California Driver License Suspension for Parkinson’s Disease

Why does the California DMV suspend a driver license for Parkinson’s disease?  Once a person is licensed to drive motor vehicles in the State of California, they forever remain under the watchful eye of the California Department of Motor Vehicles (DMV).  One of the DMV’s primary functions is to ensure all drivers on California roadways maintain the physical and mental fitness for driving.  If at any time, the DMV were to receive information that a driver may no longer possess the requisite ability to drive, the department will begin an investigation to determine if a driver license suspension or revocation is warranted.

California Vehicle Code section 13953 empowers the DMV to immediately and without a hearing, suspend or revoke the driving privilege of any driver who may pose an immediate hazard to the motoring public.  One of the most profound physical or mental conditions a driver may develop that will cause the DMV to take such an immediate action is a diagnosis with any disease or disorder that effects cognition or motor skills.

Some of the most common disorders that cause the DMV so suspend or revoke a driver license are:

• Dementia or Alzheimer’s Disease
• Brain Tumors
• Multiple Sclerosis
• Parkinson’s Disease
• Any seizure disorder such as Epilepsy
• Sleep Disorders such as Narcolepsy or Sleep Apnea
• Stroke
• Vertigo

Parkinson’s disease is a progressive disorder of the nervous system that affects movement. It develops gradually, sometimes starting with a barely noticeable tremor in just one hand. But while a tremor may be the most well-known sign of Parkinson’s disease, the disorder also commonly causes stiffness or slowing of movement.

In the early stages of Parkinson’s disease, your face may show little or no expression, or your arms may not swing when you walk. Your speech may become soft or slurred. Parkinson’s disease symptoms may worsen as your condition progresses over time.

Although Parkinson’s disease can’t be cured, medications may markedly improve your symptoms. In occasional cases, your doctor may suggest surgery to regulate certain regions of your brain and improve your symptoms.

The danger in driving is that Parkinson’s Disease may eventually effect both your motor skills and cognition.

Motor Skills:   A Parkinson’s patient may experience some changes in their visuospacial skills. This essentially means that one’s ability to gauge the distance to a stop sign or other vehicles.  It may affect one’s ability to maintain a safe lane position.  Parkinson’s Disease will often cause problems with muscle tightness or rigidity that can impair one’s ability to react quickly to emergencies or changing traffic patterns.

Cognitive Skills:  Cognitive function refers to one’s ability to receive and process incoming information by using perception, reasoning, judgement, intuition and memory.  It is not uncommon for a Parkinson’s patient to become confused when driving.

Because Parkinson’s Disease may eventually impact the person’s ability for critical thinking, cognition and multi-tasking, allowing them to drive could have deadly consequences.

A 1999 study by the National Center for Injury Prevention and Control found that with people age 65 to 74, motor vehicle accidents are the number one cause of injury related death.  Clearly as a person ages, they become frail and are not quite as able to survive trauma as a younger person.

Accordingly, if the DMV receives information that a driver has received a diagnosis with Parkinson’s disease, the department will initiate an investigation to assess the person’s fitness to continue driving.  The department’s investigation can seem, probative, impersonal and onerous.   To the effected driver, it can seem that they are being treated like a criminal and for that person, the loss of their driving freedom can be devastating.

How does the DMV suspend the driver license of a person with Parkinson’s?

The DMV’s “Re-Examination” process is essentially broken down into three progressive stages:

• Notification
• Re-Examination
• Hearing

Notification:  At this stage, the DMV may receive notice from a variety of sources that a driver has been diagnosed with Parkinson’s disease or some other medical disorder that may affect motor skills or cognition.  The most common means by which the DMV learns a person has Parkinson’s Disease is:

• Physician’s report: In California, all physicians are mandated by law to report any diagnosis that may affect one’s ability to drive to the California Department of Public Health.  The doctor will prepare a Confidential Morbidity Report that briefly documents how he or she came into contact with the patient and the symptoms observed.  Once the Department of Public Health receives the report, it is then mandated to pass the report onto the California Department of Motor Vehicles.
• Referral from Law Enforcement Officer, Fire-Fighter, or Paramedic: Many times, emergency first responders will come into contact with a person on the street or in their homes.  During that contact, the first responder may detect some issue that causes them concern and they may report that contact to the DMV.  It is very common for a law enforcement officer to contact a driver during a traffic stop or the investigation of a traffic accident and then see symptoms consistent with Parkinson’s Disease.  Because most Law Enforcement Officers are not well trained in understanding this disorder, they will often refer the driver to the DMV.
• Referral from family members: In some instances a driver may not recognize that he or she is beginning to lose proper driving skill and cognition.  In other instances the affected driver may choose to ignore obvious signs of a problem.  In either case, it is not uncommon for family members to report the driver to the DMV in the interest of protecting their loved one and other drivers.
• Referral from friends or neighbors: It is common for friends or neighbors to see or hear something that gives them concern that a driver no longer possesses the ability to drive as a result of Parkinson’s disease and may report them to the DMV.
• Referral from anonymous sources: Because the DMV is mandated to investigate all reports of medical disorders which effect driving, it will also initiate an investigation when it receives information from a person who wishes to remain anonymous; and will work to protect the anonymity of the reporting party.
• Self Reporting by the Driver: At times, the individual driver may be the source of the DMV’s information.  At times, a driver may be experiencing body tremors while testing to renew their driver license. At other times, the effected driver may enter the DMV and making inquiry regarding the effect of Parkinson’s Disease on their ability to drive.  All DMV employees are empowered to report issues of concern to the Driver Safety Office.

