How do you do that?
Good news: in recent months, the ‘medical fitness to drive’ rules have been relaxed for a number of illnesses. Thousands of people can get back behind the wheel faster as a result.
In the summer of 2009, Herman Walker (61), while driving, was struck by a light stroke. He was on his way back from vacation, along with his wife. “My left arm got a bit heavy, but otherwise I felt fine. I could just drive on.”
A day later, just to be sure, he went to the doctor, who referred him to the hospital. “The neurologist diagnosed a minor stroke and told me that I was not allowed to drive for six months. I could still afford that. But after reporting to the Central Bureau for Driving Skills (CBR) my driving license was marked ‘code 100’. This meant that after six months I was only allowed to use the car privately and was no longer allowed to drive professionally for five years. I thought that was an absurdly long time.”
Herman is a part-time driver at Connexxion and drove a fixed group of mentally handicapped people from home to the sheltered workshop and back every day. “It was my lust and my life. If you experience each other like this every day, you build a bond.” Code 100 meant no more disabled transport for Herman.
Medical Progress
Those rules have since changed. Anyone who has had a stroke or a TIA no longer has to wait six months before being allowed to drive again, but in many cases can get behind the wheel again after two weeks. For professional driving (bus, truck and taxi drivers) the term has been shortened even more drastically: from five years to four weeks.
New scientific insights and better medical treatment have led to this adjustment of the rules. Significant medical progress has been made in recent years, especially in the field of TIA and stroke. TIAs and strokes are nowadays recognized more quickly and can therefore be treated in time, which significantly reduces the risk of harmful consequences. Practice shows that many people recover quickly from a TIA or stroke and hardly have any limiting ‘residual symptoms’. As a result, many people are able to safely participate in traffic again after a short period of time.
Smoother rules
The requirements for medical fitness to drive have not only been relaxed for TIA and stroke, the rules for a number of other illnesses and disorders have also been adjusted (see box ‘Wel/(Yet) not relaxed’ at the end of this article).
This was determined by the Ministry of Transport, Public Works and Water Management after obtaining advice from the Health Council. In July, the ministry introduced the relaxed rules for TIA and stroke; the new rules for a number of other diseases and conditions (such as diabetes and MS) were given the green light in August. However, people with chronic heart failure and consciousness disorders have to wait a little longer for the rules to be relaxed. Those changes will take effect in November at the earliest.
Get back behind the wheel faster, but sometimes under stricter conditions. That differs per condition. People who have poor vision as a result of diabetes, for example, often have to undergo a later examination: from ten years the maximum term for fitness to drive will be increased to five years. This is due to stricter European standards that also apply to the Netherlands since August.
Herman Walker suffered a minor stroke last year. He had to leave his car for six months. Anyone who now receives such a TIA can in principle go back on the road after two weeks. At least if it goes well with the application procedure.
Procedure
What should you do if you think the new rules apply to you? Suppose you have had a TIA or stroke, what is involved in keeping your driver’s license? The same procedure applies to both ‘old’ and ‘new’ cases: so regardless of whether you became ill before or after the introduction of the new rules, you must follow the same procedure.
Reporting an illness to the CBR is your own responsibility. The doctor will point this out to you, but reporting is not required by law. One speaks of a ‘moral obligation’. If you do not report, you run the risk that the insurance will not pay out in the event of an accident. The CBR wants from you a ‘Personal statement’ (a health statement with questions about your physical and mental condition). The ‘Own declaration’ is a form that you can obtain from the municipality and the CBR (costs: €22.90).
The CBR will then review your application. A TIA or stroke also requires a report from a neurologist or other specialist. The CBR assigns you an independent neurologist or specialist, who must examine you medically. When that report is ready, send it to the CBR.
Sometimes another driving test is necessary, for example if you have reduced strength in your arm due to a stroke. The CBR will then decide whether you will receive a ‘Certificate of fitness to drive’. All in all, it may take some time before you can get back on the road. The CBR may take a maximum of four months to process your application; in simple cases this will be much faster.
Earlier on the road?
That period of two weeks driving ban after a TIA and stroke sounds nice on paper, but in practice you will have to leave the car for longer because the ‘Certificate of fitness to drive’ from the CBR is not yet available. The temptation to get on the road earlier can be great, especially if you are feeling well and the neurologist has already given a positive advice.
What you can do to speed up the application to the CBR is to send a report from the medical specialist together with the ‘Own declaration’. The CBR is not obliged to accept that report – it is possible that you will still be referred to another specialist – but the CBR can deviate from this formal procedure if the specialist’s report has been drawn up properly.
For example, the report must in any case describe the following matters: what is going on (which disorder or disease is involved), since when has the patient had this, has it resulted in functional disorders and if so which, have other complications occurred? ?
Pleased
Herman Walker went through the entire procedure. After the six months were almost over, he sent a ‘Self-declaration’ with a medical report from the neurologist to the CBR. He was then allowed to drive again quickly. Due to the introduction of the new rules, he is now allowed to drive again as a driver in group transport.
“Now that after a year of sitting at home I see that it is allowed to drive professionally again after four weeks, it hurts a bit. The worst thing I think is that because of all that hassle I lost my regular group in the group transport. I’ll have to see if I can get it back. But of course I am happy to be able to drive again.”
More information about the relaxed fitness to drive regulations: CBR,
T 0900-0210 (€0.10 pm), www.cbr.nl
Well relaxed
The rules for medical fitness to drive have been relaxed in the past year for the following diseases and conditions:
- mild dementia
- Sleep disturbances
- Certain eye abnormalities (including a ‘lazy eye’)
- TIA and stroke
- Diabetes (limited eyesight)
- MS
- brain tumors
- autism
- Epilepsy
Not (yet) relaxed
Further research has yet to show whether the rules for the following cases can also be changed:
- People with an ICD (Implantable Cardioverter Defibrillator, a type of pacemaker)
- Chronic heart failure
- Psychoses/moods
- ADHD
- Consciousness disturbances (including fainting)
- kidney dialysis
The web links with the full texts of the ‘Regulation requirements suitability 2000’ of the government and the ‘Proposal for some amendments to the
You can find the Health Council’s 2000 Suitability Requirements Regulations at
www.plusonline.nl/rijfitheid.
Sources):
- Plus Magazine
