Kentucky Administrative Regulations
Title 601 - TRANSPORTATION CABINET - DEPARTMENT OF VEHICLE REGULATION
Chapter 13 - Driver Improvement
Section 601 KAR 13:100 - Medical standards for operators of motor vehicles
Universal Citation: 601 KY Admin Regs Service 13:100
Current through Register Vol. 51, No. 3, September 1, 2024
RELATES TO: KRS 186.411, 186.440, 186.444, 186.570, 186.577, Chapter 218A, Chapter 311, Chapter 320
NECESSITY, FUNCTION, AND CONFORMITY: KRS 186.570 requires the Transportation Cabinet to withhold driving privileges from an individual who has a mental or physical condition that makes it unsafe to drive upon the highways. KRS 186.411 requires that a person with a seizure condition be seizure-free for ninety (90) days prior to licensing. This administrative regulation establishes the standards to be used by the Transportation Cabinet and Medical Review Board in determining who is unsafe to operate a motor vehicle because of a mental or physical condition.
Section 1. Definitions.
(1) "Altered consciousness" means a state of
awareness characterized by loss or distortion of the impressions made by the
senses or the inability to respond to the impressions made by the
senses.
(2) "Assessment" means an
evaluation of a person's substance abuse performed by a certified chemical
dependency counselor, a certified driving under the influence (DUI) assessor,
or other mental health professional in a licensed treatment facility.
(3) "Best corrected" means the corrected
distance visual acuity of an individual through the use of traditional
prescription lenses or contacts.
(4) "Chemical" means alcohol, drug, or
controlled substance as established in KRS Chapter 218A.
(5) "Cognition" means the ability to think,
perceive, and remember.
(6)
"Comorbid" means that more than one (1) condition is present at the same
time.
(7) "Corrective lens" means
an ophthalmic lens, whether an eyeglass, contact lens, or single lens system,
that corrects the refraction error or other optically correctable deficiency of
the eye.
(8) "Driving evaluation"
means a test conducted to determine if a person adequately compensates for a
medical, mental, or physical condition or functional impairment.
(9) "Episode" means any incident or segment
of time involving "altered consciousness" or "loss of bodily
control."
(10) "Field of vision"
means the entire horizontal and vertical planes a person has for each eye
without shifting the gaze.
(11)
"Functional ability" means the degree of cognitive, mental or emotional,
sensorimotor, and sensory capability in performing activities of daily living,
including safely per forming the tasks of driving.
(12) "Licensed medical specialist" means
anyone who is licensed in the Commonwealth of Kentucky to make a medical
report, make medical recommendations, or identify risk factors or other
conditions within the specialist's scope of medical practice regarding an
individual's physical or mental condition.
(13) "Licensing action" means any action by
the Transportation Cabinet involving the denial, cancellation, restriction, or
issuance of a motor vehicle operator's license pursuant to KRS Chapter
186.
(14) "Loss of bodily control"
means involuntary movements of the body characterized by muscle spasms or
muscle rigidity, or loss of muscle tone or muscle movement.
(15) "Loss of muscle tone" means the loss of
nerve impulses in muscle as distinguished from poor conditioning.
(16) "Medical condition" means any physical,
mental, or emotional condition that affects a person's health for which a
person is receiving medical or substance abuse treatment, or for which medical
or substance abuse treatment is usually prescribed.
(17) "Mental or emotional function" means
interaction and communication skills, adaptive behavior or coping capacity, and
orientation.
(18) "Overall
condition" means the presence or absence of comorbid conditions or disorders
affecting a person's health and information considered by the Medical Review
Board or department pursuant to Section 3 of this administrative
regulation.
(19) "Review board"
means the Medical Review Board established pursuant to
KRS
186.444 and
186.570(1)(c).
(20) "Sensory function" means vision,
hearing, touch, smell, or vibration sense.
(21) "Vision specialist" means a person
licensed to practice optometry as established in KRS Chapter 320, or a
physician licensed pursuant to KRS Chapter 311.
Section 2. General Requirements.
(1) If the Department of Vehicle Regulation
learns that a person applying for, renewing, or holding a motor vehicle
operator's license could have a medical condition that might affect safe
driving, the department may, pursuant to
601
KAR 13:090 and this administrative regulation, require
the person to provide the department with medical information about the
person's medical condition. The department shall review the medical information
as established in this administrative regulation.
(2) A person holding a Kentucky operator's
license or instruction permit shall report to the department medical conditions
that adversely affect his or her driving skills.
