††††† 601 KAR 13:100. Medical standards for operators of motor vehicles.

 

††††† RELATES TO: KRS 186.411, 186.440, 186.444, 186.570

††††† STATUTORY AUTHORITY: KRS 186.444, 186.570

††††† NECESSITY, FUNCTION, AND CONFORMITY: KRS 186.570 requires the Transportation Cabinet to withhold driving privileges from an individual who has a mental or physical disability that makes it unsafe for him to drive upon the highways. KRS 186.411 requires that a person with a seizure condition be seizure-free for ninety (90) days prior to licensing. This administrative regulation establishes the standards to be used by the Transportation Cabinet and Medical Review Board in determining who is unsafe to operate a motor vehicle because of a mental or physical disability.

 

††††† Section 1. Definitions. (1) "Altered consciousness" means a state of awareness characterized by loss or distortion of the impressions made by the senses or inability to respond to the impressions made by the senses.

††††† (2) "Assessment" means an evaluation of a person's substance abuse performed by a certified chemical dependency counselor, a certified driving under the influence (DUI) assessor, or other mental health professional in a licensed treatment facility.

††††† (3) "Chemical" means alcohol, a drug, or a controlled substance as defined in KRS Chapter 218A.

††††† (4) "Cognition" means the ability to think, perceive, and remember.

††††† (5) "Comorbid" means that more than one (1) condition is present at the same time.

††††† (6) "Corrective lens" means an ophthalmic lens, whether an eyeglass, contact lens or single lens system, that corrects the refraction error or other optically correctable deficiency of the eye.

††††† (7) "Driving evaluation" means a test conducted to determine if a person adequately compensates for his medical, mental, or physical condition or functional impairment.

††††† (8) "Episode" means any incident or segment of time involving altered consciousness or loss of bodily control.

††††† (9) "Field of vision" means the entire horizontal and vertical planes a person has for each eye without shifting the gaze.

††††† (10) "Functional ability" means the degree of cognitive, mental or emotional, sensorimotor and sensory capability in performing activities of daily living, including safely performing the tasks of driving.

††††† (11) "Licensing action" means any action by the Transportation Cabinet involving the denial, cancellation, restriction, or issuance of a motor vehicle operatorís license under KRS Chapter 186.

††††† (12) "Loss of bodily control" means involuntary movements of the body characterized by muscle spasms or muscle rigidity, or loss of muscle tone or muscle movement.

††††† (13) "Medical condition" means any physical, mental, or emotional condition which affects a person's health for which a person is receiving medical or substance abuse treatment, or for which medical or substance abuse treatment is usually prescribed.

††††† (14) "Mental or emotional function" means interaction and communication skills, adaptive behavior or coping capacity, and orientation.

††††† (15) "Review board" means the Medical Review Board established under KRS 186.444 and 186.570.

††††† (16) "Sensory function" means vision, hearing, touch, smell, or vibration sense.

††††† (17) "Vision specialist" means a person licensed to practice optometry as defined by KRS Chapter 320, or a physician licensed pursuant to KRS Chapter 311.

 

††††† Section 2. General Requirements. (1) If the Department of Vehicle Regulation learns that a person applying for, renewing, or holding a motor vehicle operator's license may have a medical condition which may affect safe driving, the department may require the person to provide the department with medical information about the person's medical condition. The department shall review the medical information using the standards specified in this administrative regulation.

††††† (2) A person holding a Kentucky operator's license or instruction permit shall report to the department medical conditions that adversely affect his driving skills.

 

††††† Section 3. Information to be Considered in Licensing Actions. Pursuant to 601 KAR 13:090, the Medical Review Board if making recommendations, and the department if taking licensing action, may consider the following information:

††††† (1) Any medical condition affecting the person including:

††††† (a) History of illness;

††††† (b) Severity of symptoms and prognosis;

††††† (c) Complications or comorbid conditions, or both;

††††† (d) Treatment and medications, including effects and side effects, and the person's knowledge and use of medications;

††††† (e) Results of medical tests and reports of laboratory findings;

††††† (f) Physician's medical report;

††††† (g) Physician's recommendations with regard to functional impairment; and

††††† (h) Physicians' identification of risk factors.

††††† (2) Reports of driver condition or behavior;

††††† (3) The results of any driving evaluation of the person;

††††† (4) Substance abuse assessment reports from a licensed treatment facility, certified chemical dependency counselor, or certified driving under the influence (DUI) assessor;

††††† (5) Traffic accidents that may have been caused in whole or in part by a medical condition;

††††† (6) Vision specialist's report;

††††† (7) A person's failure to provide requested information to the department; or

††††† (8) A report from a rehabilitation specialist.

