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 physical or mental condition that may prevent him or her from safely operating a motor vehicle. S.C. Code Ann. §§ 56-1-130(A), -210(D) (2012). The application form also asks 1) if he or she has experienced an episode of loss of consciousness, muscular control, or seizure, within the last six months and 2) if a doctor has advised the applicant against driving or suggested driving with restrictions at this time. South Carolina Department of Motor Vehicles, "Application for Non-Commercial Credential," Form 447-NC (Rev. 04/2013). Applicants who answer yes to either of these questions must have medical evaluation forms filled out by their physicians. S.C. Code Ann. §§ 56-1-130(A), -210(D) (2012) (authorizing licensing agency to require evaluations of applicants' mental and physical fitness). The license application also asks whether an applicant wishes to have a medical symbol placed on his or her license to alert law enforcement and emergency personnel to the presence of a medical condition. If the applicant answers yes, he or she must give the name of the condition. S.C. Code Ann. § 56-1-80(A)(6), (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?
The state accepts reports of potentially unsafe drivers from police officers, the courts, and physicians. The licensing agency does not accept anonymous reports and does not accept reports directly from family members or other citizens. TransAnalytics, LLC, "Summary of Medical Advisory Board Practices in the United States," June 18, 2003, p. 279, (Cautionary Note: information likely out of date). Drivers also may be required to have medical evaluations if they have impairments that are observed by licensing agency personnel during the licensing process or after accumulating a given number of accidents in a certain time period. S.C. Code Ann. § 56-1-225 (2012) (providing that an individual involved in four accidents within 24 months may be required at the discretion of he agency to re-take any portion of the license examination); S.C. Code Ann. § 56-1-270 (2012) (generally providing that the licensing agency may compel an individual to submit to a medical examination when it has good cause to believe that he or she is incompetent or otherwise unqualified to be licensed).
What is the process for medical evaluations of drivers?
When the licensing agency has reason to believe that a driver may be medically unsafe to operate a motor vehicle, 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 will require the individual to undergo a medical evaluation. S.C. Code Ann. §§ 56-1-130(A), -210(D), -225, -270 (2012). When this happens, a medical evaluation form is sent to the individual, which then must be completed by his or her physician. The medical evaluation form contains a section that the individual must complete which, along with other questions about accident and medical history, asks whether he or she has diabetes and what medications he or she is taking. The next section of the form must be filled out by his or her physician and includes a section on diabetes, which asks how long the individual has had diabetes, whether he or she is compliant with medical instructions, whether the condition is controlled, whether the individual follows a prescribed diet, and whether and how often the individual suffers from "insulin shock" and "diabetic acidosis." The physician also is asked to provide the highest and lowest blood glucose values recorded in the last year. Finally, the physician is asked to give an opinion on whether, given the individual's condition, the physician would be willing to ride with the individual as an operator of a motor vehicle. Medical evaluation forms are returned to the licensing agency for review and a licensing decision. S.C. Code Ann. § 56-1-221(C) (2012) (generally authorizing medical review board to request reports and evaluations from treating physicians).
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 granting immunity from civil or criminal liability to physicians who report or fail to report drivers with medical conditions that could affect their ability to drive safely. However, the medical advisory board members are immune from liability for their opinions and recommendations. S.C. Code Ann. § 56-1-221(D) (2012).
Who makes decisions about whether drivers are medically qualified?
Licensing decisions generally are made based on the medical information provided, and the recommendation of the treating physician. If the treating physician gives an unfavorable recommendation for an individual with diabetes, his or her case would be referred to the state's independent Medical Advisory Board. When a case is referred to the Medical Advisory Board, it reviews the available information, may cause an individual to undergo a medical evaluation, and makes a recommendation, which generally will be followed by the licensing agency. S.C. Code Ann. § 56-1-221(C) (2012) (generally providing that when the licensing agency has reason to believe that an individual may not be physically or mentally qualified to drive, it may obtain the advice of the Medical Advisory Board). Ultimate authority over licensing decisions resides with the licensing agency. S.C. Code Ann. § 56-1-221(C) (2012) (licensing agency obtains "advice" from the board).
