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Social and Leisure Matters after Stroke: Driving Eligibility

Post-stroke management on going back to driving.

Physical and cognitive changes after stroke may restrict your ability to engage in some activities temporarily or on a longer-term basis. You may be eager to resume driving.

Can I drive after a stroke?

This is best discussed with your specialist doctor (neurologist / neurosurgeon) and the stroke care team. You need to be (i) medically stable after your stroke, with low risk of stroke recurrence and compliant to the stroke treatment, (ii) assessed to have no new deficits that could affect your driving abilities.

According to the Singapore Police Force (2023), "if you have an existing medical condition or physical disability that may render you unfit to drive in Singapore under the Singapore law, you will be asked to obtain a confirmation of your fitness to drive at any Singapore registered medical practitioner."

Medical doctors will make an individualized assessment and recommendation for each stroke patient. The doctor will consult with his stroke care team and also refer to the Medical Guidelines on Fitness to Drive (2011) by Singapore Medical Association.

A brief summary on the SMA Medical Guidelines on Fitness to Drive for Stroke Condition

Persons with disability such as seizure, significant visual field defects, double vision, mental or coordination impairment that is assessed to be severe enough to interfere with control of the vehicle should not drive.
Group 1 (Class 1, 2 & 3 Licences)

Persons without any residual disability may resume driving after 1 month.
Persons with mild residual disability that may not interfere with control of the vehicle may be allow to drive if they pass a driving assessment (by certified driver-assessor occupational therapist) and a final review by a neurologist.

3. Group 2 (Class 4, 5 & Vocational Licences)

Persons may return to driving after 1 year post stroke with full recovery
Persons must pass the driving assessment (by certified driver assessor therapist) and a final review by a neurologist.

Can I drive after a Transient Ischaemic Attack (TIA)?

Group 1 (Class 1, 2 and 3 license)

You are only allowed to drive once free from TIA for 1 month
If you have multiple TIA, you will need to wait for 6 months before returning to driving.

Group 2 (Class 4, 5 and vocational license)

You are allowed to drive once free from TIA for 6-months
If you have a multiple TIA or brainstem TIA, you will require to be free from TIA for more than 1 year before you can return to driving.

Where can I have my driving assessment?

Your doctor will refer you to a certified driver-assessor occupational therapist who will do a comprehensive driving assessment at one of the following hospitals:

If needed, the certified therapist will arrange for you to have the correct vehicle modifications (e.g. spinner knob, left foot accelerator, hand controls) and specialized driving rehabilitation / refresher lessons with qualified driving instructors (from Handicap Welfare Association or specialist personal driving instructors) to help you to return to driving properly.

All final driving assessment outcome reports from the certified driver-assessor occupational therapist will need to be endorsed by the referring doctor, to certify medical fitness to drive after stroke.

Driving without fitness certification?

Everyone plays a part in keeping the road safe. Driving without a medical fitness certification may pose a danger to self and other road users.

Will the Traffic Police (TP) or the Land Transport Authority (LTA) be informed of my condition?

At present, there is no statutory requirement for doctors to notify the TP or LTA. However, the Singapore Medical Council states that there is no breach of medical confidentiality if doctors notify the authorities of the patient's unfitness to drive if their driving poses a definite danger to the public.

If you do not attend Occupational Therapy Driving Assessment after a medical referral has been made, it means that your functional fitness-to-drive has not been determined for your referring doctor to provide a final medical fitness-to-drive endorsement. As such, you should update your referring doctor about your non-attendance at the Occupational Therapy Driving Assessment during your medical review.

If you are assessed to be fit to drive only certain types of vehicle with or without vehicle modifications e.g. automatic car only; automatic car with left foot accelerator or spinner knob; hand controls, you will be advised by DARP or DARS to also notify TP after your doctor has endorsed the final driving report. This enables TP to update your driving licence status.