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
operator’s 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.)
