Section 83.5. Other physical and medical standards

(a) General disqualifications. A person who has any of the following conditions will not be qualified to drive:

(1) Unstable diabetes mellitus leading to severe hypoglycemic reactions or symptomatic hyperglycemia unless there has been a continuous period of at least 6 months free from a disqualification in this paragraph. Once the diabetic condition has stabilized, and as long as the individual has not had another disqualifying episode within the last 6 months, the driving privilege may be restored. The individual shall submit to a diabetic examination, which includes an HbA1C test as well as a vision screening, and the treating health care provider shall certify on a completed form provided by the Department that the individual has been free from a disqualifying episode. Thereafter, the individual shall submit to a diabetic examination, which includes an HbA1C test as well as a vision screening, in accordance with the following schedule:

(i) Six months after the diabetic examination required in this paragraph, the individual shall submit to a follow-up diabetic examination and the treating health care provider shall certify, on a completed form provided by the Department, that the individual has been free from a disqualifying episode.

(ii) Twelve months after the previous diabetic examination, the individual shall submit to a follow-up diabetic examination and the treating health care provider shall certify, on a completed form provided by the Department, that the individual has been free from a disqualifying episode.

(iii) Twenty-four months after the previous diabetic examination, the individual shall submit to a follow-up diabetic examination and the treating health care provider shall certify, on a completed form provided by the Department, that the individual has been free from a disqualifying episode.

(iv) Forty-eight months after the previous diabetic examination, the individual shall submit to a follow-up diabetic examination and the treating health care provider shall certify, on a completed form provided by the Department, that the individual has been free from a disqualifying episode.

(v) Diabetic examination may be required more frequently if recommended by the treating health care provider.

(vi) Providing the condition of the individual remains under good control, the individual will not be required to submit to additional diabetic examinations.

(2) A waiver may be granted if an individual has been previously free from severe hypoglycemic reactions or symptomatic hyperglycemia for the preceding 6 months and the subsequent severe hypoglycemic reaction or symptomatic hyperglycemia occurred while the individual was under the treating health care provider’s care, during or concurrent with a nonrecurring transient illness, toxic ingestion or metabolic imbalance. This waiver will only be granted if the treating health care provider submits written certification indicating it is a temporary condition or isolated incident not likely to recur.

(3) Cerebral vascular insufficiency or cardiovascular disease which, within the preceding 6 months, has resulted in one or more of the following:

(i) Syncopal attack or loss of consciousness.

(ii) Vertigo, paralysis or loss of qualifying visual fields.

(4) Periodic episodes of loss of consciousness which are of unknown etiology or not otherwise categorized, unless the person has been free from episode for the year immediately preceding.

(b) Disqualification on provider’s recommendation. A person who has any of the following conditions will not be qualified to drive if, in the opinion of the provider, the condition is likely to impair the ability to control and safely operate a motor vehicle:

(1) Loss of a joint or extremity as a functional defect or limitation.

(2) Impairment of the use of a joint or extremity as a functional defect or limitation.

(i) The provider should inform the patient of the prohibition against driving due to the functional impairment.

(ii) The provider shall inform the Department in writing of the impairment if the condition has lasted or is expected to last longer than 90 days.

(3) Rheumatic, arthritic, orthopedic, muscular, vascular or neuromuscular disease.

(i) The provider should inform the patient of the prohibition against driving due to the functional impairment.

(ii) The provider shall inform the Department in writing of the impairment if the condition has lasted or is expected to last longer than 90 days.

(4) Cerebral vascular insufficiency or cardiovascular disease which, within the preceding 6 months, has resulted in lack of coordination, confusion, loss of awareness, dyspnea upon mild exertion or any other sign or symptom which impairs the ability to control and safely perform motor functions necessary to operate a motor vehicle.