Re-Examination:  At this stage, the DMV will initiate an investigation to determine if a person actually has been diagnosed with Parkinson’s Disease or any other medical disorder, and if so, how far the disease has progressed.  Normally the department will send the accused driver a “Notice of Appointment” in the mail that indicates that an investigation has begun and that the department requires the driver to file a medical report prepared by their physician.  This document is known as a Driver Medical Evaluation, or DME.

**If the driver does not file the requested medical forms, the driver license will be revoked.

**If the original notice to the department came from a physician, then the department will immediately revoke the driver license without an investigation, but the driver then becomes eligible for a hearing.

As part of the DMV’s re-examination, the department may require that the driver complete an entire litany of testing sequences:

• Written knowledge test. This is an 18-question multiple choice test that measures a person’s knowledge of the rules of the road and recognition of street signs.
• Vision Test.
• Special Driving Test. This is a “behind the wheel” test administered by a DMV examiner who is specifically trained to detect the signs of impaired driving.  During the drive test, the examiner will be evaluating the driver for concentration, perception, attention, judgement and motor skills.
• The driver will be interviewed and evaluated by a DMV Hearing Officer. The hearing officer will ask numerous probing questions to evaluate a person’s driving record, need to drive, daily routine and need for assistance in daily activities.
• Medical Evaluation: The DMV Hearing Officer will review and consider any medical evidence presented.

** If the driver were to fail the knowledge test, the driving test or the interview, the driver license will be revoked and the driver then becomes eligible for a Hearing.

Hearing:  Also known as a Physical and Mental Hearing, or “P & M Hearing,” this is a full-blown evidentiary hearing where evidence is presented, witnesses may testify, experts may offer opinions and legal arguments are heard.  This is run very much like a mini trial.  At this stage, few California drivers have the skill or knowledge to adequately represent themselves.  At this stage, it would be wise for a driver to contact the DMV Defense Experts at California Drivers Advocates to step in and take over the case.

In preparation for a P & M hearing of this nature, CDA will prepare a broad attack on the case that may include:

• Medical Evaluations from all of the driver’s doctors.
• Medical Evaluation from a Neuro-Psychologist to confirm diagnosis of Parkinson’s Disease.
• Assessment from an Occupational Therapist with a specialty in Parkinson’s disease and to determine to what stage the disease has progressed.
• Attendance at an on-line driving school.
• Interviews of friends, family and neighbors who may offer positive testimony as to the driver’s level of cognition and ability to drive.
• Prepare the driver for examination and cross-examination at the hearing.

What are the possible outcomes at the DMV? First of all, it is important to realize that the DMV has decided there are three developmental stages of any cognitive disease:

• Mild: The person with mild impairmen still maintains the capacity for independent living. This person is able to handle personal hygiene, grocery shopping, banking and meal preparation.  This person’s judgement remains relatively intact.

In this stage, a driver may still be able to safely operate a motor vehicle; however, because of the progressive nature of the disease, the DMV will want to monitor the driver through a form of Medical Probation until such time as their disease progresses to the next stage.

• Moderate: For the person with moderate impairment, day to day life and activity can be dangerous.  Some degree of supervision is necessary.  There is a loss of judgement and reaction and they have difficulty coping with their environment.  It would be too dangerous to permit this person to test for driving and therefore the driver license will be revoked.
• Severe: The person who has developed to the severe stages of impairment where continual supervision is required to maintain even a minimal level of hygiene.  In many instances this patient is largely incoherent and mute. At this stage, the person is mentally or physically incapacitated and must not drive.

**If the DMV determines that a driver is either at the stage of Moderate or Severe impairment, they will go no further.  The department will not entertain the idea of any further testing because it is thought at these two stages the disease has progressed too far for there to be any chance of the person driving safely.  Only if it is determined that the driver is at the stage of Mild is there a chance of reinstating the driving privilege.

If the driver is at the Mild stage the DMV may grant a full driving privilege with no restrictions provided the driver check in with the department at 6 month or 1 year intervals to ensure continued stability in their disease.   The DMV may also grant a limited driver license on a term of Medical Probation.  This means the Hearing Officer may order that the driver only drive during day-time hours and not on the freeway.  The Hearing Officer may require that the driver file a new Driver Medical Evaluation at periodic intervals to monitor the progression of the disease.

How can I protect my driving privilege if I have Parkinson’s disease?   If you have been diagnosed with the early stages of Parkinson’s disease, the cruel truth is that with time, your disease may get progressively worse, requiring that your driving privilege be revoked. One of the most difficult decisions for a driver to make may be to voluntarily give up your keys.  Remember, however, it is far better to relinquish your driving privilege in a controlled and planned format than to have it yanked from you by the DMV.

If however, you have mild Parkinson’s and there is some evidence that the disease will not progress rapidly, intervention by a DMV Defense Experts from California Drivers Advocates may help to maintain your driving privilege for an extended period of time.

If the DMV is seeking to revoke your driving privilege, don’t let them take your driving freedom without a fight. Call CDA today.  Our team of compassionate and driven professionals will keep you on the road until the last possible moment.