Why does the California DMV suspend a driver license for Alzheimer’s Disease?
We all recognize the California Department of Motor Vehicles as the government agency empowered to issue the California Driver License to qualified drivers. What few people realize, however, is just how much power the DMV has to suspend or revoke a person’s driver license if it believes there is cause to do so.
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, if they are allowed to continue driving. 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 Alzheimer’s disease or any other form of Dementia. This section of the Vehicle code determines:
“In the event the department determines upon investigation or reexamination that the safety of the person subject to investigation or reexamination or other persons upon the highway require such action, the department shall forthwith and without hearing suspend or revoke the privilege of the person to operate a motor vehicle or impose reasonable terms and conditions of probation which shall be relative to the safe operation of a motor vehicle. No order of suspension or revocation or the imposition of the terms or conditions of probation shall become effective until 30 days after the giving of written notice thereof to the person affected, except that the department shall have authority to make any such order effective immediately upon the giving of notice when in its opinion because of the physical or mental condition of the person such immediate action is required for the safety of the driver or other persons upon the highway.
California Vehicle Code Section 12806 (c) determines:
“The department may refuse to issue to, or renew a driver’s license of an person who has a disorder characterized by lapses of consciousness or who has experienced, within the last three years, either a lapse of consciousness or an episode of marked confusion caused by any condition which may bring about current lapses, or who has any physical or mental disability, disease, or disorder which could affect the safe operation of a motor vehicle unless the department has medical information which indicates the person may safely operate a motor vehicle. In making its decision, the department may rely on any relevant information available to the department.”
Essentially, this means the DMV is empowered to remove a person from the road if they have any physical or mental disorder that may affect their ability to safely drive. Because the effects of Alzheimer’s Disease or some forms of Dementia generally become apparent with people in their 60’s (known as “late onset Alzheimer’s), our mature citizens seem to be a primary focus of the DMV. That being said, the signs and symptoms of Alzheimer’s Disease may appear in people in their 30’s and 40’s (known as “early onset Alzheimer’s). Young or old, the DMV will thoroughly investigate to determine a person’s fitness to drive.
Alzheimer’s Disease is a progressive and irreversible brain disorder that may eventually leave its victim incoherent and completely incapacitated. All sane people would agree that allowing a person in the advanced stages of the disease to drive is a recipe for disaster. Because Alzheimer’s Disease will eventually impact the person’s ability for critical thinking, cognition and multi-tasking; allowing them to drive could have deadly consequences.
Accordingly, when the DMV receives information that a driver has received a diagnosis with Alzheimer’s Disease, the department will initiate an investigation to assess the person’s fitness to continue driving. The department’s investigation classically probative and invasive. To the effected driver, it can seem that they are being treated like a criminal. It is, however, the DMV’s obligation to do all they can to keep our roadways safe.
How does the DMV learn I have Alzheimer’s Disease?
The DMV may receive notice from a variety of sources that a driver has been diagnosed with Alzheimer’s Disease or some other form of Dementia. The most common means by which the DMV learns a person has Alzheimer’s Disease or Dementia is:
- Physician’s report: In California, all physicians or surgeons are mandated by law to report any diagnosis of Alzheimer’s disease or Dementia 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. The doctor will also make a recommendation as to whether or not the patient should be driving. Once the Department of Public Health receives the report, it is then mandated to pass the report onto the California Department of Motor Vehicles. This will cause the DMV to act.
- 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 information to the DMV.
- Referral from family members: In some instances, a driver may not recognize that he or she is beginning to lose proper awareness 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: If 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 Alzheimer’s Disease or Dementia and may report them to the DMV.
- Referral from anonymous sources: Because the DMV is mandated to investigate all reports of Alzheimer’s Disease or Dementia, 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.
How does the DMV suspend the driver license of a person with Alzheimer’s?
If the DMV receives information from any source that a person may be afflicted with Alzheimer’s Disease, Dementia or Cognitive Decline, it will begin a process of investigating the issue to determine if the accused driver is safe to drive. The DMV may select from two different options to make that determination:
- Immediate Suspension
Reexamination: If the DMV opts to proceed through the reexamination process, it will initiate an investigation to determine if a person actually has been diagnosed with Alzheimer’s or Dementia, and if so, how far the disease has progressed. One of the benefits of a reexamination as opposed to an immediate suspension is the person’s driving privilege remains valid while the case develops.
Normally, the DMV will exercise its right to reexamination if the information reporting the driver has Alzheimer’s Disease or Dementia comes from a source other than a physician or if the information received is vague.