(5) Mental disorder, whether organic or without known organic cause, as described in the current Diagnostic and Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric Association, 1700 18th Street NW, Washington, DC 20009, especially as manifested by the symptoms set forth in subparagraphs (i)—(iii). While signs or symptoms of mental disorder may not appear during examination by the provider, evidence may be derived from the person’s history as provided by self or others familiar with the person’s behavior.

(i) Inattentiveness to the task of driving because of, for example, preoccupation, hallucination or delusion.

(ii) Contemplation of suicide, as may be present in acute or chronic depression or in other disorders.

(iii) Excessive aggressiveness or disregard for the safety of self or others or both, presenting a clear and present danger, regardless of cause.

(6) Periodic episodes of loss of attention or awareness which are of unknown etiology or not otherwise categorized, unless the person has been free from episode for the year immediately preceding, as reported by a licensed physician.

(7) Use of any drug or substance, including alcohol, known to impair skill or functions, regardless whether the drug or substance is medically prescribed.

(8) Other conditions which, in the opinion of a provider, is likely to impair the ability to control and safely operate a motor vehicle.

(c) Driving examination. A person who has any of the conditions enumerated in subsection (b)(1), (2), (3) or (8) may be required to undergo a driving examination to determine driving competency, if the Department has reason to believe that the person’s ability to safely operate a motor vehicle is impaired. The person may be restricted to driving only when utilizing appropriate adaptive equipment.

The provisions of this § 83.5 adopted May 18, 1979, effective May 19, 1979, 9 Pa.B. 1631; readopted April 19, 1991, effective April 12, 1991, 21 Pa.B. 1813; amended July 16, 2004, effective July 17, 2004, 34 Pa.B. 3748; amended October 8, 2010, effective October 9, 2010, 40 Pa.B. 5813; corrected December 31, 2010, effective December 4, 2010, 41 Pa.B. 46. Immediately preceding text appears at serial pages (352987) to (352989).

Notation

Authority

The provisions of this § 83.5 amended under the Vehicle Code, 75 Pa.C.S. § § 1517, 1518 and 6103.

Notes of Decisions

Alcoholism

Physicians may render an opinion based on a review of records. Therefore, the physician was justified in formulating a medical opinion based on the information provided by the certified registered nurse practitioner indicating that the petitioner was an alcoholic and the suspension of the petitioner’s license under this regulation was justified. Satler v. Department of Transportation, 670 A.2d 1205 (Pa. Cmwlth. 1996).

A letter from a physician as to the driver’s alcoholism, although hearsay, is admissible and may provide basis to recall an operator’s license. Ploof v. Commonwealth, 590 A.2d 1318 (Pa. Cmwlth. 1991); appeal denied 606 A.2d 903 (Pa. 1992).

A driver’s diabetic condition which was neither unstable nor brittle did not place the driver within this provision and the driver’s physician was not liable to third parties due to the driver’s condition. Crosby v. Sultz, 592 A.2d 1337 (Pa. Super. 1991).

Evidence

If the Department alleges ‘‘lapse of consciousness’’ under 67 Pa. Code § 83.5(a)(4) in its official license recall notice, it must prove this at trial, even though an unspecified ‘‘other condition’’ under subsection (a)(9) may be applicable. Commonwealth v. Kipp, 18 Pa. D. & C.3d 592 (1980).

Certified records of the Department’s medical reports are insufficient proof of incompetency under subsection (a)(9) unless the examining physician is produced as a witness. Commonwealth v. Kipp, 18 Pa. D. & C.3d 592 (Pa. Com. Pl. 1980).

Incompetency

In determining incompetency to drive, the Department may compare a licensed driver’s physician’s report with the standards defining incompetency in subsection (a)(1)—(9), provided a properly qualified person makes the comparison. Commonwealth v. Kipp, 18 Pa. D. & C.3d 592 (1980).

Physicians

For reasons of public safety, it is the physician’s opinion that there is a medical condition sufficient to impair the licensee, and not the specific diagnosis, which is paramount. Commonwealth v. Oswald, 24 D & C 4th 231 (1995).