Are applicants for a driver's license asked questions about diabetes?

The driver's license application (first-time and renewal) asks an applicant whether he or she has any mental or physical disabilities that would affect his or her driving. If an applicant answers yes to this question, he or she will be questioned by agency personnel to determine the extent of the disability and its effect on driving. An applicant may then be required to have a medical examination performed by a physician. See 761 Iowa Admin. Code r. 600.4(2) (2013) (agency will not license any person "unable to operate a motor vehicle safely because of a physical or mental disability until that person has submitted a medical report.")

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 accepts reports of potentially unsafe drivers from peace officers, courts, and "a properly documented citizen's request." 761 Iowa Admin. Code r. 604.50(5) (2013). In addition, a physician, an optometrist, a registered nurse, or physician's assistant may report a physical or mental condition affecting driving competence. Iowa Code § 321.186(4) (2013). Anonymous reports are not accepted: the driver must be notified. Id. Reports will remain confidential. Id. Drivers may also be required to have a medical evaluation if they have impairments which are observed by licensing agency personnel during the licensing process, if they are involved in an at-fault crash involving a fatality, or if they are involved in multiple crashes that may involve an episode of loss of consciousness. See 761 Iowa Admin. Code r. 604.50 (2013).

What is the process for medical evaluations of drivers?

When the licensing agency has reason to believe that a driver may be medically unsafe, either because the driver gave positive answers to medical questions on the license application or because of a report from one of the other sources listed above, it may require the individual to have a medical evaluation. See above; see generally Iowa Code § 321.186(1) (2013) (examination required if person physically or mentally incompetent to drive). When this happens, an evaluation form is sent to the individual, which must be completed by his or her physician. See 761 Iowa Admin. Code r. 600.4(4) (2013) (setting forth standards for loss of consciousness evaluations). Medical evaluation forms for loss of consciousness, if requested, must be based on an examination of the patient within the past six-month period, and six months after the most recent loss of consciousness. 761 Iowa Admin. Code r. 600.4(4) (2013).

The medical evaluation form asks questions about the individual's diabetes and its severity, test results, medications, compliance with treatment, and the circumstances surrounding. Episodes of loss of consciousness also are detailed (if applicable). The physician is also asked whether the patient is qualified to operate a motor vehicle, whether further evaluation by a specialist is recommended, and whether reevaluation is recommended before the end of the next renewal period.

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 the state licensing agency. Nevertheless, a physician has no duty to make a report or to warn third parties with regard to any knowledge concerning a person's mental or physical competency to operate a motor vehicle in a safe manner. Iowa Code § 321.186(4) (2013).

Are physicians who report drivers with medical conditions immune from legal action by the patient?

Yes. They are immune from civil or criminal liability for anything resulting from their report. Iowa Code § 321.186(4) (2013).

Who makes decisions about whether drivers are medically qualified?

Where licensing agency personnel decide that a medical evaluation is required, the case may be referred to the state's independent Medical Advisory Board, which makes a recommendation based on the medical record. 761 Iowa Admin. Code r. 600.4(6) (2013). Conditions involving loss of consciousness require review by the Medical Advisory Board, and must have a favorable recommendation from the Board. 761 Iowa Admin. Code r. 600.4(4)(a) (2013). The Medical Advisory Board generally adheres to recommendations made by the evaluating physician although it is not required to do so. The licensing agency generally accepts the Medical Advisory Board's recommendations in making licensing decisions.

What are the circumstances under which a driver may be required to undergo a medical evaluation?

A driver may be required to undergo a medical evaluation if he or she is found to have contributed to a fatal motor accident; if he or she has contributed to two accidents within a three-year period; if he or she is 65 years of age or older, has been involved in an accident, and the need for reexamination has been asserted by a police officer; or if a police officer, court, or citizen having filed proper documentation has requested a reexamination. 761 Iowa Admin. Code r. 604.50 (2013). An individual also may be required to undergo a medical evaluation if he or she responded positively to medical questions on the license application and agency personnel have determined that an examination is necessary, or if agency personnel observe any impairments affecting the individual's ability to drive during the licensing process. Iowa Code § 321.186 (2013).

