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Driving with medical conditions

Some medical conditions affect your fitness to drive but what health issues should you declare to the DVLA and your car insurer?
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Motorists are required by law to notify the Driver and Vehicle Licencing Agency (DVLA) if they develop a medical condition or disability that affects their ability to drive safely. 

The most recent figures from the DVLA suggest that many drivers are failing to do this. In the six years to 2019, the agency had to intervene and revoke licences from over 360,000 motorists who had DVLA notifiable health issues that made them a danger to others on the road.

In England and Wales, over 8.8 million motorists have a health condition and it is the duty of the licence holder or applicant to inform the DVLA (DVA in Northern Ireland) and their insurance company if they have medical conditions on the DVLA list.

Research from Direct Line found that of the 3.4 million drivers who don’t declare their condition, half said it was because they didn’t think their health affected their driving and 14% did not realise that it was their responsibility.

DVLA health conditions and driving

You can be fined up to £1,000 if you don’t report medical conditions that make you unfit to drive. If you are involved in an accident your car insurance  will be invalidated and only the minimum third-party cover will apply. And you might be prosecuted. 

DVLA statistics show that 65% of drivers who have their licences removed are over the age of 50 years. Epilepsy, alcohol dependency issues and poor eyesight were the top three reasons for motorists being unsafe behind the wheel. 

This was followed by memory problems, mental health issues, neurological and cardiac conditions, blackouts and diabetes.

Drivers must also surrender their licence to DVLA if their doctor tells them that they need to stop driving for three months or more because a medical condition would make them a risk on the road.

List of DVLA reportable medical conditions

Anyone with a medical condition likely to cause a sudden disabling event at the wheel, or who is unable to control their vehicle safely for any other reason, must not drive. 

Medical standards are continually reviewed, and the most up-to-date information will always be online on GOV.UK. The government list currently includes:

  • Epilepsy

  • Strokes

  • Diabetes or taking insulin

  • Syncope (and other fainting conditions)

  • Heart conditions (including atrial fibrillation and pacemakers)

  • Physical disabilities

  • Visual impairments

  • Brain injury or condition

  • Sleep apnoea

  • Glaucoma

Why is it important to report health conditions to the DVLA?

Driving is a complex skill that requires many cognitive processes to occur simultaneously from vision and hearing to muscle power and control. 

To drive safely, you need to pay attention and concentrate not just on manoeuvring the vehicle but also the external environment. This requires planning and co-ordination as well as judgement and a good reaction time.

Any illness or accident that impacts on one or more of these abilities needs to be reviewed and you have a legal duty to:

  • Notify the DVLA of any injury or illness that would have a likely impact on safe driving ability (except some short-term conditions)

  • Respond fully and accurately to any requests for information from either the DVLA or healthcare professionals

  • Comply with the requirements of the issued licence, including any periodic medical reviews indicated by the DVLA

How do you notify the DVLA of medical conditions?

On the government website is a list of medical conditions and corresponding forms that need to be completed and returned. The DVLA usually decides within six weeks, but they will also inform you if the decision is going to take longer.

In some cases, you will be asked to take a driving test or have a medical examination. You can usually keep driving while your application is being assessed. One of four things will then happen:

  • You will get a new driving licence

  • You will be issued with a shorter licence for one, two, three or five years

  • You will need to make car adaptations and fit special controls 

  • You must stop driving and give up your licence

All decisions can be appealed within six months by contacting the local magistrate’s court. In Scotland this is reduced to 21 days and done through the local sheriff’s court.

Medical disclosure and car insurance

You need a valid driving licence to obtain car insurance and if you do not notify the DVLA of a medical condition that could lead to a licence removal or drive against a doctor’s advice you could invalidate your insurance policy.

This would mean that in the event of an accident, only the bare minimum of third compensation claims would be paid.

Medical conditions can also lead to increased insurance premiums or a larger excess on the policy if an insurer believes you are a higher risk for causing an accident. The Equalities Act 2010, however, means that the insurance company must provide evidence of the additional cost to them.

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What are DVLA reportable medications?

It is illegal in England, Scotland and Wales to drive with legal drugs in your body if it impairs your ability to drive.

Car insurers need to know if you are taking certain medications for a DVLA reportable condition. Your doctor will usually let you know if a treatment puts you at risk on the road. 

So, what medical conditions, medications and potential health problems could affect your entitlement to drive and your car insurance?

Visual impairment and car insurance

There is a minimum eyesight standard for driving that requires motorists to be able to (with contacts or glasses, if necessary) read a car number plate from a distance of 20 metres and to have a visual acuity of at least 0.5 (6/12) on the Snellen scale. 

If you fail a vision test then the DVLA will be informed, and your licence will be revoked.

In addition, if your eyesight worsens and you drive without glasses or contacts, you would be breaking the law. The DVLA and insurance companies must also be told of any eye changes such as double vision or sight loss in one eye. 

All drivers should have regular eye tests and it is more important for people over the age of 70 because eyesight is more likely to deteriorate with age. Older people are also more at risk of cataracts, glaucoma and night blindness.

