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North Carolina’s Medical Review for Drivers

State offers safety evaluation program for at-risk drivers.


  • About 900 to 1,200 drivers a month are referred for a medical review
  • The medical review program is not based on age
  • Two years ago, 380 drivers 50 and over were killed in a motor vehicle accident in the state

Judith Hutchens’ neurologist had some disturbing news: She might have Alzheimer’s disease. Concerned for her safety, he asked the 69-year-old Sanford woman to sign a form saying she wouldn’t drive until cleared by the Division of Motor Vehicles’ medical review branch.

Roughly 900 to 1,200 people a month are referred for medical review in an effort to keep potentially unsafe drivers off the road. About 70 percent are age 50 or older.

Of those, about 15 percent lose their license. Another 25 percent keep their license without further restrictions. The rest keep their license but stay in the program, perhaps with follow-up evaluations or restrictions, such as driving only during daylight hours, said Susan Stewart, who manages the program.

Anyone can make a referral for a driver of any age.

Anyone can make a referral, not just doctors. Referrals must be signed. Drivers who pay a fee will have access to their file.

“Any age can be referred. There is no targeting by age. It is by ability to be on the road,” Stewart said. “We get referrals from the court, the highway patrol, physicians, friends, family.”

That’s what Suzanne LaFollette-Black, associate state director for community outreach forAARP North Carolina, likes about the program, which she called an “outstanding evaluation process.”

“It is not age-based. We support capability, not age. Just because you are 85 doesn’t mean you can’t drive,” LaFollette-Black said.

How the Process Works

Once a referral is made, the program can proceed in several ways. If referred by anyone other than a doctor, drivers usually go to a local DMV office for a free evaluation. There, an examiner tests their vision and knowledge of traffic signs, reviews medications to see if they are on a list of drugs that could impair driving, and asks general questions about health.

If they pass the vision and sign tests, they take a road test. If it’s a close call, the driver can retest. If problems emerge, drivers may need to pay for a doctor’s exam to verify they can safely drive.

For those referred by a doctor, the review is more complex. Nurses and doctors who serve on the medical review board may ask the driver to pay for an evaluation by an occupational therapist or medical expert of the driver’s choosing. Usually the driver can keep his or her license during this process.

Hutchens’ case was more unusual in that she voluntarily gave up her license. Although she did not have Alzheimer’s or dementia, she did have a mild cognitive impairment. She now takes medication for her condition.

The evaluation process was frustrating, Hutchens said. She had to pay $500 for the outside evaluation by a driver rehabilitation specialist, and it took several months to get her license back.

“A lot of people see us as trying to take their license,” Stewart said. “That is not the intent. I am looking for a reason to allow them to safely continue to drive. We understand that everyone wants their independence.”

North Carolina is not alone: 33 other states have a form of medical advisory board to help deal with medically at-risk drivers, according to the AAA Foundation for Traffic Safety.

In North Carolina, 380 drivers 50 and over were killed in a motor vehicle accident in 2007, a rate of nearly 14 per 100,000 residents in that age group—the 12th highest rate in the country, according to the National Highway Traffic Safety Administration.

Sandy Hill is a freelance writer living in Charlotte, N.C.

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