Are applicants for a driver's license asked questions about diabetes?
The license application (first-time and renewal) asks if the applicant ever has ever suffered from any physical or mental disability that could affect his or her ability to operate a motor vehicle safely. See Haw. Code R. § 19-122-353(a) (2013). Persons with diabetes are required to answer "yes" to this question. If an applicant answers "yes," he or she must submit a medical evaluation form. See Hawai'i Dep't. Of Transp., "Medical Report," Form DOT-H 2058, Rev. June 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?
The state has "reasonable cause to believe written information" of potentially unsafe drivers from police authorities, the courts, licensed physicians and optometrists, and driver license examiners. Haw. Code R. § 19-122-352 (2013). The licensing agency does not accept anonymous reports or referrals from family members and friends, nor does it investigate any of the reporting sources before it initiates an evaluation. Drivers also may be required to undergo a medical evaluation if they have impairments that are observed by licensing agency personnel during the licensing process (Haw. Code R. § 19-122-353(c) (2013)), or if they are involved in an at-fault crash involving a fatality.
What is the process for medical evaluations of drivers?
When the licensing agency becomes aware that an individual has a medical condition that may affect safe driving, the applicant is required to have a medical evaluation form completed by a physician. See Hawai'i Dep't. Of Transp., "Medical Report," Form DOT-H 2058, Rev. June 2012. An applicant generally has 30 days to submit the form. Haw. Code R. § 19-122-354 (2013). A 90-day, temporary license may be issued while the medical evaluation form is pending. Haw. Code R. § 19-122-353(f) (2013).
In addition to requiring information about the applicant's condition, the medical evaluation form asks the physician whether the applicant is capable of driving safely, whether follow-up medical evaluations should be required, and if so, how often such follow-up examinations should be required. See Hawai'i Dep't. Of Transp., "Medical Report," Form DOT-H 2058, Rev. June 2012. Specific questions about diabetes include questions regarding insulin or oral medication dosage, history of hypoglycemia, hypoglycemic unawareness, blood glucose checks, and carrying glucose tablets. Id. Finally, the form asks if the patient's diabetes is "under control." Id.
Once the medical evaluation form is returned, licensing agency personnel review it to determine whether a licensing decision may be made or whether the case should be referred to the state's Medical Advisory Board. Individuals with diabetes are frequently referred to the Medical Advisory Board. Follow-up medical evaluations may be required, usually based on the physician's recommendation. See Haw. Code R. § 19-122-361 (2013) (authorizing various medical restrictions).
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?
There is no statutory authority providing immunity from civil or criminal liability for physicians reporting drivers with medical conditions that could affect their ability to drive safely to the licensing agency.
Who makes decisions about whether drivers are medically qualified?
As noted above, where diabetes is involved decisions are frequently based on recommendations from the Medical Advisory Board. The Medical Advisory Board makes a decision after reviewing the medical information submitted and the state's guidelines. See Haw. Code R. § 19-122-360 (c)-(d) (2013). Nevertheless, the licensing agency retains authority to suspend or revoke any license when there is reasonable cause to believe that a driver is afflicted with a physical or mental condition that would impair his or her ability to drive safely. Id.; Haw. Rev. Stat. § 286-119 (2013).
What are the circumstances under which a driver may be required to undergo a medical evaluation?
An applicant may be required to undergo a medical evaluation if the answer to any question on the license application "indicates the existence of any physical or mental condition that…may prevent the applicant from safely operating a motor vehicle." Haw. Code R. § 19-122-353(b) (2013); see also Haw. Code R. § 19-122-359(a)(1)-(7) (2013) (specifying various medical conditions the presence of which necessitate a medical examination; diabetes is not included). An applicant also may be required to undergo a medical evaluation if the licensing agency has "reasonable cause beyond self-disclosure on the application form to believe that an applicant has a medical condition which may prevent the applicant from safely operating a motor vehicle or which makes such operation hazardous to public safety." Haw. Code R. § 19-122-353(c) (2013).
Has the state adopted specific policies about whether people with diabetes are allowed to drive?
Besides the lapse of consciousness policy, (see below), Hawaii has not adopted specific guidelines determining which individuals with diabetes should be allowed to drive. However, the Medical Advisory Board generally follows guidelines published by the American Medical Association. Hawaii has adopted numerous guidelines determining which individuals with diabetes may obtain commercial driver's licenses. See Haw. Code R. § 19-122-26, -27 (LexisNexis 2013).
What is the state's policy about episodes of altered consciousness or loss of consciousness that may be due to diabetes?
The Medical Advisory Board makes decisions based on the individual facts of each case. For both first-time and renewal applicants, any individual that within the previous two years has experienced loss of consciousness as the result of a physical or mental condition, including diabetes, must submit a written medical report "describing the condition and its effect on the person's ability to operate a motor vehicle safely." Haw. Code R. § 19-122-359(a)(1) (2013). The report usually must have been made within six months of submission and must indicate "whether the condition of the applicant and any medication prescribed for the applicant would affect the applicant's ability to safely operate a motor vehicle." Haw. Code R. § 19-122-359(b)-(c) (2013). If the condition would impair the applicant's driving ability, a license will not be issued or renewed. Haw. Code R. § 19-122-362 (2013). To obtain a license, the medical report must state that the applicant has been episode-free for at least six months or that the lapse of consciousness was an isolated incident and is unlikely to recur. Haw. Code R. § 19-122-362(1)(A)-(B) (2013). The medical report may be reviewed by the Medical Advisory Board. Haw. Code R. § 19-122-359(d) (2013); see generally Haw. Rev. Stat. § 286-4.1 (2013) (describing the functions of the Medical Advisory Board); Haw. Code R. § 19-122-360 (2013) (describing the functions of the Medical Advisory Board).
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, even if an individual has been denied a license because of a physical or mental condition resulting in loss of consciousness, he or she may obtain a license by providing a medical report stating that "[t]he seizure or other condition resulting in the lapse of consciousness was an isolated incident and is unlikely to reoccur." Haw. Code R. § 19-122-362(1)(B) (2013).
What is the process for appealing a decision of the state regarding a driver's license?
The first level of the appeal process is an informal hearing. An individual may petition the licensing agency for a hearing within 30 days "after the effective date of a suspension, revocation or cancellation of a license or permit, the denial of an application or imposition of a restricted license." Haw. Code R. § 19-122-364(a) (2013). At the hearing, an individual may present evidence of his or her fitness to operate a motor vehicle safely. Haw. Code R. § 19-122-364(b) (2013). Next, an individual may appeal any licensure refusal, suspension, revocation, or cancellation to the circuit court of the circuit in which he or she resides by filing an appeal within 30 days of being notified of the adverse decision. Haw. Rev. Stat. § 286-129 (2013). The order of the licensing agency remains in effect while the appeal is pending. Haw. Rev. Stat. § 286-129 (2013).
May an individual whose license is suspended or denied because of diabetes receive a probationary or restricted license?
Yes, if a medical report justifies restrictions on the license. Restrictions may include limiting driving to day-light hours only, amongst others restrictions. The license may be issued for a shorter time period to allow for follow-up monitoring of the condition. See Haw. Rev. Stat. § 286-103 (2013) (providing that the licensing agency may impose restrictions on licensure as "necessary for the safety and welfare of the traveling public"); Haw. Code R. § 19-122-361 (2013 (providing that the licensing agency may impose restrictions on licensure related to medical conditions).
Is an identification card available for non-drivers?
Yes, with proper identification. For more information, see State of Hawaii Department of Transportation, "Hawaii State Identification Card".
Driver licensing in Hawaii is coordinated by the state's Department of Transportation.