The reexamination process normally includes these progressive steps:
- Notice of Reexamination: The accused driver will receive a “Notice of Reexamination” by US Mail. The notice will advise the driver that an investigation has begun and why the action is being taken. The Notice will also include a Driver Medical Evaluation, known as a DME, which must be prepared by the physician most familiar with your medical history. The DME must be filed by a date that is documented in the Notice.
If a driver does not file the DME with the department in the time frame required by the notice, that person’s privilege to drive will be immediately suspended or revoked. If the medical information contained within the DME is not favorable, that person’s privilege to drive will be immediately suspended or revoked.
- Reexamination Interview: Assuming the accused driver has filed his DME in a timely manner, and assuming the medical information is favorable, the person will then receive another notice in the mail entitled “Notice of Reexamination Interview.”
At the scheduled date and time of the interview, the assigned DMV Hearing Officer will review all of the department’s evidence and will then question the driver extensively. That person must be able to answer a litany of questions that range from their awareness of their disorder and how it affects them day to day. The person will have to be ready to speak about medical history, medications, driving history and criminal history. The accused driver can expect to be asked questions that measure their awareness. This can include questions regarding what things they tend to forget, what they had for dinner the night before, and the name of the current President of the United States.
If a driver does not participate in the Reexamination Interview of if they do not convince the hearing officer of their fitness to drive, that person’s privilege to drive will be immediately suspended or revoked.
- Vision Test: Assuming the reexamination interview goes well, the hearing officer will order that the accused driver take a vision test. If the vision test is failed the driving privilege will be suspended.
- Written knowledge test: This is a 25-question multiple choice test that measures a person’s knowledge of the rules of the road and recognition of street signs. If the written test is failed, the hearing officer may permit another opportunity or may go to immediate suspension.
- Special Driving Test: Known as a Supplemental Driver Performance Evaluation, this is a “behind the wheel” test administered by a DMV examiner who is specifically trained to detect the signs of Alzheimer’s Disease or Dementia in the affected driver. During the drive test, the examiner will be evaluating the driver for concentration, perception, attention and judgement. If the driving test is failed, the hearing officer will normally move to immediate suspension.
At the conclusion of the reexamination process, the Hearing Officer may:
- Close the case and take no further action.
- Close the case and place the driver on Medical Probation. This requires the driver to file periodic medical reports from the physician to determine that they remain medically stable.
- Suspend or revoke the person’s driving privilege, thereby taking them off the road.
Immediate Suspension/ Administrative Hearing: If the information reporting that a person has Alzheimer’s Disease is generated by a physician or surgeon, the DMV presumes that a doctor knows what they are talking about and will bypass the reexamination process altogether and move to immediately suspend the driving privilege. If the information received comes from another source but is unambiguous and presents a picture of a real and present danger to the driver or other persons, the DMV will also move to immediate suspension.
If the result of a reexamination is not favorable, the DMV will also use this to move to immediate suspension.
At this juncture the accused driver becomes eligible for an administrative hearing to reverse the suspension.
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 for Alzheimer’s Disease or dementia, CDA will prepare a broad attack on the case that may include:
- An extensive interview of the driver.
- Medical Evaluations from all of the driver’s doctors.
- Medical Evaluation from a Neuro-Psychologist to confirm diagnosis of Alzheimer’s disease.
- Assessment from an Occupational Therapist with a specialty in Alzheimer’s disease and dementia to determine to what stage the disease has progressed and if the accused person is safe to drive.
- 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.
- Conduct of the hearing at the Driver Safety Office closest to the driver’s home.
It is important to realize that the DMV has decided there are four developmental stages of Cognitive Disease:
- Mild Cognitive Impairment: It seems likely that damage to the brain starts a decade or more before memory and other cognitive problems appear. During this pre-clinical stage of Alzheimer’s Disease, people seem to be symptom free, or have very mild symptoms. Some of the more common effects of Mild Cognitive Impairment are:
- –Losing things often
- –Forgetting to go to events or appointments
- –Forgetting to take prescription medications
- –Having more trouble coming up with words than other people their age
In most instances, and if well represented, drivers with Mild Cognitive Impairment should be perfectly safe to drive.
- Mild Dementia/Alzheimer’s Disease: A person diagnosed with mild Dementia or Alzheimer’s Disease 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. Some of the more common effects of Mild Dementia and/or Alzheimer’s Disease are:
- –Memory Loss
- –Poor judgement leading to bad decisions
- –Loss of spontaneity and sense of initiative
- –Taking longer to complete daily tasks
- –Repeating questions
- –Trouble handling money and paying bills
- –Wandering and getting lost
- –Losing things or placing them in odd locations
- –Mood and personality changes
- –Increased anxiety or aggression
In most instances, and if well represented, a driver diagnosed with Mild Dementia/ Alzheimer’s Disease should be able to regain their privilege to drive; although the DMV is likely to monitor them for any progression of their disease.
