Driving after a stroke – transient ischaemic attacks (TIA) and others

Can you drive after a stroke?

If you have a stroke you must stop driving for at least one month. How soon you can drive again depends on the type of stroke and the type of licence you hold. 

Most drivers can drive just one month after a transient ischaemic attack (TIA), known as a 'mini-stroke’. If you had more than one mini-stroke in succession you cannot drive until you have been clear of attacks for three months.

If you have had a more serious stroke, or you drive buses, taxis or lorries, different rules apply. You may have to get the all-clear from your doctor before you can drive again. You may never be able to drive again.

Giving up driving for most people means losing their independence and freedom – highly frustrating – but there are good reasons for the rules.

Can I drive immediately after a stroke? 

Even if you are recovering well, going back to driving soon after a stroke may be dangerous. Strokes can have temporary or permanent effects that affect your ability to drive safely, such as:

• Physical effects, such as weakness in arms, legs or both, sensation changes, pain and balance problems.

• Visual issues, such as double or blurred vision, loss of central vision, or visual field loss (loss of an area of vision, often on the same side as weakness in your face, arms or legs).

• Cognitive effects that may reduce your ability to concentrate, navigate, multi-task, and understand driving situations. There may be problems with your memory and perception of space and time.

• Fatigue. Being very tired affects your driving ability.

• Epilepsy. Some people develop epilepsy after a stroke, which affects their ability to drive.

Your ability to go back to driving depends on your medical condition. If you want to return to driving your doctor or medical team should assess your ability to drive safely and explain the current DVLA (DVA in Northern Ireland) guidelines. 

Your doctor may contact other professionals or the DVLA’s medical advisers for advice.

How long after a stroke can you drive?

The rules on how soon you can drive after a stroke vary according to the type of stroke and the type of licence you hold.

Ischaemic stroke, (including lacunar) or transient ischaemic attack (TIA, or 'mini-stroke.')

Car or motorcycle licence: you cannot drive for one month after an ischaemic stroke or single transient ischaemic attack. During this month you do not need to inform the DVLA. 

If a doctor judges that you have any remaining cognitive or visual issues after a month you are likely to have to wait longer. If you only have limb weakness you may be allowed to restart driving.

If you have a series of TIAs over a short period, you cannot drive until you have been free of them for three months. 

Heavy goods vehicle (HGV) or public service vehicles (PCV) licence:  you cannot drive these types of vehicles for a year and must tell the DVLA immediately. 

Taxi drivers must inform their local authority (or in London, the Public Carriage Office), which will decide on the medical standards you must meet before returning to driving. Special rules apply to drivers of vehicles such as police cars and ambulances.

Haemorrhagic strokes

a) Subarachnoid haemorrhage

Car/motorcycle licence: you must not drive until certified safe by a doctor - but you do not need to tell the DVLA. If you have surgery for intracranial aneurysm, you cannot drive for at least six months.

HGV/PSV licence: You cannot drive for at least six months - the period depends on location of haemorrhage and type of treatment. You must inform the DVLA. 

b) Intracranial haemorrhage due to infratentorial arteriovenous malformations (AVMs)

Car/motorcycle licence: You can continue driving and do not need to notify the DVLA as long as you have no symptoms that may affect your driving.

HGV/PSV licence: You must notify the DVLA and your licence will be revoked for a period of time. If the condition is untreated, your licence will be revoked permanently. If treatment removes the AVM and you have no symptoms that could impair your driving you may be able to drive again.

There are other conditions associated with strokes that may affect your ability to drive, such as: 

Epilepsy: If you have a seizure or develop epilepsy after a stroke you must stop driving, and inform the DVLA. If you have a seizure within 24 hours of a stroke but don’t have any more after that, the DVLA will assess your case on an individual basis. 

Do I need to tell DVLA about my stroke?

Not everyone has to notify the DVLA. Most car and motorcycle owners do not need to. But it's your responsibility (not that of your doctor) to tell the DVLA about any medical issue that impacts your ability to drive safely, including a stroke. You can report your stroke to the DVLA online.

You must notify the DVLA as soon as possible if:

• 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

• you are a Group 2 driver (lorry and bus). 

If you are in the group that does not have to notify the DVLA for a month, you must notify the DVLA after a month if you have any ongoing effects. If your doctor says you cannot drive for more than three months you will need to surrender your licence to the DVLA.

The Stroke Association has a downloadable guide, Driving After a Stroke.

What happens if I don't tell the DVLA about my stroke?

You can be fined up to £1,000 if you do not tell the DVLA about a medical condition that affects your driving. You could also be prosecuted if you have an accident.

Reporting is easy. You can report your stroke to the DVLA online. If your doctor says you cannot drive for more than three months you will need to surrender your licence to the DVLA.

