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Physician input plays a critical role in keeping Iowa’s roadways safe. Medical conditions, functional limitations, and certain medications can directly affect a patient’s ability to drive. As healthcare providers, you are often the first to recognize changes in vision, cognition, physical ability, or overall health that may impact driving performance. Your expertise helps the DOT make informed, balanced decisions that support both public safety and the individual driver’s independence. Working together ensures that drivers on the road are medically capable of operating a vehicle safely.
Medical Conditions That May Impact Driving
The more common types of health conditions that can affect driving are:
Reporting Requirements
In Iowa, physicians are not required to report medical or vision conditions to the DOT. Reporting is voluntary but strongly encouraged when a condition may affect a patient’s ability to drive safely.
Healthcare providers who report in good faith are protected from civil and criminal liability. Your input helps the DOT identify drivers who may need additional evaluation, restrictions, or follow-up to keep themselves and others safe on the road. 321.186(3)
Reporting Process and Forms
If, in your professional opinion, a patient is no longer medically or visually safe to operate a motor vehicle, you may request suspension of their driver’s license. To do this, fax your signed recommendation on your official letterhead to 515‑239‑1837.
If you believe a medical or vision condition may affect an individual’s driving ability, but suspension is not warranted, you may request that the DOT conduct a driver re-examination. To request a re-exam, please submit a signed Request for Reexamination Form#431030
Medical and Vision Reports
Medical and vision reports help the DOT ensure that drivers can safely operate a motor vehicle. Certain health conditions such as vision loss, seizures, heart issues, cognitive impairment, or other medical changes can affect a person’s ability to react, make decisions, or control a vehicle. When a potential concern is identified, a medical or vision report provides the DOT with accurate, up-to-date information from a licensed healthcare professional.
These reports allow the DOT to make balanced decisions that support both public safety and the driver’s independence. They help determine whether a driver may need restrictions, follow-up, or additional testing, and ensure that they meet medical standards needed for safe driving.
Medical Reports cannot be accessed online, as they are tailored to each customer and their specific circumstances
Vision Reports are available online Vision Report Form#430032
Medical Advisory Board (MAB)
The Iowa DOT utilizes a Medical Advisory Board. The board is made up of licensed physicians and specialists who review complex or unusual medical or vision related cases referred to the DOT. Their recommendations help ensure the driver licensing process is fair, consistent, and based on current medical standards. Not all cases are forwarded to the Medical Advisory Board for review.
The board does not make licensing decisions. Instead, it offers professional consultation to the DOT when additional medical expertise is needed. This partnership helps balance public safety and ensures drivers on Iowa’s roads are medically capable of operating a vehicle safely.
Suggested Communication with Patients
To help ensure a smooth licensing process, please discuss any driver license recommendations you provide to the DOT with your patient. This includes advising them of any suggested restrictions, referrals for additional testing, or recommendations for suspension. Clear communication helps the driver understand what to expect before they visit the DOT, prevents confusion or frustration at the service counter, and supports safer decision-making.
Referring the Patient to Occupational Therapy or Driver Rehabilitation
If you determine that a patient may need occupational therapy or driver rehabilitation before you can make a driver licensing decision, please communicate this directly to the patient and provide an appropriate referral.
Clear communication helps the patient understand why additional assessment or training is needed and prepares them for what to expect. Driver rehabilitation specialists and occupational therapists can offer comprehensive evaluations, skills training, and recommendations for restrictions that support safe driving.
Providing the referral up front reduces confusion, supports compliance, and ensures the DOT receives the information necessary to make an informed licensing decision.
After the assessment is complete and you have reviewed the occupational therapy/driver rehab report, you are asked to submit your driving recommendations to the DOT using the Medical Report form provided to the patient or Supplemental Medical Report Form#420010
Special and Restricted Instruction Permits
A Special or Restricted Instruction Permit allows certain drivers, whose license has been denied or suspended for medical reasons or failed testing, or is expired, to continue driving for a limited time while completing the steps needed to regain full driving privileges. The permit is valid for six months and allows the individual to drive a non‑commercial vehicle under the direct supervision of staff from an occupational therapy or driver rehabilitation facility. This allows them time to complete any required testing or evaluations. A favorable medical report must be submitted to the DOT to qualify for this permit.
This physicians guide to special permits provides the steps to follow to support a smooth and efficient process.
Special Permit Resources:
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