Are applicants for a driver's license asked questions about diabetes?
The application form (first-time and renewal) asks if the applicant has a medical condition that may affect his or her ability to safely operate a motor vehicle. If the applicant answers "Yes" to this question, he or she may be required to have a medical examination report completed by their physician and returned to the department, depending on the condition and when it was experienced. See Ariz. Admin. Code § R17-4-502(B)(1)-(2), (C)(1)(b) (2012).
What other ways does the state have to find out about people who may not be able to drive safely because of a medical condition?
Any person with "direct knowledge" may submit information to the licensing agency about "specific events or conduct" indicating a disqualifying medical condition. Ariz. Admin. Code § R17-4-502 (C)(1)(d)(2012). The information must be in writing. Id. The licensing agency accepts reports of potentially unsafe drivers from: police officers, the courts, physicians, family members, friends, other citizens and hospitals. The licensing agency does not accept anonymous reports, and investigates reports to ensure that they are valid.
If licensing agency personnel observe "unexplained confusion, loss of consciousness, or incoherence" during the licensing process, the driver may be reported as needing a medical evaluation. Ariz. Admin. Code § R17-4-502(C)(1)(c) (2012).
In addition, a driver must self-report new medical conditions. The driver must notify the licensing agency, as soon as the medical condition allows, that he or she has a previously unreported medical condition that affects the applicant's functional ability. Ariz. Admin. Code § R17-4-502(B)(4) (2012).
Are physicians required by law to report drivers who have medical conditions that could affect their ability to drive safely?
There is no statutory authority requiring physicians to report drivers with medical conditions that could affect their ability to drive safely to a central state agency.
Are physicians who report drivers with medical conditions immune from legal action by the patient?
Yes. A physician or nurse practitioner may voluntarily report to the licensing agency a patient whose medical condition could "in the opinion of the physician, registered nurse practitioner or psychologist could significantly impair the person's ability to safely operate a motor vehicle." Ariz. Rev. Stat. § 28-3005(B) (2013). A physician or nurse practitioner submitting a good faith report is immune from civil or criminal liability. Id.
In addition, a physician who submits a good faith medical evaluation, on behalf of a driver and at his or her request, is free from personal liability with respect to the information provided. Ariz. Rev. Stat. § 28-3005(A) (2013).
What is the process for medical evaluations of drivers?
When the licensing agency receives notification that a driver has a medical condition or functional impairment that may affect safe driving ability, that driver is sent a medical examination report form, which must be completed by the applicant's physician. The physician is asked to make recommendations on the person's ability to safely operate a motor vehicle. Completed forms are sent back to the licensing agency, which then makes a decision on the driver's qualifications. Ariz. Admin. Code § R17-4-502(C)(2) (2012).
If the medical examination report is inclusive as to the presence of a disqualifying medical condition, the licensing agency may require the applicant to appear for an interview or submit to further examination. Ariz. Admin. Code § R17-4-502(C)(3)-(4) (2012). Drivers may be required to submit periodic medical forms, as recommended by their treating physician. Applicants or drivers must pay for any expense incurred through this evaluation process. Ariz. Admin. Code § R17-4-502 (C)(5) (2012).
What are the circumstances under which a driver may be required to undergo a medical evaluation?
First-time applicants who report disqualifying medical conditions may require a medical evaluation. Ariz. Admin. Code § R17-4-502(B)(1)-(2) (2012). These conditions can include vision problems, seizures, and loss of consciousness (see below). Id. License renewal applicants who have had a change in their medical condition, and now may have a disqualifying condition, must also submit to an evaluation. Ariz. Admin. Code § R17-4-502(B)(3) (2012). Licensing agency personnel may require an evaluation if they observe unexplained confusion, loss of consciousness, or incoherence in the individual. Finally, any driver may be evaluated if a person with direct knowledge submits to the licensing agency information about specific events or conduct indicating the existence of a disqualifying medical condition. Ariz. Admin. Code § R17-4-502(B)(2), (C)(1)(d) (2012).
Who makes decisions about whether drivers are medically qualified?
Licensing agency personnel evaluate forms submitted by physicians and may make licensing recommendations or request additional medical information. See Ariz. Rev. Stat. § 28-3314 (2013); Ariz. Admin. Code § R17-4-502. The licensing agency may request an interview if written materials are not sufficient. Ariz. Admin. Code § R17-4-502(C)(4).
