2010 BC Guide in Determining Fitness to Drive

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Version HistoryDocument Information and Revision HistoryProjectTitleDriver Fitness Reform InitiativeBC Guide In Determining Fitness To DriveVersion Version 1.5StatusFinalHISTORYDate Changes made by: Description of ChangeDraft 1 June 2007Draft 2 November 21 2007Draft 3 June 18 2008Draft 4 June 21 2008Draft 5 August 4 2008Draft 6 September 23 2008Draft 7 October 31, 2008Draft 8 December 9, 2008Draft 9 April 30, 2009Final July12, 2010Revisionv1.4.1Revisionv1.5Revisionv1.6March 14, 2013 Kevin Murray One word revision to change error in17.42 to correctly read “Commercial”instead “Private”May 1, 2013 Kevin Murray •17.27 -- new text outlining CCSconsensus on pacemaker insertion•17.28 -- new text outlining CCSconsensus on pacemaker insertion•17.45 and 17.45.1 -- new text outliningrevised CCS consensus on LVAD•Chapter 29 – drug names andclassifications revised following inputfrom CCMTA SMEs•Pages 46, 47, 56, 353 & 354:SIMARD cut-points inserted to reflectthe recommendations of theresearcher who designed the toolFebruary 2014 Kevin Murray Update information on cognitivescreening assessments in recognitionthat there are many assessment toolsin use by health care professionalsiii
Table of Contents (click on any item to jump to that page)Foreward ………………………………………………………………………………………….iAcknowledgments ...............................................................................................................................iiVersion History ................................................................................................................................. iiiTable of Contents ............................................................................................................................... ivPART 1: BACKGROUND ............................................................................................................... 1Chapter 1: Introduction .............................................................................................................. 21.1 How this Manual is organized........................................................................................ 21.2 Purpose of this Manual ................................................................................................... 31.3 A changing approach to driver fitness.......................................................................... 3Chapter 2: The Driver Fitness Program .................................................................................. 52.1 The legal and policy authority for the Driver Fitness Program ............................... 52.2 Driver Fitness Program overview ................................................................................. 72.3 Roles and responsibilities .............................................................................................. 11Chapter 3: Driver Fitness Program Principles...................................................................... 153.1 Overview .......................................................................................................................... 153.2 Risk management ........................................................................................................... 163.3 Functional approach ...................................................................................................... 173.4 Individual assessment .................................................................................................... 233.5 Best information ............................................................................................................. 25PART 2: POLICIES AND PROCEDURES ................................................................................ 26Chapter 4: Introduction to the Policies and Procedures ...................................................... 274.1 Overview .......................................................................................................................... 27Chapter 5: Screening Policies ................................................................................................... 305.1 Overview .......................................................................................................................... 305.2 Screening individuals with known or possible medical conditions ........................ 315.3 Screening aging drivers ................................................................................................. 335.4 Screening commercial drivers...................................................................................... 335.5 Transient impairments .................................................................................................. 355.6 Cancelling or restricting a licence because of an immediate public safety risk ... 35Chapter 6: Assessment Policies and Procedures ................................................................... 376.1 Overview .......................................................................................................................... 376.2 Assessments will only be requested if necessary to determine fitness ................... 396.3 Requesting medical assessments .................................................................................. 396.4 Requesting specialist assessments................................................................................ 416.5 Requesting functional assessments .............................................................................. 426.6 Requesting assessments of cognitive function ........................................................... 466.7 Requesting assessments of motor function................................................................. 476.8 Time period during which assessments are valid ..................................................... 486.9 Time limits for drivers to complete assessments ....................................................... 486.10 Assessment procedures.................................................................................................. 50Chapter 7: Determination Policies and Procedures.............................................................. 527.1 Overview .......................................................................................................................... 52iv
Page 1 and 2: Ministry of Public Safety and Solic
Page 3: AcknowledgmentsResearcherBonnie M.
Page 7 and 8: 11.7 Private and commercial drivers
Page 13 and 14: BACKGROUND ........................
Page 15 and 16: PART 1:BACKGROUND1
Page 17 and 18: Appendix 2: Excerpts from the MVA t
Page 19 and 20: Chapter 2: The Driver Fitness Progr
Page 21 and 22: for the exercise of discretion by O
Page 23 and 24: 1. SCREENINGA driver disclosesa med
Page 25 and 26: 2.3 Roles and responsibilitiesOSMV
Page 27 and 28: Medical practitionersMedical practi
Page 29 and 30: Chapter 3:Driver Fitness Program Pr
Page 31 and 32: Because of these limitations, OSMV
Page 33 and 34: Example: the temporary storage of i
Page 35 and 36: Motor functions (including sensorim
Page 37 and 38: an individual with poor contrast se
Page 39 and 40: 3.5 Best informationDriver fitness
Page 41 and 42: Chapter 4: Introduction to the Poli
Page 43 and 44: 3. DETERMINATIONFrom2. AssessmentAn
Page 45 and 46: Once identified, a DMER is mailed t
Page 47 and 48: 5.3 Screening aging driversDefiniti
Page 49 and 50: 5.5 Transient impairmentsDefinition
Page 51 and 52: Chapter 6: Assessment Policies and
Page 53 and 54: 6.2 Assessments will only be reques
Page 55 and 56:
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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11.7 Private and commercial drivers
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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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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
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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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