Section 3. Information to be Considered in Licensing Actions. A person shall be ineligible to apply for, renew, or hold a motor vehicle operator's license if that person does not comply with the standards established in Sections 4 through 11 of this administrative regulation. Pursuant to 601 KAR 13:090, the Medical Review Board, if making recommendations, and the department, if taking licensing action, may consider:
(1) Any medical condition affecting the
person, including:
(a) History of
illness;
(b) Severity of symptoms
and prognosis;
(c) Complications or
comorbid conditions, or both;
(d)
Treatment and medications, including effects and side effects, and the person's
knowledge and use of medications;
(e) Results of medical tests and reports of
laboratory findings;
(f) Medical
reports of licensed physicians and licensed medical specialists and
rehabilitation specialists;
(g)
Recommendations of licensed physicians and licensed medical specialists and
rehabilitation specialists with regard to functional impairment;
(h) Identification of risk factors as
identified by licensed physicians and licensed medical specialists and
rehabilitation specialists; and
(i)
"Overall condition" as defined by Section 1.
(2) Reports of driver condition or
behavior;
(3) The results of any
driving evaluation of the person;
(4) Substance abuse assessment reports from a
licensed treatment facility, certified chemical dependency counselor, or
certified driving under the influence (DUI) assessor;
(5) Traffic accidents with a police report or
citation that could have been caused in whole or in part by a medical
condition;
(6) A person's failure
to provide requested information to the department; or
(7) A report from a licensed physician,
including vision specialists, or other licensed medical specialists and
rehabilitation specialists, including rehabilitation specialists, advanced
practice registered nurses, physician assistants, psychologists, physical
therapists, occupational therapists, chiropractors, or social
workers.
Section 4. Conditions Affecting Cardiovascular Function.
(1) With respect to conditions affecting
cardiovascular function, the Medical Review Board, if making recommendations,
and the department, if taking licensing action, may consider disorders,
including:
(a) Cardiac dysfunction;
(b) Arrhythmias; and
(c) Other cardiac or circulatory disorder or
dysfunction.
(2) The
department or the Medical Review Board may, pursuant to this administrative
regulation and
601
KAR 13:090, require a person to provide information on
the person's cardiovascular functional abilities and disorders.
(3) A motor vehicle operator's license shall
not be issued to, renewed by, or held by a person who does not meet the
applicable medical review standards for conditions affecting cardiovascular
function of this subsection, and a person who applies for, renews, or holds a
motor vehicle operator's license shall meet all of the cardiovascular function
criteria established in paragraphs (a) through (g) of this subsection.
(a) There shall not be current symptoms of
coronary artery disease, such as unstable angina, dyspnea, or pain at rest,
which interfere with safe driving.
(b) There shall not be a cause of cardiac
syncope present, including ventricular tachycardia or fibrillation, which is
not successfully controlled.
(c)
There shall not be congestive heart failure that limits functional
ability.
(d) There shall not be
cardiac rhythm disturbances if not successfully controlled.
(e) There shall not be an automatic
implantable cardioverter defibrillator, unless the device is assessed by an
electrophysiologist as not interfering with safe driving.
(f) There shall not be medications
interfering with safe driving.
(g)
There shall not be valvular heart disease or malfunction of prosthetic valves
that interferes with safe driving.
Section 5. Conditions Affecting Cerebrovascular Function.
(1) With respect to
conditions affecting cerebrovascular function, the Medical Review Board, if
making recommendations, and the department, if taking licensing action, may
consider disorders, including:
(a)
Cerebrovascular accident; and
(b)
Other cerebrovascular disorder or dysfunction.
(2) The department or Medical Review Board
may, pursuant to this administrative regulation and
601
KAR 13:090, require information on a person's central
nervous system functional abilities and disorders.
(3) A motor vehicle operator's license shall
not be issued to, renewed by, or held by a person who does not meet the
applicable medical review standards for conditions affecting cerebrovascular
functions of this subsection, and a person who applies for, renews, or holds a
motor vehicle operator's license shall meet all of the cerebrovascular function
criteria established in paragraphs (a) through (c) of this subsection,
(a) There shall not be a sensorimotor deficit
preventing safe driving.
(b) There
shall not be impairment of reasoning or judgment preventing safe operation of a
vehicle.
(c) There shall not be
medications interfering with the person's ability to operate a motor vehicle
safely.
Section 6. Conditions Affecting Endocrine Function.
(1) With respect to conditions affecting
endocrine function, the Medical Review Board, if making recommendations, and
the department, if taking licensing action, may consider disorders, including:
(a) Diabetes mellitus; and
(b) Other endocrine disorder or
dysfunction.
