illnesses or disabilities are the Medical Fitness to Drive Guidelines, March 2015. These guidelines are updated every year. You will find the latest version on www.ndls.ie. It is your responsibility to check that you have met all current requirements before you return to driving. Speak to your GP for guidance.
A brain injury can affect your ability to drive in many different ways. Some of the effects are obvious because they are physical, while other effects can be invisible or hidden.
When we drive, we use many different mental and physical abilities - for example: being aware of our surroundings, ignoring distractions, as well as using the car controls such as the pedals, gears and steering wheel. Many different effects following a brain injury can impact on a person’s ability to drive.
Physical effects include:
Hidden effects include:
This depends on how severe your injury was and what after-effects you still have. Before returning to drive, you need to allow yourself plenty of time to recover and to adjust to any changes from your brain injury.
If any after-effects you have are likely to impact on your ability to drive safely, you must get yourself checked as safe to drive by a registered medical professional. This can be your consultant or your GP. They must base their decision on their medical judgement and the current Medical Fitness to Drive Guidelines. You can check what the medical guidelines are for your condition at www.ndls.ie .
If you are able to return to driving, it will usually be a number of months after your brain injury. Your doctor may ask you to get an assessment done to help them to make their decision if you are ready to return to driving. You can also apply to get a driving assessment done yourself by contacting your nearest assessment provider. See page 8 for more on this. See Help and information on page 22 for contact details of providers of driving assessments and the National Driving Licence Service (NDLS).
This booklet is mainly for anyone driving their own car. If you drive a truck or a bus, you need to make sure you comply with the Medical Fitness to Drive Guidelines for truck and bus drivers (called Group 2 drivers). The Group 2 guidelines are much stricter than for driving a private car. Talk to your employer and your GP about this.
If you are not able to meet the requirements for returning to work as a truck or bus driver, this does not automatically mean you cannot drive your own car. Discuss this with your GP.
If you cannot drive for work any longer, in most cases, your employer is obliged to take reasonable steps to give you different duties. This known as ‘reasonable accommodation’. Talk to your employer about this or contact Citizens Information for advice t: 076 107 4000 or visit www.citizensinformation.ie .
Taxi drivers and cab drivers
If you hold a Small Public Service Vehicle licence (SPSV), you are required by law to tell the licensing authority of any illness or physical disability you have that could affect your ability to safely drive a taxi or cab. Talk to your GP or consultant about this. They should tell you if you are safe to return to driving or if you need to report any change in your abilities to the licencing authority.
If your brain injury has caused any of the physical or hidden changes listed on page 2 it is important to:
Many people can drive safely with hearing loss by using their mirrors more and being more observant of what is going on around them.
Difficulty communicating (Aphasia)
It is possible for people with receptive aphasia to continue to drive. Receptive aphasia is where someone has difficulty understanding written or spoken language. It is advisable to bring someone with you initially to make sure you are comfortable finding your way. Give yourself extra time. Many people who can no longer read road signs or maps find a Sat Nav (Satellite Navigation System) or the map function on their phones, invaluable.
Changes in eyesight and visual perception
You may still be able to drive a motorcycle, car or tractor, if you have adequate vision and meet the necessary eyesight standards. Ask your GP or consultant about this. 6 Physical disability and car adaptations If your brain injury has affected you physically, it is a good idea to get an in-car assessment done by an Occupational Therapist or Driving Assessor. They will be able to see if you need any adaptations made to your car. If you get your car adapted, you must inform your insurance provider. If you do not inform your insurance provider, your insurance may be invalid.
Before making any decision about ordering adaptive equipment or making changes to your car, arrange a demonstration and try out using the adaptation yourself. It is very important to practice using any adaptations yourself to make sure they work well for you. See page 22 for where to find details for licenced car adaptation companies.
Perception is the mental process of recognising and interpreting objects, through one or more of the senses. The most important sense for driving is vision. Depth perception: This is the ability to recognise and interpret the distance from yourself to an object or the distance between two objects. Depth perception is very important in being able to drive safely. If you can only see with one eye, it is possible to perceive depth but it is more difficult than using both eyes.
The medical guidelines are very detailed with regard to driving with epilepsy or seizures. Your consultant, or GP, should tell you how they apply to you. You can get the Medical Fitness to Drive Guidelines online at www.ndls.ie .
Epilepsy : If you have been diagnosed with epilepsy, the current rule is that you need to be free of seizures for one year before returning to driving, in most cases.
Single seizure : If you had a single seizure at the time of your brain injury, shortly afterwards or during brain surgery, you may be able to return to driving in less than one year. This is providing there are no other risk factors. Ask your consultant about this. If you would like help and support regarding epilepsy and seizures, contact Epilepsy Ireland on 01 455 7500 or visit www.epilepsy.ie.
A driving assessment is where an assessor runs through a series of checks to measure your skills in relation to driving. The Driving Assessor is usually an Occupational Therapist or specialist driving instructor. The skills they measure are in thinking, planning and awareness, they also assess your visual skills, your movement and your reactions.
The Driving Assessor does an assessment in a stationary car first and next does an on-road assessment, where appropriate. They should give you advice and feedback during the session.
The purpose of the driving assessment is:
It is important to remember that if the assessor recommends you do not drive, this can often be re-visited at some point in the future if your health or abilities improve.
You can do the assessment in your own vehicle, or in an automatic or adapted vehicle, provided by the assessor.
You can get more information and access specialist driving instructors, through the Irish Wheelchair Association, the Disabled Drivers Association and other providers (contact details are on page 22). You do not need to use a wheelchair or have a physical disability to use these services.