While Arizona has an independent medical advisory board, its main function is to advise on medical standards or procedures, not to review individual cases. Ariz. Rev. Stat. § 28-3051, 28-3052 (2013). In rare cases where the licensing agency cannot decide whether a medical condition is disqualifying, the licensing agency will perform another evaluation, performed by an appropriate specialist. Ariz. Admin. Code § R17-4-502(C)(4). This evaluation will be reported to the Medical Review Program board. Id.
Has the state adopted specific policies about whether people with diabetes are allowed to drive?
No. Arizona has no specific policies about licensing of drivers with diabetes. It does have specific seizure policies. (See below).
What is the state's policy about episodes of altered consciousness or loss of consciousness that may be due to diabetes?
Anyone who has had a seizure within the past three months prior to a license application must have a medical evaluation. Ariz. Admin. Code § R17-4-506(A)(1) (2012). A "seizure" is defined as a "neurological disorder" with "abnormal electrical discharge in the brain" that can lead to "sudden alteration in consciousness, sensation, motor control, or behavior." Ariz. Admin. Code § R17-4-506(A)(1) (2012). The driver who has a seizure must immediately stop driving and report the episode to the licensing agency. Ariz. Admin. Code § R17-4-506(B)(1)-(2) (2012).
The licensing agency makes a decision as to whether a medical condition affects the individual's ability to operate the motor vehicle safely based on the medical examination form and the physician's recommendation. Ariz. Admin. Code § R17-4-506(B)(1)-(2), R7-4-502 (2012). The examination report will consider age of onset, history of seizures, aftereffects, cause, frequency, duration, and date of most recent seizure, along with the physician's medical opinion. Ariz. Admin. Code § R17-4-506(C). The examination form asks questions about episodes of "altered consciousness," including the date and cause of the last such episode and the degree of control the applicant has achieved over the episodes.
The agency will not issue a license to a person if the medical examination report shows that the person has a "neurological disorder" that affects the person's ability to operate a motor vehicle safely. Ariz. Admin. Code § R17-4-506(A)(3), (B)(3) (2012). Drivers who have had seizures must undergo a follow-up medical examination within one year after the seizure or within a shorter time, as recommended by the physician. Ariz. Admin. Code § R17-4-506(B)(1)(c) (2012).
Does the state allow for waivers of this policy, e.g., a waiver for a one-time episode of severe hypoglycemia that has mitigating factors (e.g., recent change in medication, illness, etc.) or that has been addressed with a physician?
Yes. A neurological disorder does not affect a person's ability to drive safely if the physician concludes with reasonable certainty that the seizure or seizures (1) were due to deliberate change in anticonvulsant medication ordered by a physician; (2) were isolated occurrences that are unlikely to recur with reasonable medical certainty; (3) occurred only during sleep; or (4) have an established pattern of an aura of sufficient duration to allow an individual to safely cease operating a motor vehicle at the onset of the aura. Ariz. Admin. Code § R17-4-506(D)(1)-(4) (2012).
What is the process for appealing a decision of the state regarding a driver's license?
An applicant may request an administrative review by the licensing agency's Executive Hearing Office of any suspension, revocation, or denial of a license within either 15 days of delivery notification of the state's action or within 20 days of such notification being mailed to the applicant. Ariz. Admin. Code § R17-4-502(F)(1)(a)-(b) (2012). A petitioner may request a full administrative hearing. Ariz. Admin. Code § R17-1-501 through R17-1-511 (2013).
May an individual whose license is suspended or denied because of diabetes receive a probationary or restricted license?
No, but the licensing agency may issue with good cause a license appropriately restricted to ensure the safe operation of a motor vehicle. Ariz. Rev. Stat. § 28-3159(A)(1)(c) (2013).
Is an identification card available for non-drivers?
Yes, with proper identification. Ariz. Rev. Stat. § 28-3165 (2013). The non-operating license for a person who is suspended from driving is only valid for 180 days. Id. The fee to obtain an identification card is $12.00. Ariz. Admin. Code § R17-4-409(C)(2012).
Driver licensing in Arizona is administered by the Motor Vehicle Division within the State Department of Transportation.