Driving and Adaptive Driving
Driving can provide significant independence for disabled people. This page covers the process of learning to drive or continuing to drive with a disability, adaptive equipment options, and the legal and practical aspects of driving with disabilities.
Where Are You?
Section titled “Where Are You?”Jump to your country:
Understanding Adaptive Driving
Section titled “Understanding Adaptive Driving”Who Can Drive
Section titled “Who Can Drive”Many people assume certain disabilities preclude driving. In reality, people with a wide range of disabilities drive safely using adaptive equipment and techniques:
- People who use wheelchairs
- People with limb differences or amputations
- People with limited hand function
- People with some vision impairments (meeting legal requirements)
- People with hearing impairments
- People with certain neurological conditions
- People with cognitive differences (varies by condition and individual)
The key question isn’t “Can people with [disability] drive?” but “Can this individual drive safely with appropriate adaptations?”
Types of Adaptive Equipment
Section titled “Types of Adaptive Equipment”Primary controls (steering, acceleration, braking):
Hand controls:
- Push/pull hand controls (accelerate by pushing, brake by pulling, or reverse)
- Push/rock hand controls
- Push/right-angle controls
- Electronic accelerator and brake
Steering modifications:
- Spinner knobs
- Tri-pin grips
- Palm grips
- Reduced-effort steering
- Joystick steering
Pedal modifications:
- Left-foot accelerator
- Pedal extensions
- Pedal guards
Secondary controls:
- Turn signal extensions
- Horn and wiper modifications
- Voice-activated controls
- Touch pads
- Remote control for vehicle functions
Wheelchair and mobility device access:
- Wheelchair lifts (for loading chair into vehicle)
- Wheelchair ramps
- Transfer seats
- Tie-down systems
- Wheelchair docking systems (drive from wheelchair)
Vehicle modifications:
- Lowered floors
- Raised roofs
- Widened doors
- Ramps (manual or power)
- Kneeling systems
Finding the Right Solutions
Section titled “Finding the Right Solutions”No two drivers are the same. The right adaptive equipment depends on:
- Your specific physical abilities
- Your disability’s stability or progression
- The types of driving you’ll do
- Vehicle preferences
- Budget
Professional evaluation is essential to determine what adaptations you need and to learn to use them safely.
United States
Section titled “United States”Getting Evaluated
Section titled “Getting Evaluated”Driver Rehabilitation Specialists (DRS):
A driver rehabilitation specialist is a professional (often an occupational therapist) trained to evaluate and train disabled drivers.
What they do:
- Clinical evaluation of physical, visual, cognitive abilities
- Behind-the-wheel assessment
- Equipment recommendations
- Training on adaptive equipment
- Written prescription for equipment
- Help with licensing process
Finding a DRS:
- Association for Driver Rehabilitation Specialists (ADED): aded.net
- Your state vocational rehabilitation agency
- Rehabilitation hospitals
- VA medical centers (for veterans)
The evaluation process:
- Clinical assessment (physical, cognitive, visual abilities)
- Behind-the-wheel assessment (if appropriate)
- Equipment recommendations
- Training on equipment
- Final evaluation
- Documentation for licensing
Licensing
Section titled “Licensing”State-by-state process:
Each state handles disabled driver licensing differently, but generally:
- Get evaluated by a driver rehabilitation specialist
- Obtain necessary documentation
- Apply for license or license modification
- May need to take modified driving test
- License may have restrictions coded (e.g., must use hand controls)
License restrictions:
Your license may be coded with restrictions indicating required equipment:
- Hand controls required
- Automatic transmission only
- Left-foot accelerator
- Corrective lenses
- Other adaptive equipment
Medical reporting:
Some states require doctors to report certain conditions. Know your state’s laws.
Renewals:
You may need periodic medical review or driving assessment for renewal.
Getting Equipment
Section titled “Getting Equipment”Paying for adaptations:
Vocational Rehabilitation: If you need to drive for work or to get to work, state VR agencies may fund evaluations, training, and equipment.
Veterans Affairs: Veterans with service-connected disabilities may receive vehicle modifications and adaptive equipment through VA.
Private insurance: Auto insurance rarely covers adaptive equipment. Health insurance generally doesn’t either.
Workers’ compensation: May cover if disability is work-related.
Charitable organizations: Various organizations provide grants for adaptive equipment.
Out of pocket: Many people pay for equipment themselves. Costs range from hundreds for simple modifications to tens of thousands for extensive vehicle modifications.
Selecting a vehicle modifier:
NMEDA members: The National Mobility Equipment Dealers Association (NMEDA) has quality assurance programs. Members meet certain standards.
Questions to ask:
- What certifications do you have?
- How long have you been in business?
- Can you provide references?
- What warranty do you offer?