Has the state adopted specific policies about whether people with diabetes are allowed to drive?

No. Iowa has not adopted specific medical guidelines related to diabetes, except for its guidelines related to episodes of loss of consciousness (see below).

What is the state's policy about episodes of altered consciousness or loss of consciousness that may be due to diabetes?

An individual cannot be licensed if he or she has had an episode of loss of consciousness or loss of voluntary control within the last six months. 761 Iowa Admin. Code r. 600.4(4) (2013). Even if an individual has remained episode-free for six or more months, he or she may be licensed only upon submission of a favorable medical report stating as much. 761 Iowa Admin. Code r. 600.4(4) (2013). The Medical Advisory Board may be required to give a favorable recommendation before the licensing agency grants approval for a license. 761 Iowa Admin. Code r. 600.4(4)(a) (2013).

A license so issued must state "Medical report to be furnished at the end of six months," 761 Iowa Admin. Code r. 605.5(5)(b)(1) (2013), and upon submission of another favorable medical report after six months, a duplicative license must be issued, stating, "Medical report required at renewal." 761 Iowa Admin. Code r. 605.5(5)(b)(2) (2013). Licenses may be granted only for two-year periods, and a medical evaluation is required at each two-year renewal thereafter. 761 Iowa Admin. Code r. 605.5(5)(b)(2) (2013). Upon the recommendation of a physician, an individual who is episode free for two years, and has not been prescribed medicine to control these episodes, can be issued a full-term and restriction free license. 761 Iowa Admin. Code r. 605.5(5)(b)(4) (2013).

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. If a driver's latest medical report indicates that he or she has experienced only a single, nonrecurring episode, that the cause has been identified, and that the physician believes it is unlikely to recur, then the licensing agency may waive the medical report requirement upon recommendation by the medical advisory board. 761 Iowa Admin. Code r. 605.5(5)(b)(3) (2013).

What is the process for appealing a decision of the state regarding a driver's license?

The licensing agency may suspend a driver's license upon 30 days written notice and without a preliminary hearing for medical reasons. Iowa Code § 321.210(1)(a)(3) (2013). The driver may request an informal settlement or administrative review of the decision within 30 days of the request. Iowa Code § 321.211(1) (2013). The request for an administrative review must be submitted within 20 days of receipt of the notification, unless otherwise specified. 761 Iowa Admin. Code r. 615.38(3)(c)(1) (2013). The hearing usually will occur via telephone but also may occur in person at a time and place agreeable to both the driver and the Department of Inspections and Appeals. Iowa Code § 321.211(1) (2013). Evidence and testimony may be presented at this hearing. Iowa Code § 321.211(1) (2013). Any license suspension might be stayed pending the outcome of the hearing. 761 Iowa Admin. Code r. 615.38(5)(a) (2013). But see Iowa Admin. Code r. 761-615.38(5)(b)(1) (2013) (excepting suspensions for incapability from those stayed pending the outcome of administrative review).

May an individual whose license is suspended or denied because of diabetes receive a probationary or restricted license?

Yes. A driver whose license has been suspended may petition the licensing agency for a temporary restricted license that would allow him or her to drive to and from his or her place of employment. Iowa Code § 321.215(1)(a) (2013). But see Iowa Admin. Code r. 761-615.45(1)(b) (2013) (disallowing the issuance of temporary restricted licenses to individuals whose licenses have been suspended for reasons of incapability).

Is an identification card available for non-drivers?

Yes, with proper identification and payment of a $5.00 fee. Iowa Code § 321.190(1)(a), (d) (2013). An identification shall be valid for a period of five years, except if the recipient is seventy years of age or older, in which case it shall be valid indefinitely. Iowa Code § 321.190(1)(d) (2013). If an identification card is issued because a driver's license has been suspended due to medical reasons, no fee shall be charged. Iowa Code § 321.190(1)(d) (2013); see also Iowa Code § 321.210(1)(a)(3) (2013) (authorizing the licensing agency to suspend a driver's license for medical reasons).


Driver licensing in Iowa is administered by the Office of Driver Services within the Motor Vehicle Division of the state Department of Transportation.