(2) The
department or Medical Review Board may, pursuant to this administrative
regulation and
601
KAR 13:090, require information on a person's
endocrine functional abilities and disorders.
(3) A motor vehicle operator's license shall
not be issued to, renewed by, or held by a person who does not meet the
applicable medical review standards for conditions affecting endocrine
functions of this subsection, and a person who applies for, renews, or holds a
motor vehicle operator's license shall meet all of the endocrine function
criteria established in paragraphs (a) through (c) of this subsection.
(a) There shall not be diabetic neuropathy,
retinopathy, or other complication that interferes with safe driving.
(b) There shall not be frequent and
functionally impaired hypoglycemic reactions.
(c) There shall not be evidence of use of
alcohol or other drugs to an extent that interfere with the person's prescribed
treatment program for the condition.
Section 7. Conditions Affecting Musculoskeletal Function.
(1) With respect to
conditions affecting musculoskeletal function, the Medical Review Board, if
making recommendations, and the department, if taking licensing action, may
consider disorders, including:
(a) Rheumatoid
arthritis;
(b) Paralysis;
and
(c) Other musculoskeletal
disorder or dysfunction.
(2) The department or Medical Review Board
may, pursuant to this administrative regulation and
601
KAR 13:090, require information on a person's
musculoskeletal functional abilities and disorders.
(3) A motor vehicle operator's license shall
not be issued to, renewed by, or held by a person who does not meet the
applicable medical review standards for conditions affecting musculoskeletal
function of this subsection, and a person who applies for, renews, or holds a
motor vehicle operator's license shall meet of the musculoskeletal function
criteria established in paragraphs (a) through (c) of this subsection.
(a) Pain shall not interfere with the
person's ability to safely operate a motor vehicle.
(b) The person's operation of a vehicle in a
driving evaluation demonstrates adequate compensation for any weakness or
limitations in range of motion or mobility.
(c) There shall not be effects or side
effects of medication interfering with safe driving.
Section 8. Conditions Affecting Neurological or Neuromuscular Function.
(1)
With respect to conditions affecting neurological or neuromuscular function,
the Medical Review Board, if making recommendations, and the department, if
taking licensing action, may consider disorders, including:
(a) Central nervous system diseases or
disorders;
(b) Demyelinating
diseases;
(c) Muscular diseases or
disorders; and
(d) Seizure
disorders.
(2) The
department or Medical Review Board may, pursuant to this administrative
regulation and
601
KAR 13:090, require information on neurological or
neuromuscular functional abilities, instances of altered consciousness or loss
of bodily control, or disorders.
(3) A motor vehicle operator's license shall
not be issued to, renewed by, or held by a person who does not meet the medical
review standards for conditions affecting neurological or neuromuscular
function of this subsection, and a person who applies for, renews, or holds for
motor vehicle operator's license shall meet all of the neurological and
neuromuscular function criteria established in paragraphs (a) through (e) of
this subsection.
(a) There shall not have been
a seizure episode as established in
KRS
186.411.
(b) The person adequately compensates for any
paralysis or sensory deficit while operating a vehicle.
(c) Fatigue, weakness, muscle spasm, or
tremor at rest does not impair safe driving.
(d) There shall not be effects of or side
effects of medication that interferes with safe driving.
(e) There shall not be a decline in cognition
to an extent that interferes with safe driving.
(f) The person shall satisfy the vision and
sensory function standards established in Section 11 of this administrative
regulation.
Section 9. Conditions Affecting Psychosocial, Mental, or Emotional Function.
(1) With respect to conditions
affecting psychosocial, mental, or emotional function, the Medical Review
Board, if making recommendations, and the department, if taking licensing
action, may consider disorders, including:
(a)
Substance and alcohol abuse; and
(b) Other mental or emotional disorder or
dysfunction.
(2) The
department or Medical Review Board may, pursuant to this administrative
regulation and
601
KAR 13:090, require information on mental or emotional
functional abilities and disorders.
(3) A motor vehicle operator's license shall
not be issued to, renewed by, or held by a person who does not meet the medical
review standards for conditions affecting mental and emotional function of this
subsection, and a person who applies for, renews, or holds any classification
of operator's license shall meet all of the psychosocial, mental, and emotional
function criteria established in paragraphs (a) through (g) of this subsection.
(a) There shall not be dementia that is
unresponsive to treatment or that interferes with safe driving.
(b) There shall not be a behavior disorder
with threatening or assaultive behavior that interferes with safe
driving.
(c) There shall not be a
delusional system that interferes with safe driving.