- How long will modifications take?
Vehicles
Section titled “Vehicles”Choosing a vehicle:
Consider:
- What modifications you need
- Vehicle size and type
- Entry and exit requirements
- Wheelchair storage or access needs
- Budget (new vs. used, modification costs)
Vehicle options:
Minivans: Most common for wheelchair access conversions. Lower entry height than SUVs.
SUVs and trucks: Can be modified but often require more extensive work for wheelchair access.
Cars: Work well for simple hand controls and someone who transfers to driver seat.
Wheelchair-accessible vehicles:
Side-entry conversions: Most common. Wheelchair enters from side via ramp.
Rear-entry conversions: Wheelchair enters from rear. Less common, different trade-offs.
Lowered floor: Required for most wheelchair access. Allows wheelchair user to enter and ride or drive.
Driving from a wheelchair:
Some people drive while remaining in their wheelchairs. This requires:
- Appropriate vehicle conversion
- Wheelchair tie-down or docking system
- Accessible primary and secondary controls
Financial Assistance Programs
Section titled “Financial Assistance Programs”Vocational Rehabilitation:
- State agencies providing employment support
- May fund evaluation, training, equipment, vehicle modifications
- Must be connected to employment goal
Veterans programs:
- Automobile Adaptive Equipment (AAE) grant
- Vehicle modification coverage for service-connected disabilities
Nonprofits and charities:
- Challenged Athletes Foundation
- Paralyzed Veterans of America
- Various local and condition-specific organizations
Canada
Section titled “Canada”Getting Evaluated
Section titled “Getting Evaluated”Driver Assessment Centers:
Each province has certified driver assessment services.
Finding services:
- Occupational therapists specializing in driver rehabilitation
- Rehabilitation hospitals
- Provincial motor vehicle offices for referrals
Licensing
Section titled “Licensing”Provincial process:
Licensing is provincial. Generally:
- Medical evaluation/documentation
- Driver rehabilitation assessment
- Modified road test (if required)
- License with any necessary conditions
Medical fitness requirements:
Each province has medical standards for driving. Report requirements vary.
Funding Equipment
Section titled “Funding Equipment”Provincial programs:
Assistive Devices Programs (vary by province):
- Ontario: Assistive Devices Program (ADP) covers some equipment
- Alberta: AADL (Alberta Aids to Daily Living)
- British Columbia: Various programs
- Other provinces have their own programs
Other funding:
- Workers’ compensation boards
- Veterans Affairs Canada
- Private insurance
- Charitable organizations
Vehicle acquisition: Programs are limited. Most vehicle costs are out of pocket.
United Kingdom
Section titled “United Kingdom”Getting Evaluated
Section titled “Getting Evaluated”Driving Assessment Centers:
Driving Mobility: National network of driving assessment centers. Provides:
- Assessment of ability to drive
- Advice on adaptations
- Tuition with adapted vehicles
- Information on vehicle grants
Referral:
- Can self-refer
- GP referral
- Referral from other services
Licensing
Section titled “Licensing”DVLA (Driver and Vehicle Licensing Agency):
You must declare certain medical conditions to DVLA. Conditions that must be reported include:
- Epilepsy
- Stroke
- Diabetes (if taking certain medications)
- Physical disabilities affecting driving
- Visual impairments
- Many others
The process:
- Declare condition to DVLA
- DVLA may request medical reports
- May require driving assessment
- License issued or refused based on assessment
- May have conditions (e.g., must use adapted controls)
License codes:
Your license may have codes indicating:
- Adapted controls required
- Specific adaptations
- Automatic only
- Other restrictions
Funding Equipment
Section titled “Funding Equipment”Motability Scheme:
What it is: Scheme allowing you to lease a car, wheelchair-accessible vehicle, or scooter using mobility component of PIP, DLA, AFIP, or WPP.
How it works:
- Use mobility benefit as payment
- Vehicle includes insurance, maintenance, breakdown cover
- Adaptations may be included or require advance payment
- Wide range of vehicles available
Wheelchair-accessible vehicles: Available through Motability with Advance Payment varying by vehicle and adaptation needs.
Grants:
- Motability charitable grants (for those on Motability but needing additional help)
- Access to Work (for work-related transport)
- Local authority grants (limited)
- Charitable organizations
Australia
Section titled “Australia”Getting Evaluated
Section titled “Getting Evaluated”Occupational Therapy Driving Assessment:
Conducted by occupational therapists trained in driver assessment.
Where to find:
- State motoring organizations (NRMA, RACV, etc.)
