2010 BC Guide in Determining Fitness to Drive

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GUIDELINES27.6 Private and commercial drivers with cognitive impairment or dementiaApplicationAssessment guidelinesFitness guidelinesOSMV determinationguidelinesConditionsRestrictionsRe-assessmentguidelinesPolicy rationaleThese guidelines apply to driver fitness determinations for privateand commercial drivers who have cognitive impairment or dementia.If the treating physician or cognitive screening indicates: cognitive impairment, or dementiathat may impair the cognitive functions necessary for driving, OSMVwill request a DriveABLE assessment, unless there has been nosignificant change in the individual’s condition or cognitive abilitysince a previous functional assessment.If cognitive screening indicates that the cognitive functions necessaryfor driving are impaired, OSMV will not request further assessments.Individuals may drive if: the results of a cognitive screening test such as MOCA, MMSE,SIMARD-MD, Trails A, or Trail B indicate that they havesufficient cognitive function to drive safely, or where required, a DriveABLE assessment or other functionalassessment indicates that they are fit to drive, and the entirety of the file information supports a finding of sufficientcognitive function to drive safelyOSMV may find individuals fit to drive if a functional assessmentindicates that they have the functional ability required for their classof licence held.No conditions are required.No restrictions are required.OSMV will re-assess annually if an individual has: dementia, or a cognitive impairment that is progressive.The result of a cognitive screening test such as MOCA, MMSE,SIMARD-MD, Trails A, or Trail B, while considering the entirety ofthe file information, will inform whether further assessment isrequired.340
Chapter 28: Sleep DisordersBACKGROUND28.1 About sleep disordersSleep disorders involve any difficulties related to sleeping, including: difficulty falling asleep (insomnia) or staying asleep falling asleep at inappropriate times excessive total sleep time, or abnormal behaviours associated with sleep.This chapter focuses on the most common form of sleep disordered breathing - obstructive sleepapnea - and on narcolepsy.In addition to sleep disorders, a number of other factors such as work schedules or lifestylechoices may result in inadequate nocturnal sleep. Regardless of the cause, the risks of excessivesleepiness for driving safety are similar.Sleep disordered breathingSleep disordered breathing consists of three distinct clinical syndromes: obstructive sleep apnea-hypopnea syndrome (OSAHS): apnea-hypopnea caused by repeatedclosure of the throat or upper airway during sleep. This is the most common form of sleepdisordered breathing. central sleep apnea-hypopnea syndrome (CSAHS): includes types of apnea-hypopnea causedby a neurological problem that interferes with the brain’s ability to control breathing duringsleep, as well as high altitude periodic breathing, and apnea-hypopnea due to drug orsubstance abuse. sleep hypoventilation syndrome (SHVS): a type of sleep disordered breathing characterizedby insufficient oxygen absorption during sleep. It usually occurs in association withrestrictive lung disease in morbidly obese individuals, with respiratory muscle weakness, orwith obstructive lung disease such as COPD.Obstructive sleep apnea-hypopnea syndromeWith OSAHS, the tissue and muscles of the upper airway repetitively collapse during sleep,reducing or preventing breathing. As oxygen levels in the blood fall, arousal causes the airwayto re-open. Although individuals with OSAHS often remain asleep, their sleep patterns aredisrupted. These sleep disturbances result in excessive daytime sleepiness. Impairments incognitive function are common in individuals with OSAHS and these may include difficulties in: attention concentration341
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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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17.15 Private drivers who have vent
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17.19 Private drivers who have sust
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17.21 Commercial drivers who have s
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17.27 Private drivers with atrioven
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17.28 Commercial drivers with atrio
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17.29 Private drivers with permanen
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17.31 Private drivers who have decl
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17.33 Private drivers where ICD the
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17.35 Commercial drivers who have d
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17.37 Commercial drivers with inher
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17.39 Commercial drivers with medic
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17.41 Private drivers with surgical
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17.43 Private drivers with mitral v
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17.45 Private drivers with congesti
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17.46 Commercial drivers with conge