Your current licence is still valid unless your GP:
The current Medical Fitness to Drive Guidelines state that people with epilepsy, or with certain disabilities caused by their brain injury, or with certain types of brain injury, must notify the NDLS. Your GP will advise you if this rule applies to you or not.
If your GP says you can drive but your condition means that you must notify the NDLS, you notify them by applying for a change in personal details on your driving licence. However:
To make a change in personal details on your licence, you need to:
Temporary Learner Permit
If your GP believes you are not safe to drive on your own yet and that you should get a driving assessment done, they can apply to the Medical Fitness section in the Road Safety Authority (RSA) for a temporary learner permit for you.
See also Renewing your licence on page 11. If you have any questions, speak to your GP or contact the NDLS on t: 0761 087 880 or visit www.ndls.ie.
If your driving licence has expired since your brain injury, you need to apply to renew it. To do this you fill out the licence renewal form and personally go to one of the National Driver Licencing Service centres (NDLS). If you have one of the disabilities or conditions specified on the driving licence renewal form, your GP will need to fill in a Medical Report form.
Some of the conditions that require a medical report form are:
If you have not already had one, your GP may ask you to have a driving assessment done. This assessment is to make sure you are still safe to drive or to see if you should have some driving lessons or get adaptations done to your car.
Contact the National Driver Licencing Service for driving licence forms and information – t: 0761 087 880 or visit www.ndls.ie.
Before you start driving again, you need to let your motor insurance company know about your medical condition. Otherwise, it could make your insurance invalid and affect any claims you make in the future.
If your doctor says you are fit to return to driving, your insurance company cannot charge you more for your cover. They also cannot refuse to provide you with cover.
If you have been refused a quotation for motor insurance, you can request the reasons in writing from your insurance provider.
If you are not satisfied, you are entitled to go to the Declined Cases Committee of Insurance Ireland. Insurance Ireland is the representative body for most insurance companies in Ireland — t: 01 676 1914.
If you get your car adapted, you must inform your insurance provider. If you do not inform your insurance provider, you may not be covered.
You can get clear information and advice on car insurance from the Competition and Consumer Protection Commission. Helpline t: 01 402 5555 or visit www.consumerhelp.ie .
Disabled Drivers and Disabled Passengers Scheme
If you have a severe physical disability, you may be eligible to apply for tax relief for adapting a car, buying an adapted car and other expenses, under the Disabled Drivers and Disabled Passengers Scheme.
Call the HSE Infoline for information on applying for a Primary Medical Certificate t: 1850 24 1850.
You can get the rules of the Disabled Drivers and Disabled Passengers Scheme, and how to apply, from: Citizen’s Information on t: 076 107 4000 or The Revenue Commissioners on t: 047 621 00.
Disabled Parking Badge
A blue Disabled Parking Badge allows permit holders to use official disabled parking spaces.
You can get further information on the rules and how to apply for a Disabled Parking Badge from the Irish Wheelchair Association (IWA) or the Disabled Drivers Association of Ireland (DDAI). These two organisations process all applications for the parking badges on behalf of the Department of Transport, Tourism and Sport (contact details are on page 22).
Many people find that a simple way to make driving easier is to change to an automatic car. If you would like to consider this, get advice and make sure you take a few test drives to check if an automatic car suits you.
Not everyone can go back to driving after their brain injury. This can be very challenging and hard to accept. Everyone reacts to this news in different ways. However, there are a few points to bear in mind:
My doctor has told me I am medically safe to drive but I don’t feel confident enough.
Is it safe to have one drink and still drive?
I’m ready to get driving again but I’m not sure what is the best way to start.
I have a full driver’s licence. I recently had my car adapted and will be returning to drive. Do I have to re-take my driving test?
I’m sure I am fine to drive but my doctor and my family say I’m not. What can I do?
I am ok driving on short journeys but I get very tired on longer ones. Any advice?
You can download and print a useful checklist of important points to consider when returning to driving.
Advice on the disabled parking badge, driving assessments, lessons and car adaptations. Disabled Drivers Association of Ireland, Claremorris, Co Mayo. t: 094 936 4054 or visit www.ddai.ie Irish Wheelchair Association – various centres t: 045 893 094 or visit www.iwa.ie There are other regional providers of these services, contact Headway for a list or visit www.headway.ie/information .
For a list of licenced car adaptation companies, contact the National Standards Authority of Ireland on t: 01 807 3800 or visit www.nsai.ie .
Medical Fitness to Drive Guidelines
Road Safety Authority t: 1890 406 040 or visit www.rsa.ie
Driving Licence and medical reports
The National Driver Licence Service (NDLS) has centres throughout Ireland. t: 0761 087 880 and www.ndls.ie
Grants and entitlements
Contact Citizens Information for assistance and forms. Lo-call t: 076 074 000 or visit www.citizensinformation.ie
The Revenue Commissioners, Central Repayments Office, Monaghan. t: 047 621 00 or visit www.revenue.ie
Primary Medical Certificate
Contact the HSE’s Information Line for rules and how to apply. t: 1850 24 1850 or visit www.hse.ie
Insurance Ireland provide an information service on all insurance matters. They also deal with complaints about Insurance companies who are members of Insurance Ireland. t: 01 676 1914 or visit www.insuranceireland.eu The Competition and Consumer Protection Commission offer independent information and advice on insurance. t: 01 402 5555 or visit www.consumerhelp.ie
Epilepsy and seizures
Epilepsy Ireland can give you advice and support. t: 01 455 7500 or visit www.epilepsy.ie