- Rehabilitation hospitals
- Private occupational therapy practices
Licensing
Section titled “Licensing”State-based licensing:
Each state has its own licensing authority and requirements:
- NSW: Transport for NSW
- Victoria: VicRoads
- Queensland: Queensland Transport
- Other states have their own authorities
Process:
- Medical assessment/declaration
- Occupational therapy driving assessment
- Practical assessment if needed
- License with any conditions
- May require periodic review
Funding Equipment
Section titled “Funding Equipment”NDIS:
The National Disability Insurance Scheme may fund:
- Vehicle modifications
- Driver rehabilitation
- Some equipment
Must be:
- Reasonable and necessary
- Related to disability
- Support goals
State programs:
Various state-based programs may assist:
- Equipment loan programs
- Some rebates or grants
Other funding:
- WorkCover/workers’ compensation
- TAC (Transport Accident Commission in Victoria)
- Private insurance
- Charitable organizations
Other Countries
Section titled “Other Countries”General Principles
Section titled “General Principles”Most countries with driver licensing have processes for disabled drivers:
- Medical fitness standards
- Assessment requirements
- License conditions for equipment
- Varying support for equipment costs
What to research in your country:
- Who does driving assessments?
- What are medical reporting requirements?
- What license conditions apply?
- What funding exists for equipment?
- What vehicle modification regulations exist?
European Union
Section titled “European Union”Many EU countries have:
- Standardized license codes for adaptations
- Medical fitness directives (with national variation)
- Disability-specific driving assessment services
Global Resources
Section titled “Global Resources”- International Association of Rehabilitation Professionals (has some driver rehabilitation information)
- Country-specific disability organizations
Making the Decision
Section titled “Making the Decision”Is Driving Right for You?
Section titled “Is Driving Right for You?”Consider:
- Is driving possible with adaptations?
- Will it improve your independence?
- Are alternatives available (accessible transit, paratransit)?
- Is the cost justified for your situation?
- What are the ongoing costs (maintenance, insurance)?
Driving isn’t the only option:
For some people, alternatives work better:
- Public transit (if accessible)
- Paratransit services
- Ride-share services (with varying accessibility)
- Taxis (accessible options in some areas)
- Rides from others
When Driving Becomes Harder
Section titled “When Driving Becomes Harder”If your condition is progressive or you’ve had changes:
- Get reassessed
- Equipment can be modified as needs change
- Some adaptations allow continued driving with progression
- There may be a point when driving is no longer safe
Making the transition:
Stopping driving is a significant life change. Plan for:
- Alternative transportation
- Maintaining independence
- Emotional adjustment
Specific Considerations
Section titled “Specific Considerations”Wheelchair Users Who Drive
Section titled “Wheelchair Users Who Drive”Transfer drivers:
- Transfer from wheelchair to vehicle seat
- Wheelchair is stored (manually or with lift)
- Wide range of vehicles work
Drive from wheelchair:
- Remain in wheelchair while driving
- Requires wheelchair-accessible vehicle
- Wheelchair docking system
- Adapted primary and secondary controls
One-Handed Driving
Section titled “One-Handed Driving”With appropriate equipment, people can drive safely with one hand:
- Spinner knob or other steering modification
- Relocated or voice-activated secondary controls
- Turn signal extensions
Lower Limb Differences
Section titled “Lower Limb Differences”Options include:
- Hand controls for acceleration and braking
- Left-foot accelerator (for right leg impairment)
- Prosthetic leg use (with training and evaluation)
Limited Hand Function
Section titled “Limited Hand Function”Options include:
- Modified grips for steering
- Reduced-effort steering
- Alternative switch placement
- Voice control for secondary functions
Visual Impairments
Section titled “Visual Impairments”Driving requirements include minimum visual acuity. Some people with visual impairments can drive:
- With corrective lenses
- Using bioptic telescopic lenses (rules vary by state/country)
- Meeting specific visual field requirements
Seizure Conditions
Section titled “Seizure Conditions”Driving with epilepsy or seizure conditions:
- Most jurisdictions require seizure-free period
- Length of required seizure-free period varies
- Medical clearance usually required
- Must report to licensing authority in most places
Resources
Section titled “Resources”United States
Section titled “United States”- Association for Driver Rehabilitation Specialists (ADED): aded.net
- NMEDA: nmeda.com
- State Vocational Rehabilitation agencies
- VA Automobile Adaptive Equipment program
Canada
Section titled “Canada”- Provincial licensing authorities
- Assistive Devices Programs by province
- Driving rehabilitation services
United Kingdom
Section titled “United Kingdom”- Driving Mobility: drivingmobility.org.uk
- DVLA medical fitness information
- Motability: motability.co.uk
Australia
Section titled “Australia”- State licensing authorities
- NDIS
- State motoring organization assessments
Help Build This Page
Section titled “Help Build This Page”What’s your experience with adaptive driving? What resources should be added? What questions should be answered?
Share through our [contribution form] or email [email protected].
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