Are you fit to drive?

Transport for NSW needs to ensure that all drivers are medically fit and competent to drive. If you’re an older driver, or you have a medical condition, you may be asked to have regular medical tests. Some heavy vehicle drivers also need regular medical tests.

Medical standards

The medical standards for licensing and clinical management guidelines Assessing Fitness to Drive have been developed by the National Transport Commission and Austroads in consultation with a wide range of medical experts, peak medical bodies and colleges, the road transport industry and State and Territory licensing authorities.

These guidelines have been adopted by all licensing authorities when assessing a licence holder’s medical fitness to drive.

Age-based medical reviews

When you reach 75 years of age, you’ll need to have a medical review every year to keep your licence. Transport for NSW will send you a form around eight weeks before your birthday, for your doctor to complete. See Older drivers for more information.

A medical review is required every year, even if you have a three or five year licence.

Medical reviews for heavy vehicle drivers

If you hold a class MC licence (road train or B-double multi-combination), you need to have a medical review more regularly:

  • At age 21, and then every 10 years
  • At age 40, and then every five years
  • At age 60, and then every two years
  • At age 70, and then every year.

Eyesight tests

All drivers must meet the eyesight standards set out in the publication Assessing Fitness to Drive. When you apply for, or renew your licence, you may be required to pass an eyesight test.

For car (class C) and rider (class R) licences, you need to pass an eyesight test every 10 years until you’re 45 years old, then every five years. Once you reach 75, you need to pass an eyesight test every year.

Note: Customers will need to pass an eyesight test when applying for a ten year licence. If a customer takes up the ten year licence renewal option and will be over 45 years of age within the ten year duration, the customer is exempt from having to pass an eyesight test until the next renewal.

For other vehicle licences (class LR and above), you need to pass an eyesight test, when renewing your licence.

If you only require glasses/contact lenses in specific circumstances, for example at night or when driving a heavy vehicle, this requirement will also be added as a condition on your licence.

Deferral of eyesight tests for online licence renewals

Eyesight tests may be deferred automatically for low risk drivers with class C, C/R, R, LR or LR/R to allow online licence renewal.

If your eyesight test has been deferred, you will be notified by Transport for NSW to complete an eyesight test within 8 weeks.

You can take an eyesight test at either:

  • A service centre (free of charge)
  • An optometrist or ophthalmologist (may incur a fee)

It is important to note if you do not undertake the eyesight test within the required time your licence may be suspended.

For a high risk driver, you may not renew your driver licence online as your eyesight test cannot be deferred. Drivers who are considered high risk include those who require a specialist review, police identified drivers, heavy vehicle drivers and drivers who hold a Bus Driver Authority or carry public passengers.

Customers with licence classes MR, HR, HC and MC, may renew their licence online if they have had an eyesight test in the last 12 months.

If you are a high risk driver and you are not able to renew online, please go to a Service NSW Centre to renew your licence.

Change in visual aids (glasses, contacts etc)

You must pass a new eyesight test if you start or stop wearing glasses or contact lenses to drive. If you pass the test wearing glasses or contact lenses a condition will be added to your licence.

If you pass the eyesight test without wearing glasses or contact lenses the condition will be removed.

Note: You must comply with the conditions of licence until you inform Transport for NSW and the condition is removed from your licence.

Completing a medical review and report

If you need to undergo a medical review, Transport for NSW will send you a letter around eight weeks before you’re due for the review.

Your doctor can complete your medical assessment online, saving you a trip to a Service NSW Centre to hand in a paper form. If the form is completed online your doctor will receive an instant response confirming your assessment has been received by Transport. A copy of the completed form will be stored by your doctor for future reference.

Transport are in the process of phasing out the paper medical form, so when you visit your doctor please ask them to submit your assessment online.

Note: The Medicare Benefits Schedule covers age or health related medical examinations, to obtain or renew a licence to drive a private vehicle (section G.13.1).

Overdue medical reports

If you do not provide a medical report to Transport for NSW before the due date, your licence may be suspended.

In some circumstances, and on a case-by-case basis, Transport for NSW may allow an extension of the due date. We recognise that it can be difficult to obtain an appointment with a doctor or specialist, especially in regional areas. An extension will only be given if you can prove that you’ve made arrangements to book an appointment well before the due date, even if the appointment cannot be made until afterwards.

Generally, no consideration for an extension will be given if you’ve reached the due date and/or been issued a suspension notice.

Occupational Therapist reviews

Some health conditions may require a driving assessment by a suitably qualified Occupational Therapist, before a licence can be issued or renewed. Your doctor will recommend this option, if necessary. To find a qualified Occupational Therapist, see the Occupational Therapy Australia website.

Injuries, illness and medical conditions

You’re required by law to inform Transport for NSW of any long term injury, illness or medical condition which may affect your ability to drive safely. If you’re involved in a crash and it’s found that your health condition was a contributing factor, you may be prosecuted and your insurance may not be valid.