What are the circumstances under which a driver may be required to undergo a medical evaluation?
An individual may be required to undergo a medical evaluation if he or she gives affirmative answers to questions on the licensing application. S.C. Code Ann. §§ 56-1-130(A), -210(D) (2012). An individual may be required to undergo a medical evaluation if he or she is reported to the licensing agency as a potentially unsafe driver; if he or she has been involved in four accidents within 24 months, see S.C. Code Ann. § 56-1-225 (2012), or if the licensing agency has good cause to believe that he or she may be physically or mentally incompetent to operate a motor vehicle safely. S.C. Code Ann. § 56-1-270 (2012) (medical evaluation if cause to believe unfit to operate vehicle). Additionally, the Medical Advisory Board may require an individual to undergo a medical evaluation before formulating a recommendation as to whether or not he or she should be licensed. S.C. Code Ann. § 56-1-221(C) (2012).
Has the state adopted specific policies about whether people with diabetes are allowed to drive?
No. South Carolina has adopted no specific medical guidelines related to diabetes.
What is the state's policy about episodes of altered consciousness or loss of consciousness that may be due to diabetes?
An individual will not be licensed if he or she has had an episode of loss of consciousness within the last six months. When an episode of loss of consciousness occurs, his or her driving privileges will be suspended until the individual can prove that he or she has been episode-free for at least six months. The applicant also must submit a physician's statement regarding his or her condition. The Medical Advisory Board then reviews the medical information. If the last episode occurred more than six months ago, the individual may be licensed if otherwise qualified, but a follow-up medical evaluation will be required in six months. A follow-up evaluation then is required every year until the individual has been episode-free for three years, at which time the case is closed. A report of a loss-of-consciousness or blackout episode due to a non-medical condition may be approved for driving privileges with no yearly follow-up. TransAnalytics, LLC, "Summary of Medical Advisory Board Practices in the United States," June 18, 2003, p. 279. (Cautionary Note: information likely out of date).
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 report of a loss-of-consciousness or blackout episode due to a non-medical condition may be approved for driving privileges with no yearly follow-up examinations required. TransAnalytics, LLC, "Summary of Medical Advisory Board Practices in the United States," June 18, 2003, p. 279. (Cautionary Note: information likely out of date).
What is the process for appealing a decision of the state regarding a driver's license?
Within 10 days after notice of suspension, cancellation, or revocation of an individual's license because of a disqualifying medical condition—except in cases in which such suspension, cancellation, or revocation is mandatory—the aggrieved individual may request an administrative hearing to review the licensing decision. S.C. Code Ann. § 56-1-370 (2012). There is no statutory authority for appealing licensing decisions in court. S.C. Code Ann. § 56-1-410 (2006) (repealed 2006).
May an individual whose license is suspended or denied because of diabetes receive a probationary or restricted license?
A restriction can be placed on an individual's license if the Medical Advisory Board gives a recommendation, which is based on medical records and history, as well as medical examinations. S.C. Code Ann. § 56-1-221(C) (2012) (providing that the Medical Advisory Board shall make licensing recommendations when its advice is solicited). Furthermore, whenever good cause appears, the licensing agency may impose restrictions on an individual's license "appropriate to assure the safe operation of a motor vehicle by the licensee." S.C. Code Ann. § 56-1-170(A) (2012).
Is an identification card available for non-drivers?
Yes, with proper identification, proof of residency, and payment of a $5.00 fee. S.C. Code Ann. § 56-1-3350 (2012). To obtain an identification card, an individual must be 10 years of age or older. S.C. Code Ann. § 56-1-3350 (2012). The $5.00 fee is waived for persons who are mentally ill, mentally retarded, homeless, or who are on public assistance as the sole source of income. S.C. Code Ann. § 56-1-3350 (2012).
Driver licensing in South Carolina is administered by the Division of Motor Vehicles within the state Department of Public Safety.