Why does the California DMV suspend a driver license for Alzheimer’ 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.
Alzheimer’s disease is a progressive and irreversible brain disorder that can 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 can seem, probative and onerous. To the effected driver, it can seem that they are being treated like a criminal.
How does the DMV suspend the driver license of a person with Alzheimer’s? The DMV’s “Re-Examination” process is essentially broken down into three progressive elements:
Notification: At this stage, 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 dementia is:
- Physician’s report: In California, all physicians 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. 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.
- 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 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.
Re-Examination: At this stage, the DMV will initiate an investigation to determine if a person actually has been diagnosed with Alzheimer’s/Dementia, 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 will 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 dementia in the affected driver. During the drive test, the examiner will be evaluating the driver for concentration, perception, attention and judgement.
- The driver will be interviewed and evaluated by a DMV Hearing Officer. The hearing office 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 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.
- 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 Alzheimer’s disease:
- Mild Dementia: The person with mild dementia 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 Dementia: For the person with moderate dementia, 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 Dementia: The person who has developed to the severe stages of dementia 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.
**If the DMV determines that a driver is either at the stage of Moderate Dementia or Severe Dementia, 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 Dementia is there a chance of reinstating the driving privilege.
If the driver is at the stage of Mild Dementia, the best case result is that the DMV will 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.
If the results of the Special Drive Test are satisfactory, the driver will be placed on Medical Probation and will be scheduled for another re-examination at 6-months or less when the results of the knowledge and drive tests are marginal and the dementia is not expected to progress rapidly.
A medical probation with a calendar re-examination of 12 months may be appropriate for a driver whose test results are better than marginal in both knowledge and driving, and when the driver’s doctor has indicated that the disease is not likely to progress rapidly.
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.
If however, you have mild dementia and there is some evidence that the disease will not progress rapidly, intervention by a DMV Defense Expert 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.