Conditions which affect safe driving

Various medical conditions can affect your ability to drive safely, for example:

  • Blackouts, fainting or other sudden periods of unconsciousness
  • Vision problems
  • Heart disease or stroke
  • Epilepsy
  • Sleep disorders
  • Diabetes
  • Psychiatric disorders
  • Neurological disorders
  • Age-related decline.

Usually, this doesn’t mean that you can’t drive at all, but you may need to provide a satisfactory medical report before you can apply for, or renew your licence. In some cases you may also be required to pass a driving test.

Decisions about your ability to drive safely

Your doctor can provide advice about how your particular medical condition might affect your ability to drive safely, and how it might be managed.

Transport for NSW makes the final decision about your licence. We take into consideration the advice of your doctor, as well as other factors, such as your accident history (if any) and the type of vehicle you drive. For example, truck, bus and taxi drivers need to meet a higher standard, due to the nature of their driving. See Commercial and passenger vehicle drivers for more information.


The progressive and irreversible loss of mental functioning caused by dementia creates issues for driver safety. All drivers with dementia will likely face a situation where their condition deteriorates, to the point that they are no longer medically fit to drive.

If you’re a driver with dementia, it’s important that you regularly talk to your doctor about how your ability to drive is being affected.

By talking to doctors, family, friends and carers about driving issues as soon as possible after a diagnosis of dementia, you can make the difficult transition away from driving an easier process. It’s important to talk about any problems you have while driving, and what your transport needs might be, to work out when it’s the right time to stop driving.


If you drive a private vehicle and have epilepsy, you’ll normally only be issued a licence if you’ve been free of seizures for at least one year. You’ll have a condition applied to your licence, that you must undergo regular medical reviews with your treating doctor or specialist.

If you drive a commercial vehicle (eg a truck, bus, taxi or hire car), you generally need to be seizure free for 10 years, to be issued a licence (which will have conditions added to it).

Some exceptions may be considered, for example first seizure, childhood seizures, or sleep only seizures. Allowances may also be considered, on the advice of an epilepsy specialist.

Vision in one eye only

If you have vision in one eye only (monocular vision) you must provide a certificate from an ophthalmologist or optometrist certifying you meet the required standards for your licence. This includes copies of any recent visual field testing.

From 1 March 2017, optometrists and ophthalmologists can now submit the medical assessment form online. Submitting medical assessments to Transport for NSW is immediate and results in faster case reviews and saves you from having to attend a service centre.

If you drive a private vehicle, you may be issued with a conditional licence, subject to periodic review, usually every two years.

If you drive a commercial vehicle, you may be considered for a conditional licence, subject to a yearly review. The nature of your driving will be taken into account, along with information provided by an optometrist or ophthalmologist and the results of recent visual field testing.

In all cases,Transport for NSW will consider the extent of any visual field loss and your visual acuity, before a conditional licence is granted.


Glaucoma is an eye disease in which the optic nerve at the back of the eye is slowly destroyed. There are no warning signs and generally no pain associated with glaucoma. The loss of sight is gradual and a considerable amount of peripheral vision may be lost, before you become aware of any problem.

You must be able to see properly, to drive safely. Drivers with poor peripheral vision in both eyes are more at risk of crashing, than drivers with normal peripheral vision, particularly when pulling into, or out of traffic, or when overtaking. You may also not see pedestrians stepping onto the road.

For more information, visit the Glaucoma Australia website, or phone Glaucoma Australia on 1800 500 880.

Macular Degeneration

The macula is the central part of the retina, the light sensitive tissue at the back of the eye. The retina processes all visual images. It’s responsible for your ability to read, recognise faces, drive, and see colours clearly.

Macular Degeneration causes progressive macular damage, resulting in loss of central vision. Peripheral vision is not affected. Key symptoms include:

  • Difficulty with reading, or any other activity that requires fine vision
  • Distortion, where straight lines appear wavy or bent
  • Distinguishing faces becomes a problem
  • Dark patches, or empty spaces appear in the centre of your vision.

The need for increased lighting, sensitivity to glare, decreased night vision and poor colour sensitivity may indicate there’s something wrong. If you experience any of these symptoms, contact your eyecare professional immediately.

For more information, visit the Macular Disease Foundation website, or phone them on 1800 111 709.

Hearing loss and deafness

If you drive a private car, motorcycle or light rigid vehicle, hearing loss or deafness do not generally impair your ability to drive safely, and your licence does not need any special conditions or reviews.

If you drive a commercial vehicle however, you’re subject to hearing standards, and will need to be regularly reviewed by either an ear, nose and throat (ENT) specialist, or audiologist. There are allowances for congenital or childhood hearing loss.

Oxygen therapy and masks

If you require oxygen therapy, you must talk to your doctor about whether or not you’re medically fit to drive.

Provided your doctor states you are able to drive, you may use oxygen therapy, as long as the mask and tank do not interfere with your use of the vehicle controls, or block your view while driving.

The oxygen tank must be securely positioned and strapped into the vehicle.

Temporary medical conditions or injuries

Many temporary conditions or injuries will prevent you from driving. For example, if you’ve been under anaesthetic, your doctor will advise you not to drive, for at least 24 hours. Injuries such as broken bones will also affect your ability to drive.

