2010 BC Guide in Determining Fitness to Drive

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18.8 Hearing reportOffice of the Superintendentof Motor Vehicleswww.pssg.gov.bc.ca/osmvPO BOX 9254 STNPROV GOVTVICTORIA BC V8W 9J2Phone: (250) 387-7747Fax: (250) 952-6888HEARING REPORTNote to Driver: If you have had a hearing test done within one year prior to the date this form was issued, you maysubmit the results of that test. If you require a current hearing test to fulfill this requirement, OSMV will pay theservice provider directlyThe personal information on this form is collected under the authority of the Motor Vehicle Act and the Freedom of Information and Protection of Privacy Act. The information provided will beused to determine your fitness to drive a motor vehicle. Personal information is protected from unauthorized use and disclosure in accordance with the Freedom of Information and Protection ofPrivacy Act and may be disclosed only as provided by that Act. If you have any questions about the collection, use and disclosure of the information collected, contact the Office of theSuperintendent of Motor Vehicles at (250) 387-7747.THIS REPORT MUST BE COMPLETED IN FULL AND RETURNED WITHIN 30 DAYS TO THE OFFICE OFTHE SUPERINTENDENT OF MOTOR VEHICLESDriver’s Name DL # Date IssuedRECENT UNAIDED AUDIOGRAMIntensity in Decibels(dB)RIGHTEARLEFTEARFREQUENCY IN HERTZ (Hz)500 1000 2000If hearing loss is greater than 40 dB in the better ear, complete the following:RECENT AIDED AUDIOGRAMIntensity in Decibels(dB)RIGHTEARLEFTEARFREQUENCY IN HERTZ (Hz)500 1000 2000224
PLEASE COMPLETE THE FOLLOWING: YES NO1. Is hearing loss progressive? 2. Can hearing be corrected with an aid? 3. Was an aid prescribed? EXAMINING AUDIOLOGISTNAME AND ADDRESS (USE RUBBER STAMP OR PRINT)RECOMMENDATIONS - FOR OFFICE USEONLY DOES NOT MEET GUIDELINES MEETS GUIDELINES – NO RESTRICTIONTELEPHONE NUMBER: MEETS GUIDELINES – WITH RESTRICTIONS RESTRICTIONS ADDED 23 37 51SIGNATURE OF AUDIOLOGISTOF EXAMDATENAME (PLEASE PRINT)OFFICE_______________________________________________(YYYY/MM/DD)(YYYY/MM/DD)225
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Ministry of Public Safety and Solic
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AcknowledgmentsResearcherBonnie M.
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Table of Contents (click on any ite
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11.7 Private and commercial drivers
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BACKGROUND ........................
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PART 1:BACKGROUND1
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Appendix 2: Excerpts from the MVA t
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Chapter 2: The Driver Fitness Progr
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for the exercise of discretion by O
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1. SCREENINGA driver disclosesa med
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2.3 Roles and responsibilitiesOSMV
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Medical practitionersMedical practi
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Chapter 3:Driver Fitness Program Pr
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Because of these limitations, OSMV
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Example: the temporary storage of i
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Motor functions (including sensorim
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an individual with poor contrast se
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3.5 Best informationDriver fitness
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Chapter 4: Introduction to the Poli
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3. DETERMINATIONFrom2. AssessmentAn
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Once identified, a DMER is mailed t
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5.3 Screening aging driversDefiniti
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5.5 Transient impairmentsDefinition
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Chapter 6: Assessment Policies and
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6.2 Assessments will only be reques
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6.4 Requesting specialist assessmen
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Policy6.5.1 If a case manager or ad
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Persistent and episodic impairments
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further assessment. Drivers who sco
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6.9.4 A case manager or adjudicator
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ASSESSMENT PROCEDURESCase manager o
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A driver fitness determination is a
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Policy rationaleBecause individuals
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7.5.3 Generally, an individual whos
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7.6.2 In particular, the case manag
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7.8.3 Whether an individual can com
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in order to be fit to drive, the ca
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has the judgment and willingness to
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Policy7.11.1 If a case manager or a
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(e) the medical condition results i
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7.12 Communicating a decisionPolicy
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7.13 Determination proceduresThe fo
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During the reconsideration, the adj
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8.3 Reconsideration proceduresThe f
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Chapter 9:Introduction to the Medic
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9.4 Medical condition chapter templ
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Private and commercial drivers who
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Chapter 11: Diabetes - Hypoglycemia
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PercentFigure 1 - Prevalence of Dia
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neuropathy, nephropathy, cardiovasc
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11.8 Private drivers with diabetes
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11.9 Commercial drivers with diabet
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RestrictionsRe-assessmentguidelines
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Policy rationaleSevere hypoglycemia
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11.12 Private drivers who have pers
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11.13 Commercial drivers who have a
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11.14 Commercial drivers who have a
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11.15 Commercial drivers who have p
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PART B - HYPOGLYCEMIA11a. Has the p
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Produce my glycemic log for my doct
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Deep-vein thrombosisDeep-vein throm
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Aneurysms less than 5 cm in diamete
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GUIDELINES12.6 Private and commerci
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12.7 Private drivers who have an an
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12.9 Commercial drivers who have an
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Chapter 13: Musculoskeletal Conditi
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ConditionType of drivingimpairment
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ConditionsRestrictionsRe-assessment