 

††††† Section 4. Conditions Affecting Cardiovascular Function. (1) With respect to conditions affecting cardiovascular function, the Medical Review Board if making recommendations, and the department if taking licensing action, may consider disorders including the following:

††††† (a) Cardiac dysfunction;

††††† (b) Arrhythmias; and

††††† (c) Other cardiac or circulatory disorder or dysfunction.

††††† (2) The department or the Medical Review Board may require a person to provide information on the person's cardiovascular functional abilities and disorders.

††††† (3) A motor vehicle operator's license shall not be issued to, renewed by, or held by a person who does not meet the applicable medical review standards for conditions affecting cardiovascular function of this subsection and a person who applies for, renews, or holds a motor vehicle operator's license shall meet all of the following cardiovascular function criteria:

††††† (a) There shall not be current symptoms of coronary artery disease, such as unstable angina, dyspnea, or pain at rest, which interfere with safe driving;

††††† (b) There shall not be a cause of cardiac syncope present, including ventricular tachycardia or fibrillation, which is not successfully controlled;

††††† (c) There shall not be congestive heart failure that limits functional ability;

††††† (d) There shall not be cardiac rhythm disturbances which are not successfully controlled;

††††† (e) There shall not be an automatic implantable cardioverter defibrillator, unless the device is assessed by an electrophysiologist as not interfering with safe driving;

††††† (f) There shall not be medications interfering with safe driving; and

††††† (g) There shall not be valvular heart disease or malfunction of prosthetic valves that interferes with safe driving.

 

††††† Section 5. Conditions Affecting Cerebrovascular Function. (1) With respect to conditions affecting cerebrovascular function, the Medical Review Board if making recommendations, and the department if taking licensing action, may consider disorders including the following:

††††† (a) Cerebrovascular accident; and

††††† (b) Other cerebrovascular disorder or dysfunction.

††††† (2) The department or Medical Review Board may require information on a person's central nervous system functional abilities and disorders.

††††† (3) A motor vehicle operator's license shall not be issued to, renewed by, or held by a person who does not meet the applicable medical review standards for conditions affecting cerebrovascular functions of this subsection and a person who applies for, renews, or holds a motor vehicle operator's license shall meet all of the following cerebrovascular function criteria:

††††† (a) There shall not be a sensori-motor deficit preventing safe driving;

††††† (b) There shall not be impairment of reasoning or judgement preventing safe operation of a vehicle; and

††††† (c) There shall not be medications interfering with the person's ability to operate a motor vehicle safely.

 

††††† Section 6. Conditions Affecting Endocrine Function. (1) With respect to conditions affecting endocrine function, the Medical Review Board, if making recommendations, and the department if taking licensing action, may consider disorders including the following:

††††† (a) Diabetes mellitus; and

††††† (b) Other endocrine disorder or dysfunction.

††††† (2) The department or Medical Review Board may require information on a person's endocrine functional abilities and disorders.

††††† (3) A motor vehicle operator's license shall not be issued to, renewed by, or held by a person who does not meet the applicable medical review standards for conditions affecting endocrine functions of this subsection and a person who applies for, renews, or holds a motor vehicle operator's license shall meet all of the following endocrine function criteria:

††††† (a) There shall not be diabetic neuropathy or other complication which interferes with safe driving;

††††† (b) There shall not be frequent and functionally impaired hypoglycemic reactions; and

††††† (c) There shall not be evidence of use of alcohol or other drugs to an extent that interfere with the person's prescribed treatment program for the condition.

 

††††† Section 7. Conditions Affecting Musculoskeletal Function. (1) With respect to conditions affecting musculoskeletal function, the Medical Review Board if making recommendations, and the department if taking licensing action, may consider disorders including the following:

††††† (a) Rheumatoid arthritis;

††††† (b) Paralysis; and

††††† (c) Other musculoskeletal disorder or dysfunction.

††††† (2) The department or Medical Review Board may require information on a person's musculoskeletal functional abilities and disorders.

††††† (3) A motor vehicle operator's license shall not be issued to, renewed by, or held by a person who does not meet the applicable medical review standards for conditions affecting musculoskeletal function of this subsection and a person who applies for, renews, or holds a motor vehicle operator's license shall meet of the following musculoskeletal function criteria:

††††† (a) Pain shall not interfere with the person's ability to safely operate a motor vehicle;

††††† (b) The person's operation of a vehicle in a driving evaluation demonstrates adequate compensation for any weakness or limitations in range of motion or mobility; and

††††† (c) There shall not be effects or side effects of medication interfering with safe driving.

 

††††† Section 8. Conditions Affecting Neurological or Neuromuscular Function. (1) With respect to conditions affecting neurological or neuromuscular function, the review board if making recommendations, and the department if taking licensing action, may consider disorders including the following:

††††† (a) Central nervous system diseases or disorders;

††††† (b) Demyelinating diseases;

††††† (c) Muscular diseases or disorders; and

††††† (d) Seizure disorders.