In most cases, temporary conditions and injuries will not affect your licence, and you don’t need to report them to Transport for NSW. However, you should consult with your doctor to determine whether your injury affects your ability to drive, until you’ve recovered.

Driving with a cast

If you have to wear a cast, for example due to a fractured leg, arm, hand or other injury, talk to your doctor about whether or not you’ll be able to drive.

Casts fitted to legs and feet may interfere with your ability to safely use the accelerator, brake and clutch pedals.

If you have a cast on your arm or hand, you may still be able to drive, however you must be able to operate all vehicle controls and have a hand on the steering wheel at all times. Driving a manual vehicle may not be possible, unless you can safely change gears while keeping one hand on the steering wheel.

Seatbelt exemptions

The wearing of seatbelts is compulsory in Australia, for drivers and passengers of all vehicles (except motorcycles). This includes trucks, buses and taxis.

If you’re not wearing a seatbelt, you are more than three times more likely to be killed in a crash, than if you’re wearing one.

Transport for NSW does not issue a certificate of exemption for seatbelt use.

There are no medical conditions for which a person is unable to wear a seatbelt, although padding or other modifications may be required. Health professionals are discouraged from providing seatbelt exemption letters to people.

If your treating doctor does intend to provide you with an exemption however, they must provide you with a certificate that includes the following:

  • The certification must be dated and provided on the practitioner’s letterhead
  • It must state your name, address, sex and date of birth
  • It must state the reason for the exemption
  • It must clearly show the date the exemption expires.

An exemption cannot be issued for more than 12 months from the date of issue, except for musculo-skeletal conditions, or deformities of a permanent nature.

The certificate must be carried with you at all times while travelling in a vehicle without wearing a seatbelt, either as the driver, or a passenger. You must provide it to Police, or other authorised officers, when requested.

Mobility Parking Scheme permit holders

If you apply for a Mobility Parking Scheme permit in addition to your driver licence, and you’ve not declared any medical condition to Transport for NSW, you’ll need to provide a satisfactory medical report, before you can renew your licence. See Mobility Parking Scheme for more information.

Commercial and passenger vehicle drivers

If you drive a truck, bus, taxi or hire car, or you transport dangerous goods, you need to meet higher medical standards because of the demands of your work, and the amount of hours you spend on the road. There are also serious consequences from crashes involving these kinds of vehicles.

If you drive these kinds of vehicles, it’s important you tell your doctor when discussing any medical conditions. It may be that, with treatment and regular review, you’re able to continue driving, although your licence may have conditions added.

If you do not meet the medical standards for a commercial or passenger vehicle, you may still be able to drive a private vehicle.

Restricted licences

You may have the option to restrict your driving, for example only driving during the day, or within a certain distance of your home. Discuss this with your doctor at the time of your medical review.

Transport for NSW may also apply conditions to your licence, which means you can continue to drive, as long as you meet the conditions. If you’re issued a conditional licence, it’s your responsibility to comply with the conditions, and to be reviewed by your doctor, as required.

If your licence has been restricted and you move to a new address, you may need to obtain a new medical report form from your doctor, when you advise us of your new address.

Driving tests

In some cases, you may need to pass a driving test, as well as provide a satisfactory medical report. This will be on request for medical reviews Transport for NSW sends you, around eight weeks before your medical review is due.

To avoid delays renewing your licence, book your driving test as soon as possible. Your doctor must declare you medically fit to drive, before you can take the test.

A Guide to the Driving Test provides information about what’s involved in a driving test and what you’ll be tested on.

Licence suspension and cancellation

If you do not comply with medical review requirements,Transport for NSW may suspend and/or cancel your licence.

You’ll be notified in writing of the suspension or cancellation, the reasons for it, and the action you can take, to have the suspension or cancellation withdrawn.

If the suspension/cancellation action is because Transport for NSW requires more information from your doctor, be sure to take the notice of suspension/cancellation you receive to your doctor, so that they can provide all the required information.

You have a right of appeal against a medical suspension/cancellation of your driver licence. You must lodge the appeal within 28 days of receiving the notice. You can lodge online, or go to a NSW Local Court. The Court will require a copy of the suspension/cancellation notice, and a lodgement fee is payable to the Court when lodging an appeal.

Important: Lodging an appeal does not stop the suspension/cancellation of your licence.

Concerned about the safety of a relative or friend?

If you’re concerned about someone’s medical fitness, or ability to drive safely, it’s important to encourage them to speak with their doctor.

If you have genuine concerns, you can submit an Unsafe and/or Medically Unfit for Driving Report. This form can be used by family members, friends, carers and concerned members of the public, who have knowledge of the driver’s medical conditions and/or unsafe driving behaviour. You must take the completed report, in person, to a Service NSW Centre. Transport cannot investigate the report until you have confirmed with a customer service representative that you have provided the information in good faith, and out of genuine concern for the driver and other road users.

If a person poses a serious or immediate threat to road safety, please also raise your concerns with the NSW Police, and if possible, the person's doctor.

If you’ve witnessed unsafe driving, and the driver is unknown to you, you should raise the matter with the NSW Police.

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