Hitting the open road is about as American as apple pie, baseball, and summer family cookouts. The United States is known for having a robust and vibrant car culture. Even in larger cities, some individuals choose to rely on their own personal transportation. The reasons for this can range from personal expression, financial considerations, and convenience (when compared to taxis, buses, walking, or biking) to what we accept is inherent in American car culture: freedom and independence.
From a young age, many of us were taught that being able to drive is one of the ultimate freedoms in life. Therefore, it is not at all surprising that, once an individual begins recovering from an amputation (or becomes old enough to drive), one of their first questions might be, “what do I need to do to get back to driving?” or “what do I need to obtain my driver’s permit and license?”
While the answer may sometimes include vehicle modification and driver training, this fact sheet will focus on how to get to these recommendations in accordance with the legal requirements outlined by different DMVs (Department of Motor Vehicles; while there are DMVs, BMVs, and even RMVs, this document will use the term DMV for clarity and consistency).
Disclosing Limb Loss or Limb Difference
The process for driving as a person with limb loss or limb difference can be different depending on where you live. Each state has its own policies and procedures. However, the vast majority of states use a very similar process. Typically, there are three major steps:
- State Medical Review
- Physician Assessment
- State Medical Review Board Assessment
- State Medical Review
Every state has some form of a medical review board. You can search online using phrases including, “DMV Medical Review Board”, “DMV Medical Review Program”, or “DMV Medical Review of Drivers”.
These review boards evaluate drivers when there are concerns regarding the impact of certain medical conditions and medications on a driver’s ability to operate a vehicle safely.
- Physician Statement
There will be a Medical Review Form which you (the driver) and someone from your medical team (physician, physical therapist, occupational therapist, or prosthetist) will need to complete. Your medical provider will detail your history with them, including regular care provided, medical history, and medications.
The most important feature of this review form is where your medical provider will make their recommendation. Often, they will have options to choose from:
- Full driving privileges with no modifications;
- Full driving privileges with either vehicle modifications or prosthetic device use;
- Restricted driving privileges; and
- Request for driver review (including driver training).
- State Medical Review Board Assessment
Every state has its own process for evaluating the physician’s statement and any other supporting documents you may have been asked to provide.1 Ultimately, it is the Medical Review Board’s decision to install, modify, or remove driving privileges.
Often, the physician’s recommendation will fit under full privileges with the “use of adaptive or assistive equipment.” This could include vehicle modifications, or it could be as simple as always wearing your prosthetic device when you are driving. This would be noted on the back of your driver’s license the same way it would be noted if someone needed to wear glasses when driving.
You can find information for your state’s DMV and their Medical Review Process on your state’s page on our helpful 24/7 online resource, Community Connections.2
Alternatively, information for every state has been collected by the U.S. Department of Transportation and the National Highway Traffic Safety Administration in the document Medical Review Practices for Driver Licensing.
National Limb Loss Resource Center
888-267-5669, option 1
U.S. Department of Transportation National Highway and Traffic Safety Administration
Medical Review Practices for Driver Licensing
- Lococo, K.H.; Stutts, J., Sifrit, K.J.; & Staplin, L. (2017, April). Medical review practices for driver licensing, Volume 3: Guidelines and processes in the United States (Report No. DOT HS 812-402). Washington, DC: National Highway Safety Administration.
- Amputee Coalition. Community Connections. https://www.amputee-coalition.org/limb-loss-resource-center/community-connections/. Accessed 02/2021.
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Authors and Contributors
The Amputee Coalition is grateful to the many organizational members and individuals that have contributed to this work. The Amputee Coalition Scientific and Medical Advisory Committee (SciMAC) conducts expert peer view for the Amputee Coalition-commissioned patient education materials. SciMAC contributes clinical and scientific expertise in developing, implementing, and evaluating the Amputee Coalition program and policy initiatives.
Suggested AMA format citation for this material:
Burnell A, Hurley C, Miller ME. Getting Behind the Wheel with Limb Loss and Limb Difference. https://www.amputee-coalition.org/getting-behind-the-wheel-with-limb-loss-and-limb-difference. Published March 2021. Accessed [date].
It is not the intention of the Amputee Coalition to provide specific medical or legal advice but rather to provide consumers with information to better understand their health and healthcare issues. The Amputee Coalition does not endorse any specific treatment, technology, company, service or device. Consumers are urged to consult with their healthcare providers for specific medical advice or before making any purchasing decisions involving their care.
This project was supported, in part, by grant number 90LLRC0001-01-00, from the Administration for Community Living, U.S. Department of Health and Human Services, Washington, D.C. 20201. Grantees undertaking projects under government sponsorship are encouraged to express freely their findings and conclusions. Points of view or opinions do not, therefore, necessarily represent official Administration for Community Living policy.
© Amputee Coalition. Local reproduction for use by Amputee Coalition constituents is permitted as long as this copyright information is included. Organizations or individuals wishing to reprint this article in other publications, including other World Wide Web sites must contact the Amputee Coalition for permission to do so.