- Moderate Alzheimer’s Disease/Dementia: For the person with Moderate Dementia/Alzheimer’s Disease, day to day life and activity is changing. Some degree of supervision may be necessary. Judgement and reaction may be affected and they have difficulty coping with their environment. The stage of Moderate Dementia/Alzheimer’s Disease is a cross-road in this person’s life. Some of the more common effects of Moderate Dementia and/or Alzheimer’s Disease are:
- –Increased memory loss and confusion
- –Inability to learn new things
- –Difficulty with language and problems reading, writing and working with numbers
- –Difficulty organizing thoughts and thinking logically
- –Decreased attention span
- –Problems coping with new situations or events
- –Difficulty carrying out multi-step tasks, such as getting dressed
- –Problems recognizing family and friends
- –Hallucinations, delusions and paranoia
- –Impulsive behavior such as undressing at inappropriate times or using vulgar language
- –Inappropriate outbursts of anger
- –Restlessness, agitation, anxiety, fearfulness and anxiety
- –Repetitive statements or movement, occasional muscle twitches
At this stage, and if well represented, a driver diagnosed with Moderate Dementia/ Alzheimer’s Disease MAY be able to regain their driving privilege, but things are changing. The DMV will be resistant to putting this person back on the road, and if they do, the license is likely to be restricted to driving only during the daytime and close to their home. Medical Probation will definitely be required to monitor the progression of the disease.
- Severe Dementia: The person who has developed to the severe stages of Dementia/Alzheimer’s Disease is so impaired that 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 incapacitated and must not drive. Some of the more common effects of Severe Dementia and/or Alzheimer’s Disease are:
- –Inability to communicate
- –Weight loss
- –Skin infections
- –Difficulty swallowing
- –Groaning, moaning, or grunting
- –Increased amount of sleep
- –Loss of bowel and bladder control
At this stage, even if well represented, a driver diagnosed with Severe Dementia/Alzheimer’s Disease MUST NOT DRIVE. There is no chance the DMV will reinstate their driving privilege.
What are the possible outcomes at the DMV?
Mild Cognitive Impairment: If the driver is at the stage of Mild Cognitive Impairment, the best-case result is that the DMV will fully reinstate the driving privilege with no restrictions or medical probation. This means the Hearing Officer may order that the driver only drive during day-time hours and not on the freeway.
Mild Dementia/ Alzheimer’s Disease: If the driver is at the stage of Mild Dementia/Alzheimer’s Disease, the best-case result is that the DMV will a full reinstatement of the driving privilege, however, it is quite likely the hearing officer will order the driver to file medical reports six-months and twelve-months (for a period of one-year) after the hearing to determine if there is any progression of the disease.
Moderate Dementia/Alzheimer’s Disease: At this stage of development, any driver diagnosed with Moderate Dementia/Alzheimer’s Disease is very likely to never drive again. If, because of an abundance of favorable medical evidence, the DMV does reinstate the driving privilege, it will be restricted to day-time driving and only close to the person’s home. The hearing officer will order medical probation with the requirement the driver file frequent medical reports to monitor the progression of the disease.
Severe Dementia/Alzheimer’s Disease: Any driver who has progressed to the point of Severe Dementia/Alzheimer’s Disease will not be permitted to resume driving. The driving privilege will be revoked and the person will be issued a California Identification Card.
How can I protect my driving privilege if I have Alzheimer’s disease?
If you have been diagnosed with the early stages of Alzheimer’s Disease, the cruel truth is that with time, your disease will get progressively worse and it will require that your driving privilege be revoked. There is no reasonable way to determine how quickly your disease will progress as all people are different. Intervention by a DMV Defense Expert from California Drivers Advocates may help to maintain your driving privilege for an extended period of time.
If, however, you have Mild Dementia or Mild Cognitive Impairment and there is some evidence that the disease will not progress rapidly, you may be able to safely drive for quite some time.
If the DMV is seeking to suspend or revoke your driving privilege for Cognitive Impairment, Dementia or Alzheimer’s Disease, don’t let them take your driving freedom without a fight. Call CDA today. Our team of DMV professionals will keep you on the road until the last possible moment.
Quality and compassionate representation is just a phone call away.