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14.3 Chronic renal disease and adve
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14.8 Private drivers with end-stage
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14.10 Private and commercial driver
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Level ofImpairmentMildlyImpairedMod
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15.8 Commercial drivers with modera
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15.10 Commercial drivers with sever
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Policy rationaleDrivers who require
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Chapter 16: Vestibular DisordersBAC
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One study identified that 32.5% of
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ConditionType ofdrivingimpairmentan
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Re-assessmentguidelinesPolicy ratio
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Individuals who have undergone valv
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Episodic impairmentThe potential ep
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GUIDELINES17.6 Policy rationaleThes
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17.9 Commercial drivers with corona
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17.11 Private drivers who have had
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Page 187 and 188: 17.15 Private drivers who have vent
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Page 191 and 192: 17.19 Private drivers who have sust
Page 193 and 194: 17.21 Commercial drivers who have s
Page 199 and 200: 17.27 Private drivers with atrioven
Page 201 and 202: 17.28 Commercial drivers with atrio
Page 203 and 204: 17.29 Private drivers with permanen
Page 205 and 206: 17.31 Private drivers who have decl
Page 207 and 208: 17.33 Private drivers where ICD the
Page 209 and 210: 17.35 Commercial drivers who have d
Page 211 and 212: 17.37 Commercial drivers with inher
Page 213 and 214: 17.39 Commercial drivers with medic
Page 215 and 216: 17.41 Private drivers with surgical
Page 217 and 218: 17.43 Private drivers with mitral v
Page 219 and 220: 17.45 Private drivers with congesti
Page 221 and 222: 17.46 Commercial drivers with conge
Page 223 and 224: 17.47 Private drivers with left ven
Page 225 and 226: 17.49 Private drivers with a heart
Page 227 and 228: 17.51 Private drivers with hypertro
Page 229 and 230: 17.53 SyncopeSee the guidelines in
Page 231 and 232: Stable coronary syndromes - waiting
Page 233 and 234: Chapter 18: Hearing LossBACKGROUND1
Page 235 and 236: GUIDELINES18.6 Private drivers with
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Page 241 and 242: this manual. Axis IV addresses exte
Page 243 and 244: Negative symptoms are characterized
Page 245 and 246: Schizophrenia (Axis I)Schizophrenia
Page 247 and 248: 19.4 Effect of psychiatric disorder
Page 249 and 250: Suicidal ideationSuicidal ideation
Page 251 and 252: GUIDELINES19.6 Private and commerci
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Page 255 and 256: Cerebrovascular accidentCVAs are th
Page 257 and 258: ConditionType of drivingimpairment
Page 259 and 260: GUIDELINES20.6 Private and commerci
Page 261 and 262: Re-assessmentguidelinesPolicy ratio
Page 263 and 264: 20.9 Private drivers who have had s
Page 265 and 266: 20.10 Commercial drivers who have h
Page 267 and 268: Visual field impairment refers to a
Page 269 and 270: Right homonymous hemianopiaBinasal
Page 271 and 272: An example of the effects of diabet
Page 273 and 274: Retinitis pigmentosaRetinitis pigme
Page 275 and 276: GlaucomaApproximately 67 million pe
Page 277 and 278: indicates that wait times of 6 mont
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Page 281 and 282: Policy rationaleretinopathy dependi
Page 283 and 284: Policy rationaleIndividuals with be
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21.13 Commercial drivers with a los
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21.17 Visual field impairmentsTypes
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21.18 Examination of visual functio
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VISUAL FIELD TEST (VFT)For drivers
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To the Driver:Under section 29 of t
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Please note:Goldman, Esterman and H
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Cardiac syncopeCardiac syncope refe
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22.7 Private drivers who have had a
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22.9 Private drivers with recurrent
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22.11 Commercial drivers who have h
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22.13 Commercial drivers with recur
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Chapter 23: Seizures and EpilepsyBA
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abnormal numbnesstingling and a cra
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23.10 Private drivers with single u
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23.12 Private drivers with epilepsy
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23.18 Commercial drivers with epile
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Level of disabilityor worsening of
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Parkinson’s diseaseThere is a sma
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25.2 Prevalence and incidence of tr
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Chapter 26: Intracranial TumoursBAC
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Some examples of compensatory mecha
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i. aphasia (language disturbance)ii
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27.2 Prevalence and incidence of co
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27.4 Effect of cognitive impairment
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Chapter 28: Sleep DisordersBACKGROU
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An immediate reduction in daytime s
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28.5 CompensationIndividuals with s
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OSMV determinationguidelines cont
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Policy rationaleThe general approac
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Chapter 29: Prescription and Over-T
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Examples of newer antihistamines in
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Stimulants (for ADHD)Examples of st
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AntiepilepticsIn general, individua
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Sedating EffectLowModerateHighTCAsd
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dizziness, andblurred or double vis
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30.2 Effect of general debility and
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Appendix 1: Glossary of TermsCommer
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Medical assessmentis any kind of as
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Transient impairmentmeans a tempora
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must cause to be issued to the appl
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(ii) cancel the person's driver's l
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Appendix 3: Aging DriversAbout agin
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Percentadults. The survey also foun
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Appendix 4: Licence ClassesThe tabl
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Appendix 5: Drafting and Approval P
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drivers, this means that BC commerc
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2010 BC Guide in Determining Fitness to Drive

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