What happens to my car insurance after my stroke?

You must tell your insurance company about your stroke or TIA before you resume driving, even if your doctor has approved it. If you don't you may not be covered in full for future claims.

Once you have told your insurer, if after a month your doctor confirms you are safe to drive again, your insurance company may ask you to tell the DVLA/DVA about your stroke or TIA. Insurers may also ask for confirmation that you are safe to drive again. 

Talk to your individual insurer and check your policy - procedures vary among companies. Having had a stroke should not affect your ability to buy car insurance, multi car insurance or temporary car insurance to drive other cars. 

Can you get car insurance after a stroke?

Even if your stroke has left you disabled you should be able to get insurance. Today it is generally much easier for disabled people to get quotes. 

Disabled Motoring UK, the charity that supports disabled drivers, passengers and Blue Badge holders, says that in the past it could be difficult for some disabled people with adapted vehicles to get car insurance as many insurers would not insure adapted vehicles. 

It's always worth shopping around for better deals. 

Will a stroke make my car insurance more expensive?

Having a stroke may not affect your premiums, unless you need an adapted vehicle. Ask your insurer. Disabled Motoring UK says there is no evidence to suggest that disabled drivers pay higher insurance premiums because of a disability. 

It is also illegal for a car insurance company to charge extra because of a disability unless they can prove it’s justified, as stated in the Equality Act 2010.

How can I get cheaper car insurance after a stroke?

If you are expecting to reduce your mileage after your stroke or TIA, consider pay as you go insurance such as telematics (black box) cover or pay per mile cover. 

Changing your car may help reduce the cost of your cover. Shop around for cover. 

What if my doctor says I'm not fit to drive after my stroke?

You must tell your insurer and the DVLA. Failure to do so is a criminal offence. You could be fined £1,000 and prosecuted if you do drive and have an accident.

You might be offered an assessment at a local mobility centre, after which the DVLA will decide that you can either: 

• keep your licence and continue driving

• be granted a temporary licence 

• be given a licence, but only for a car with specific adaptations.

Alternatively it may decide that you cannot continue to drive and the DVLA will revoke your licence. 

Why do I have to take a driving assessment after a stroke?

Assessments and courses can help you return to driving after a stroke. The charity Driving Mobility https://www.drivingmobility.org.uk/ offers courses at 20 locations across the UK, where people who have had strokes, who are disabled or elderly can get assessments, lessons and help with getting back behind the wheel safely. 

"About 50% of people who have strokes can consider returning to driving. Many think they are ready before they are, but when people do return and are ready to undertake one of our assessments, about 60% of those are judged to be safe," says Driving Mobility chief executive Edward Trewhella.

Assessments are free of charge to clients at most centres if referred through the NHS, a GP, other health professional, the DVLA, DVA, or Motability. You can self-refer, in which case costs vary from zero to £140. Tuition costs £30 an hour and upwards depending on location.

Help with tuition costs can be found if you qualify for the Motability scheme and local charities sometimes support the cost of tuition for people with a disability. 

CASE STUDY 

How I got back into driving after my stroke - Nigel's story

Nigel King, 74, had been driving for 50 years until a stroke in 2018 left him with reduced mobility in his left hand and arm, making driving a standard car impossible.

Nigel, from Enfield, was concerned that he might not be able to drive again. The DVLA were informed and his driving licence was put on hold, but Nigel was keen to get back behind the wheel. 

As his rehabilitation began, his local hospital stroke department advised him to seek a specialist driving assessment to get a professional evaluation of his capabilities and recommend suitable adaptations to allow safe driving with one hand.

Nigel booked an assessment at his local Driving Mobility accredited centre in Welwyn Garden City. 

Nigel says: "After an initial phone consultation I underwent a cognitive test at the centre and was then accompanied in a dual-control car by an instructor and therapist. A steering knob or ‘lollipop’ had already been fitted to the vehicle to see if I could operate it safely and confidently.

"At first I did not find it easy. Even though I am right-handed, my 50 years of holding a steering wheel in a standard way made it difficult. Following the assessment Driving Mobility recommended driving lessons so I could get used to this new way of driving. One of their assessors was able to provide tuition."

After 20 hours of tuition and another assessment his licence was returned in November 2019. His automatic Ford Fiesta has been fitted with a wireless ‘lollipop’ which clips onto the steering wheel to provide leverage and push button control of indicators, lights, wipers and horn.

Nigel says: “It took me a year to achieve approval to drive again, and I really had to work at it, but I got there. Depending on your abilities, it's wise not to expect success overnight. Be patient, take your time, concentrate and practise and you’ll get there. Being able to drive again, thanks to Driving Mobility, has enabled me to regain my independence."