Basic information on assessment

There are different disabilities that influence the capability to drive and the car adaptations needed to be able to drive.

Assessment
Article 7 of the driving licence directive (91/439/EC) stipulates that driving licences shall only be issued to applicants who meet the medical standards of Annex III .

Article 7
Driving licences shall, moreover, be issued only to those applicants who have passed a test of skills and behaviour and a theoretical test and who meet medical standards, in accordance with the provisions of Annexes II and III.

Annex III
Annex III gives the minimum standards of physical and mental fitness for driving a power-driven vehicle.

Paragraph 8 of Annex III for example states:
Driving licences shall not be issued to or renewed for applicants or drivers suffering from complaints or abnormalities of the locomotor system which make it dangerous to drive a power-driven vehicle.

So the driving licence directive expects a critical evaluation of the functional capacities of applicants in relation to the driving task.

Because of paragraph 8 of Annex III of the driving licence directive, the fitness to drive investigation in all Member States include questions about the locomotor functions of the applicant.

Paragraph 8 of Annex III not only calls for a critical attitude towards the functional abilities of the applicant. It also encourages that physically handicapped persons are allowed to drive whenever safely possible.

Paragraph 8 of Annex III, continues with:
Driving licences subject to certain restrictions, if necessary, may be issued to physically handicapped applicants or drivers following the issuing of an opinion by a competent medical authority. This opinion must be based on a medical assessment of the complaint or abnormality in question and, where necessary, on a practical test. It must also indicate what type of modification to the vehicle is required and whether the driver needs to be fitted with an orthopaedic device, insofar as the test of skills and behaviour demonstrates that with such a device driving would not be dangerous

Driving licences may be issued to or renewed for any applicant suffering from a progressive complaint on condition that the disabled person is regularly examined to check that the person is still capable of driving the vehicle completely safely. Where the handicap is static, driving licences may be issued or renewed without the applicant being subject to regular medical examination.

The competent medical authority shall give due consideration to the additional risks and dangers involved in the driving of vehicles covered by the definition of this group.

Annex II

Chapter II of Annex II of the Driving Licence Directive clearly stipulates that:
Drivers of all power-driven vehicles must at any moment have the knowledge, skills and behaviour described for the theory test and the test of skills and behaviour, with a view to be able to:

• Recognise traffic dangers and assess their seriousness;
• Have sufficient command of their vehicle not to create dangerous situations and to react appropriately should such situations occur;
• Comply with road traffic regulations, and in particular those intended to prevent road accidents and to maintain the flow of traffic;
• Detect any major technical faults in their vehicles, in particular those posing a safety hazard, and have them remedied in an appropriate fashion;
• Take account of all the factors affecting driving behaviour (e.g. alcohol, fatigue, poor eyesight, etc.)so as to retain full use of the faculties needed to drive safely;
• Help ensure the safety of all road users, and in particular of the weakest and most exposed by showing due respect for others.

Annex II gives a clear overview of the knowledge, skill and behaviour required for driving a motor vehicle. Paragraph 9 of this annex gives a comprehensive overview of the relevant aspects to be carefully addressed when deciding whether a driver has the required driving ability or not.

There is a logical relationship between the vehicle control aspects mentioned in Annex II and the vehicle adaptation codes defined in Annex I.

Requirements Assessor

The assessor must understand how the medical condition affects the functional ability of a driver. A comprehensive evaluation of functional ability is required to assess which skills are available for use in driving and which functions are no longer available to be used.

Functional assessment will incorporate:

• Psychomotor function (strength, range of movement, speed of movement, endurance etc.)
• Anthropometrics (physical dimensions of person for functional use)
• Sensation (vision, hearing, tactile, proprioception)

Where applicable:

• Cognition (including attention, decision-making, memory, reasoning)
• Perception (interpretation of sensory input, visual perception is most commonly associated with the driving task).

Good Assessment

Good assessment should result in a disabled person being able to drive safely, in comfort and with confidence under all conditions described by the driving licence directive. This involves discussing the implications of their medical condition, their functional ability and relating it back to the driving task.

The crucial aspects for safe driving are the ability to operate the primary car controls, i.e. the brake, accelerator and steering. The disabled person must be able to operate these controls as safely as any non-disabled person.

To be able to relate the functional capabilities to the adequate operation of controls it must be clear what performance is required for operation. The characteristics and performance requirements of controls are described in a series of automotive directives i.e. brakes (71/320/EC), steering (70/311/EC), etc. Knowledge of these directives is essential to decide whether a person can operate standard controls or if any modification is required.

If there is insufficient function to operate the standard vehicle controls, this disadvantage has to be made up by means of vehicle adaptation. A knowledge of what can be done (not just of standard production adaptations) is required to ensure the best fit between the driving task, the adaptive controls and the disabled person. Too often people limit their thinking to “products” i.e. fitted on their assessment vehicle. It is important to look at the person, their functional abilities and what they need to enable them to operate the controls comfortably.

Assessment is the skilled process of considering the requirements for fitness to drive and driving ability, the vehicle construction requirements given in the relevant directives and finding a type of solution to fulfil these requirements in a way that suits the functional abilities of the specific driver.

Stages of compensation (RRR)

To enable the driver to drive safely with maximum comfort and control there are three stages:

• REDUCE
  First the workload in the driving task should be reduced. The easiest way to reduce the workload is by changing from manual transmission to automatic transmission.

• REINFORCE
  Secondly make the driving task easier by reinforcement of the operation of the controls. Reduction of the forces needed to operate the steering and brake control will often contribute significantly to proper command over the vehicle.

• REPLACE
  And (only) in the third place the possibilities to replace or modify the controls to suit the functional abilities of the driver should be considered.

Replacement of controls for operation by other limbs unfortunately tends to increase the workload for the remaining limbs. So where possible the modification of standard controls to suit any remaining function of the affected limb is preferable.

Driving ability

To be able to relate the functional capabilities to the adequate operation of controls it must be clear what performance is required for operation. The characteristics and performance requirements of controls are described in a series of automotive directives i.e. brakes (71/320/EC), steering (70/311/EC), etc. Knowledge of these directives is essential to decide whether a person can operate standard controls or if any modification is required.

Driver related aspects of these directives include for example the operation force of the control, the shape and position of the control, the position of the driver relative to the control or vehicle part, etc.

Several aspects have to be taken into account when defining an appropriate type of solution for a specific driver:

• The type of solution should comply to all relevant legislation. This requires that the assessor has to have good knowledge of the national and/or European legislation of driving licences as well as (to a minor extent) of motor vehicles.

• Financial consequences should never be a decision criteria in itself but it is fair to state that the focus should be on the cheapest ADEQUATE solution. Costs play a role but always of secondary importance to the fact that the solution must be adequate.

• Training forms an essential part of all efforts to achieve the required driving ability. The assessor has to be aware of the (im)possibilities of training in relation to different types of solutions.

Codes

When it is clear what type of solution is needed for a specific disabled driver to enable safe driving then the codes can be allocated according to the list of harmonized Community codes given in Annex I of the driving licence directive.

Codes can be allocated either as main codes (2 digits) or as sub-codes (four digits). It is open to the Member States to stipulate in their national law the use of main or sub codes. However, for codes 05 and 44 the use of subcodes is obligatory.

A0400