When is it Safe to Drive after a Brain Injury?
Many people hope to drive following their brain injury. However, even routine driving requires rapid decisions and quick physical reactions—skills that are often affected by brain injury.
After a brain injury, it can be difficult to judge for yourself if you are driving safely. Passengers may observe problems, but be unsure how serious they are. How do you know when it is safe to drive? There is not one test that can guarantee that a person is a safe driver. Cognitive testing can help tell us if a person has the attention and concentration skills necessary for safe driving. Other evaluations include those carried out in a clinic or on the road by an occupational therapist with special training.
Based on the evaluation, the occupational therapist makes a recommendation regarding driving. In some cases, if driving alone is not yet safe, driving training with the occupational therapist is recommended. In other cases, practice with another person in the car or no driving is indicated. Sometimes insurance or agencies will cover the cost of a rehab driving evaluation. In many cases, however, it must be paid for privately. You can discuss a referral with your physician. In the end, though, it is the responsibility of the Washington State Department of Licensing to determine who can drive and who can't drive. For a return to safe driving, we recommend:
1. Discuss the situation with your physician and rehabilitation team.
2. Your physician may order further cognitive testing, or a driver's screening, or an in vehicle
3. Report your brain injury to a Department of Licensing office and ask for a "Certificate of
Physical Examination Authorization."
4. Have your physician complete the form and send it back to the Department of Licensing. 5. Complete a new driving test as needed.
6. Once you are cleared for driving again, take steps to avoid accidents:
; Take mostly short or local rides
; Avoid rush hour/peak traffic times
; Use local roads instead of freeways
; Avoid driving at night, or when fatigued
; Drive with a helpful significant other
; Avoid using a cell phone while driving
; Don’t drink and drive
Returning to driving is one of the milestones in recovery from a brain injury, but the decision to drive needs to be made with appropriate concern for safety.
On-Road Driving Evaluation Sites:
UW Medical Center, Seattle 206-598-5857
VA Medical Center, Seattle 206-762-1010
Good Samaritan, Puyallup 253-848-6661
Providence, Everett 425-258-7600
St. Luke’s, Spokane 509-473-6289
Q & A with the UW TBI Model System Team
Question: If I experience seizures after a traumatic brain injury, will I be able to drive again? Answer: In order to resume driving and regain your license in the state of Washington, you must be seizure free for six months. Your doctor, however, can report any exception, which will be reviewed by the Department of Motor Vehicles (DMV) Medical Advisory Board. This Board can also request periodic medical updates. You can make an appeal of a license denial at anytime to the Washington DMV.
Question: Would “not driving” be an example of reasonable accommodation for many jobs?
Answer: Not driving on the job may be a very reasonable accommodation for a person with a traumatic brain injury. This is particularly true if driving is not an essential function of the job. In many cases, a driving requirement isn’t necessary or can be handled by a co-worker.
Question: Do others with brain injuries have difficulty finding transportation? Answer: Yes, this is a common issue. We are often not aware of how work, school, socializing, and making appointments are influenced by our ability to drive. Being dependent upon others can be frustrating. However, there are ways to get around without driving.
Question: What resources are available to me if I don’t drive?
Answer: Networks-Relatives, friends, churches, community centers or other organizations can all be transportation resources. Public Transportation-Reduced fare permits are available for
those who qualify. In King County, a reduced fare taxi service is an option for low-income residents. Specialized transportation options such as van services (ACCESS) take people who are medically unable to use the main bus services from home to appointments. Assistance with applications -Applications for such services are available at local public transportation offices. A social worker at a medical facility may also assist patients and families obtain and complete such forms, some must be signed by a physician. Medical Coupons -If
patients are going to an appointment where they are using medical coupons, DSHS can assist and reimburse travel costs. If medically necessary, this may include taxi service. DSHS should be contacted prior to appointments. Travel Aids -People who have difficulty with concentration,
memory or decision making may have difficulty navigating buses, streets, or even medical centers. Books such as day-timers that list appointment times, locations, and phone numbers are helpful tools. Some people carry a cell phone to call family members if they need assistance.
For more information about seizures, visit the National Epilepsy Foundation: http://www.epilepsyfoundation.org
For more information about transportation:
; King County Accessible Services (ACCESS) 206-689-3113
; Hopelink, DSHS medically related transportation to appointments using medical
; King County Travel Training - Free service that teaches cognitively impaired adults to
ride 1-2 bus routes. 206-633-6628
; King County 206-461-3200
; Snohomish County 800-562-1375
; Pierce County 253-798-8080
Peter Esselman M.D., Janet Powell Ph.D., and Robert Fraser Ph.D.