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17.47 Private drivers with left ven
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17.49 Private drivers with a heart
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17.51 Private drivers with hypertro
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17.53 SyncopeSee the guidelines in
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Stable coronary syndromes - waiting
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Chapter 18: Hearing LossBACKGROUND1
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GUIDELINES18.6 Private drivers with
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equirement for commercial drivers i
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PLEASE COMPLETE THE FOLLOWING: YES
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this manual. Axis IV addresses exte
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Negative symptoms are characterized
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Schizophrenia (Axis I)Schizophrenia
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19.4 Effect of psychiatric disorder
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Suicidal ideationSuicidal ideation
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Chapter 20: Cerebrovascular Disease
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Cerebrovascular accidentCVAs are th
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ConditionType of drivingimpairment
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Re-assessmentguidelinesPolicy ratio
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20.9 Private drivers who have had s
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20.10 Commercial drivers who have h
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Visual field impairment refers to a
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Right homonymous hemianopiaBinasal
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An example of the effects of diabet
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Retinitis pigmentosaRetinitis pigme
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GlaucomaApproximately 67 million pe
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indicates that wait times of 6 mont
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Although telescopic spectacles, hem
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Policy rationaleretinopathy dependi
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Policy rationaleIndividuals with be
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Re-assessmentguidelines cont’dPol
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Re-assessmentguidelines cont’dPol
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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
Page 303 and 304: Cardiac syncopeCardiac syncope refe
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Page 309 and 310: 22.11 Commercial drivers who have h
Page 311 and 312: 22.13 Commercial drivers with recur
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Page 315 and 316: abnormal numbnesstingling and a cra
Page 317 and 318: ConditionType of drivingimpairment
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Page 331 and 332: Level of disabilityor worsening of
Page 333 and 334: Parkinson’s diseaseThere is a sma
Page 335 and 336: ConditionType of drivingimpairment
Page 337 and 338: ConditionsRestrictionsRe-assessment
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Page 341 and 342: GUIDELINES25.6 Private and commerci
Page 343 and 344: Chapter 26: Intracranial TumoursBAC
Page 345 and 346: Some examples of compensatory mecha
Page 347 and 348: Re-assessmentguidelinesPolicy ratio
Page 349 and 350: i. aphasia (language disturbance)ii
Page 351 and 352: 27.2 Prevalence and incidence of co
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Page 357 and 358: An immediate reduction in daytime s
Page 359 and 360: 28.5 CompensationIndividuals with s
Page 361 and 362: OSMV determinationguidelines cont
Page 363 and 364: ConditionsRestrictionsRe-assessment
Page 365 and 366: Policy rationaleThe general approac
Page 367 and 368: Chapter 29: Prescription and Over-T
Page 369 and 370: Examples of newer antihistamines in
Page 371 and 372: Stimulants (for ADHD)Examples of st
Page 373 and 374: AntiepilepticsIn general, individua
Page 375 and 376: Sedating EffectLowModerateHighTCAsd
Page 377 and 378: dizziness, andblurred or double vis
Page 379 and 380: Re-assessmentguidelinesPolicy ratio
Page 381 and 382: 30.2 Effect of general debility and
Page 383 and 384: 30.5 Private and commercial drivers
Page 385 and 386: Appendix 1: Glossary of TermsCommer
Page 387 and 388: Medical assessmentis any kind of as
Page 389 and 390: Transient impairmentmeans a tempora
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Page 395 and 396: Appendix 3: Aging DriversAbout agin
Page 397 and 398: Percentadults. The survey also foun
Page 399 and 400: Appendix 4: Licence ClassesThe tabl
Page 401 and 402: Appendix 5: Drafting and Approval P
Page 403: drivers, this means that BC commerc
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2010 BC Guide in Determining Fitness to Drive

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