Musculoskeletal Abnormality
Category J
MUSCULOSKELETAL ABNORMALITY OR CHRONIC DEBILITY: Other categories have been developed to cover most of the more common conditions which may affect driving safety. This category J includes a variety of chronic conditions not readily included elsewhere, which have in common their potential effect upon driving safety. In some of them, medical judgment may be of primary importance in determining limitations on driving, such as osteoporosis or active infectious disease, as they affect the safety of the driver, passengers, or other vehicles. In others, the basis for limitation of driving privileges will be the functional motor impairment for the specific acts of operating a vehicle, such as amputations or congenital abnormalities, using compensatory devices as needed.
In case of obvious paralysis or absence or abnormality of limbs, etc., an applicant may be required to pass a driving skills test with or without compensatory aides. A safety assessment level may be based on the health care professional’s examination and recommendations. For stable conditions, the interval for re-evaluation may be extended to the usual re-licensing interval, but in unstable situations, the health care professional should recommend shorter intervals, depending upon the nature of the problem. No medical confirmation will be needed after the condition has been stable for three years, if the health care professional so recommends.
Many persons with chronic illness require medications for pain and other symptoms which may interfere with alertness or coordination. Use of such medications should be taken into consideration in assigning a safety assessment level. The individual should be cautioned that they are responsible to refrain from driving when their condition or medications seem to affect driving ability.
COMMERCIAL INTRASTATE DRIVERS: The health care professional may indicate a safety assessment level for commercial intrastate driving and indicate the need for a driving skills test by checking the driving skills test box at the bottom of the Functional Ability Medical Report form. Skill Performance Evaluation (SPE) skills test would be required on the initial assessment.
| Level | Musculoskeletal Abnormality | General Debility or Impairment | Medical Report Required | Interval for Review | License Class and Restrictions |
|---|---|---|---|---|---|
| 1 | No history or full recovery for one year or more | No history or full recovery for one year or more | No | N/A | Class D No restrictions |
| 2 | Mild residual loss of function with or without compensatory device | Mild residual loss of function | Yes | 5 Years | Class D No restrictions |
| 3 | Moderate loss of function with or without compensating device first-time assessment level; condition has changed or become worse in the past five years | Moderate persisting loss of function a first-time assessment level; condition has changed or become worse in the past five years | Yes | 2 Years *(c) |
Class D with recommendation of health care professional; must pass driving skills test on initial safety assessment level; restrictions TBD by examiner |
| 4 | Congenital absence or deformity of a limb or the spine, traumatic or surgical amputations, or limitations of joint motion by fusion, arthritis, contractures, etc *(ab) |
Moderate residual loss of function a first-time assessment level; condition has changed or become worse in the past five years | Yes | 1 Year *(c) |
Class D with recommendation of health care professional; must pass driving skills test on initial safety assessment level; restrictions TBD by examiner |
| 5 | Congenital absence or deformity of a limb or the spine, traumatic or surgical amputations, or limitations of joint motion by fusion, arthritis, contractures, etc., need for prosthetic or other device, such as variable weakness, episodes of pain, etc. *(ab) |
General debility or impairment from cancer, aging, chronic infections such as HIV, malnutrition, chemotherapy, drugs, or other treatment, chronic pain syndromes, etc. *(a) |
Yes | 1 Year *(c) |
Class D; must pass driving skills test on initial safety assessment level; restrictions TBD by examiner |
| 6 | N/A | ||||
| 7 | Circumstances not covered by any of the above or patient under evaluation *(a) |
Yes | 1 Year *(c) |
Class D, special restrictions not covered above, recommended by health care professional | |
| 8 | Chronic conditions making driving unsafe - not fully compensated for by restorative devices | Yes | N/A | No driving |
*(a) Safety assessment level should be indicated by the health care professional according to their best information and should indicate on the form if a driving skills test is required.
*(b) If compensatory devices used or in case of chronic disease.
*(c) Or as recommended by the health care professional, longer or shorter interval according to stability, up to the maximum period of five years.
| Level | Musculoskeletal Abnormality | General Debility or Impairment | Medical Report Required | Interval for Review | License Class and Restrictions |
|---|---|---|---|---|---|
| 1 | No history or full recovery for one year or more | No history or full recovery for one year or more | No | N/A | Class A, B, C No restrictions |
| 2 | Mild residual loss of function with or without compensatory device | Mild residual loss of function | Yes | 2 Years | Class A, B, C restricted with recommendation of health care professional; must pass driving skills test on initial safety assessment level; restrictions TBD by examiner |
| 3 | Moderate loss of function with or without compensating device | Moderate persisting loss of function | Yes | 2 Years | Class A, B, C restricted with recommendation of health care professional; must pass driving skills test on initial safety assessment level; restrictions TBD by examiner |
| 4 | Congenital absence or deformity of a limb or the spine, traumatic or surgical amputations, or limitations of joint motion by fusion, arthritis, contractures, etc *(a) |
Moderate residual loss of function | Yes | 1 Year *(b) |
Class A, B, C restricted with recommendation of health care professional; must pass driving skills test on initial safety assessment level; restrictions TBD by examiner |
| 5 | Congenital absence or deformity of a limb or the spine, traumatic or surgical amputations, or limitations of joint motion by fusion, arthritis, contractures, etc., need for prosthetic or other device, or impairment making extended commercial driving unwise | General debility or impairment from cancer, aging, chronic infections such as HIV, malnutrition, chemotherapy, drugs, or other treatment, chronic pain syndromes, etc., making extended commercial driving unwise | Yes | 1 Year *(c) |
No Class A, B, C driving |
| 6 | N/A | ||||
| 7 | Circumstances not covered by any of the above or patient under evaluation *(a) |
Yes | 1 Year *(c) |
No Class A, B, C driving during evaluation. Special restrictions as recommended by health care professional | |
| 8 | Chronic conditions making driving unsafe - not fully compensated for by restorative devices | Yes | N/A | No driving |
*(a) Safety assessment level should be indicated by the health care professional according to their best information and should indicate on the form if a driving skills test is required.
*(b) If compensatory devices used or in case of chronic disease.
*(c) Or as recommended by the health care professional, longer or shorter interval according to stability, up to the maximum period of five years.