††††† (2) The department or Medical Review Board may require information on neurological or neuromuscular functional abilities or disorders.

††††† (3) A motor vehicle operator's license shall not be issued to, renewed by, or held by a person who does not meet the medical review standards for conditions affecting neurological or neuromuscular function of this subsection and a person who applies for, renews, or holds for motor vehicle operator's license shall meet all of the following neuromuscular function criteria:

††††† (a) There shall not have been a seizure episode as set forth in KRS 186.411;

††††† (b) The person adequately compensates for any paralysis or sensory deficit when operating a vehicle;

††††† (c) Fatigue, weakness, muscle spasm or tremor at rest does not impair safe driving;

††††† (d) There shall not be effects of or side effects of medication that interferes with safe driving; and

††††† (e) There shall not be a decline in cognition to an extent that interferes with safe driving.

 

††††† Section 9. Conditions Affecting Mental or Emotional Function. (1) With respect to conditions affecting psychosocial, mental or emotional function, the review board if making recommendations, and the department if taking licensing action, may consider disorders including the following:

††††† (a) Substance and alcohol abuse; and

††††† (b) Other mental or emotional disorder or dysfunction.

††††† (2) The department or Medical Review Board may require information on mental or emotional functional abilities and disorders.

††††† (3) A motor vehicle operator's license shall not be issued to, renewed by, or held by a person who does not meet the medical review standards for conditions affecting mental and emotional function of this subsection and a person who applies for, renews, or holds any classification of operator's license shall meet all of the following mental and emotional function criteria:

††††† (a) There shall not be dementia that is unresponsive to treatment;

††††† (b) There shall not be a behavior disorder with threatening or assaultive behavior at the time of application;

††††† (c) There shall not be a delusional system which interferes with safe driving;

††††† (d) There shall not be a suicidal tendency;

††††† (e) There shall not be an impairment of judgement that interferes with safe driving;

††††† (f) There shall not be an active psychosis that interferes with safe driving; and

††††† (g) There shall not be effects or side effects of medication that interferes with safe driving.

 

††††† Section 10. Conditions Affecting Respiratory Function. (1) With respect to conditions affecting respiratory function, the review board if making recommendations, and the department if taking licensing action, may consider disorders including the following:

††††† (a) Chronic obstructive pulmonary diseases; and

††††† (b) Any other respiratory disorder or dysfunction.

††††† (2) The department or Medical Review Board may require information on respiratory functional abilities and disorders.

††††† (3) A motor vehicle operator's license shall not be issued to, renewed by, or held by a person who does not meet the medical review standards for conditions affecting respiratory function of the subsection and a person who applied for, renews, or holds a motor vehicle operator's license shall meet all of the following respiratory function criteria:

††††† (a) The person does not require medication that interferes with driving; and

††††† (b) There shall not be dyspnea that interferes with safe driving.

 

††††† Section 11. Conditions Affecting Vision and Sensory Function. (1) With respect to conditions affecting sensory function, the review board if making recommendations, and the department if taking licensing action, may consider conditions including the following:

††††† (a) Vision loss; and

††††† (b) Any other ocular or sensory disorder or dysfunction.

††††† (2) The department or Medical Review Board may require information on ocular and sensory functional abilities and disorders.

††††† (3) A motor vehicle operator's license shall not be issued to, renewed by, or held by a person who does not meet the medical review standards for conditions affecting sensory functions of this subsection and a person who applies for, renews, or holds any classification of operator's license shall meet all of the following criteria:

††††† (a) Visual acuity of at least 20/60 or better in at least one (1) eye with single lens system; and

††††† (b) Binocular horizontal field of vision of at least thirty-five (35) degrees to the left and right side of fixation and a binocular vertical field of vision of at least twenty-five (25) degrees above and below fixation.

 

††††† Section 12. License Restrictions. (1) The department may restrict a person's operating privilege based on any of the following:

††††† (a) A recommendation of a physician or vision specialist;

††††† (b) The results of a driving examination or evaluation performed by the Kentucky State Police or a rehabilitation specialist or facility; or

††††† (c) Recommendation of the Medical Review Board.

††††† (2) License restrictions may require a person to:

††††† (a) Wear corrective lenses;

††††† (b) Use special equipment or specially equipped vehicles;

††††† (c) Operate only during daylight hours;

††††† (d) Restrict the driving area; or

††††† (e) Restrict the motor vehicle operating privilege in any other manner which the department deems necessary for safety purposes. (23 Ky.R. 221; Am. 1399; 1594; eff. 10-1-96.)