(d) There shall not be a suicidal
tendency.
(e) There shall not be an
impairment of judgment that interferes with safe driving.
(f) There shall not be an active psychosis
that interferes with safe driving.
(g) There shall not be effects or side
effects of medication that interferes with safe driving.
Section 10. Conditions Affecting Respiratory Function.
(1) With respect to
conditions affecting respiratory function, the Medical Review Board, if making
recommendations, and the department, if taking licensing action, may consider
disorders, including:
(a) Chronic obstructive
pulmonary diseases; and
(b) Any
other respiratory disorder or dysfunction.
(2) The department or Medical Review Board
may, pursuant to this administrative regulation and
601
KAR 13:090, require information on respiratory
functional abilities and disorders.
(3) A motor vehicle operator's license shall
not be issued to, renewed by, or held by a person who does not meet the medical
review standards for conditions affecting respiratory function of the
subsection, and a person who applied for, renews, or holds a motor vehicle
operator's license shall meet all of the respiratory function criteria
established in paragraphs (a) and (b) of this subsection.
(a) The person does not require medication
that interferes with safe driving.
(b) There shall not be dyspnea that
interferes with safe driving.
Section 11. Conditions Affecting Vision and Sensory Function.
(1) With respect to
conditions affecting vision and sensory function, the Medical Review Board, if
making recommendations, and the department, if taking licensing action, may
consider conditions, including:
(a) Vision
loss; and
(b) Any other ocular or
sensory disorder or dysfunction.
(2) The department or Medical Review Board
may, pursuant to this administrative regulation and
601
KAR 13:090, require information on ocular and sensory
functional abilities and disorders.
(3) A motor vehicle operator's license shall
not be issued to, renewed by, or held by a person who does not meet the medical
review standards for conditions affecting vision and sensory functions of this
subsection, and a person who applies for, renews, or holds any classification
of operator's license shall meet all of the criteria established in paragraphs
(a) and (b) of this subsection for visual acuity and visual fields.
(a) Visual Acuity. Persons with visual acuity
of 20/60, best corrected, or better and visual fields in compliance with
subparagraph (b) of this subsection shall be eligible for an operator's
license.
1. Persons with visual acuity 20/40
or better without corrective lenses shall not have a restriction mandating the
use of corrective lenses added to that person's driving privilege.
2. Persons with visual acuity of 20/40 or
better with corrective lenses shall have a restriction mandating the use of
corrective lenses added to that person's driving privilege.
3. Persons with visual acuity of 20/41, best
corrected, in at least one (1) eye with a single lens system, but no worse than
20/60, best corrected, in at least one (1) eye with a single lens system, shall
have a restriction pursuant to Section 12 of this administrative regulation
added to that person's driving privilege.
4. Persons with visual acuity of 20/61 or
worse, best corrected, in at least one (1) eye with a single lens system shall
not be eligible to test for an operator's license pursuant to
KRS
186.577 and a motor vehicle operator's
license shall not be issued to, renewed by, or held by a person with visual
acuity of 20/61 or worse, best corrected.
(b) Visual Fields. Persons with a horizontal
field of vision in the person's better eye of at least thirty-five (35) degrees
to the left and right side of fixation and a vertical field of vision in the
person's better eye of at least twenty-five (25) degrees above and below
fixation shall be eligible for an operator's license.
1. Visual fields tests required by the
department shall be administered by way of a 120-point screening test on an
automatic visual fields device.
2.
Visual fields test results with over one-third of false positive, false
negative, or fixation losses shall be considered unreliable and non-responsive
to the department's visual fields test requirement.
(4) A person who does not meet
both the visual acuity and the visual fields requirements established in
subsection (3) of this section shall not be eligible for a motor vehicle
operator's license.
Section 12. License Restrictions.
(1) The
department may restrict a person's operating privilege based on:
(a) A recommendation of a licensed physician
or vision specialist;
(b) The
results of a driving examination or evaluation performed by the Kentucky State
Police or a rehabilitation specialist or facility; or
(c) Recommendation of the Medical Review
Board.
(2) License
restrictions may require a person to:
(a) Wear
corrective lenses;
(b) Use special
equipment or specially equipped vehicles;
(c) Operate only during daylight
hours;
(d) Not operate a vehicle in
inclement weather causing decreased visibility;
(e) Restrict the driving area;
(f) Restrict the maximum speed limit;
or
(g) Restrict the motor vehicle
operating privilege in any other manner which the department deems necessary
for safety purposes.
STATUTORY AUTHORITY: KRS 186.444, 186.570
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