Epilepsy and driving

You need to tell the DVLA if you develop epilepsy due to the risk of seizures while driving. Whether you lose your licence will depend on the type of seizure and this will be reviewed on a case by case basis to decide if you can still drive safely. 

Factors that will impact on the decision include whether you lost consciousness, it was a one-off seizure, the type of medication prescribed, and if your condition is well controlled.

If someone with epilepsy continues to drive, doctors can break confidentiality and tell the DVLA due to the continued risk to them and to members of the public. 

Sleep apnoea and car insurance

You do not need to inform the DVLA if you have mild, moderate or severe obstructive sleep apnoea (OSA) without excessive sleepiness. 

If you do have excessive sleepiness, you must not drive until your excessive sleepiness symptom has been satisfactorily controlled. If it cannot be controlled within three months you must notify the DVLA.

For drivers with severe OSA, the DVLA will require medical confirmation that the symptoms are under control.

Strokes and fitness to drive

Drivers who have had a stroke or single transient ischaemic attack (TIA; mini stroke) cannot drive for one month as a stroke can affect their ability to drive safely in various ways.

Concentration may be impaired because of difficulties in problem solving or fatigue. There could also be some physical weakness that can cause balance problems, eye issues and pain. 

After a month stroke-free, and if your doctor agrees, you may be able to have your licence restored but you must notify the DVLA/DVA as soon as possible if any of the following apply: 

  • You have experienced multiple TIAs over a short period of time 

  • Your condition worsens at any time

  • You have experienced any form of epileptic seizure, other than ones within the first 24 hours following your stroke

  • Your stroke treatment included brain surgery

  • You have experienced more than one stroke in the past three months

  • Your doctor expresses concern about your fitness to drive

DVLA rules and heart attacks  

You don’t need to inform the DVLA if you’ve had a heart attack, but it recommends that you stop driving for four weeks. 

Your doctor will decide when you are safe to get back behind the wheel, but you will have to surrender your licence if you are not fit to drive for three months or more. When medical advice changes you can reapply again for your licence.  

You should also inform your car insurance company of any changes to your medical condition and they will consider the details before renewing or issuing a new policy. 

Does having cancer affect car insurance?

Treatment for cancer can affect your safety on the road especially if side effects cause sleepiness or fatigue. The DVLA will probably need to monitor your condition and might give shorter licences of one, two or three years. 

For a car or motorcycle licence, you only need to tell the DVLA you have cancer if:

  • You develop problems with the brain or nervous system

  • Your doctor has concerns about your fitness to drive

  • You’re restricted to certain types of vehicles or vehicles that have been adapted for you

  • Your medication causes side effects likely to affect safe driving

Dementia and driving

Assessing the driving ability of a driver with dementia can be a challenge and the DVLA usually relies on medical assessment by doctors as cognitive functioning can vary from motorist to motorist.

The mental abilities necessary for driving safely such as attention, concentration, visuospatial skills, problem-solving skills, judgement and reaction all deteriorate with dementia, so regular monitoring is vital for your safety and others.

Dementia itself does not stop people driving but the law states anyone who has an illness such as dementia that could affect their driving has to inform the DVLA. Licences may be retained subject to restrictions such as further medical assessments after a certain period.

Physical impairments and car adaptations

Cars can be adapted to meet the needs of people with physical disabilities in numerous ways. There could be hand controls instead of pedals, ramps, steering aids and electronic accelerators. 

The DVLA must be informed if you need an adapted vehicle so they can amend their licence to reflect this.

Your car insurer must also be notified of any adaptations, particularly if your vehicle has been modified specially for you as it could make your car more expensive to repair in the event of an accident. This could increase your car insurance premiums. 

It is important to declare any vehicle changes as your insurance could be invalid if you need to make a claim. 

Diabetes and car insurance

If you have diabetes treated by insulin you need to tell the DVLA if:

  • Your insulin treatment lasts (or will last) over three months

  • You had gestational diabetes (diabetes associated with pregnancy) and your insulin treatment lasts over three months after the birth

  • You get disabling hypoglycaemia (low blood sugar) or a medical professional has told you that you’re at risk of developing it

According to Diabetes UK, the main danger of diabetes and driving is the possibility of having a hypoglycaemic episode (hypo), which could impair your judgement and lead to an accident. 

It is advised that if you have frequent ’hypos’ that are likely to affect your driving, or find it difficult to realise when you are becoming ‘hypo’ you should stop driving until your blood glucose levels under control.

Mental health conditions and driving

You must tell the DVLA if you have a diagnosis of any of the following:

  • Bipolar disorder

  • Paranoid schizophrenia

  • Psychosis

  • Psychotic depression

  • Schizoaffective disorder

  • Schizophrenia

Each case will be reviewed on an individual basis and you will be assessed on how well your condition is managed by medication.

Conditions such anxiety, depression, eating disorders and post-traumatic stress disorder do not need to be reported unless you are experiencing significant memory or concentration problems, agitation, behavioural disturbance or suicidal thoughts.

Shopping around to get the best car insurance deals

Your medical condition could lead to higher car insurance premiums, but shopping around for the best deal using insurance comparison sites could help to offset the extras charged by insurance companies.

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