Driving with a brain tumour

A brain tumour diagnosis can affect your ability to drive safely and you may need to surrender your license to the agency that issued it.

Not being able to drive is one of the things that people living with a brain tumour often report as most difficult to deal with, in terms of changes to their daily life. The loss of a driving licence is often seen as loss of independence.

But, if you’ve been diagnosed with a brain tumour, you must tell the Driver & Vehicle Licensing Agency (DVLA) or, if you live in Northern Ireland, the Driver& Vehicle Agency (DVA).

This is because it could affect your ability to drive safely. This will depend on the type, grade and location in the brain of your tumour and also on the treatment and side-effects you have.

It’s very common to be told by the DVLA or DVA to give up your driving licence. This may be temporary, but, unfortunately, some people won’t be able to drive legally again. If you have to surrender your licence there are a variety of services and practical schemes to help you get around.

Am I fit to drive?

After receiving a brain tumour diagnosis you should speak to your healthcare team or GP about assessing your fitness to drive.

If healthcare professionals decide that you are unfit to drive, the length of time you'll be unable to drive will depend on:

• the type of your brain tumour you have
• the grade of your brain tumour
• where the tumour is in your brain
• the type of treatment you’ve had and when it was
  completed.

For many types of high grade tumour, you won’t be allowed to drive for at least two years, while for lower grade tumours, it may be one year, but it can be less.

For example, with low grade tumours in the cerebellum or brain stem, or with grade one meningiomas, you can generally drive once you’ve recovered from treatment. Unless you've had a craniotomy, in which case you won't be able to drive for six months.

In all cases, there must be no other factors or after-effects of treatment that could affect your ability to drive, before you’re allowed to drive again.

These time spans are from completion of primary treatment. This can include radiotherapy and chemotherapy that you may have after, or instead of, surgery. Your doctor can advise you whether the treatment you’re having is considered primary treatment.

Seizures

Around 60% of people with a brain tumour will experience a seizure at least once and one of the major factors is the risk, or chance, of you having a seizure as a result of the tumour itself or your treatment.

If you’ve had a seizure of any type, you won’t be allowed to drive for a certain period. This will usually be for at least one year from your last seizure but for some low grade tumours it may be less, and for higher grade tumours, it’s likely to be more.

Some people may not be able to drive again, due to having repeated seizures. This is the case whether your consciousness is affected during your seizures or not.

Sight problems

Around 28% of patients with a brain tumour report problems with their vision.This can include hallucinations, double vision, sensitivity to light and reduced field of vision.

Driving while experiencing sight problems could put you and others at serious risk. Though it may be hard to hear, combination of these factors and/or your diagnosis, could mean you won’t be able to legally drive again.

Can I drive if I had a brain tumour as a child?

If you had a brain tumour as a child, with no recurrence, and don’t experience other disqualifying side-effects as a result of your tumour, you can have a regular driving licence and keep it until the usual age of 70.

Informing the DVLA or DVA

When should I tell them?

It’s a legal requirement to inform the DVLA or DVA as soon as possible after being diagnosed with a brain tumour.

You can be fined up to £1,000 if you don’t tell the DVLA or DVA about your brain tumour diagnosis. You may also be prosecuted if you’re involved in an accident caused because your tumour or the treatment you've received is affecting your ability to drive.

At any time when you’re allowed to drive, you must also tell the DVLA or DVA if:

• your condition worsens
• you begin taking any medication or treatments that could affect your driving.

Before you talk to the DVLA or DVA you should speak to your healthcare team about whether you’re fit to drive.

What if my doctor thinks I'm currently unfit to drive?

If a doctor says you should stop driving for three months or longer, you must voluntarily give up your licence to the DVLA or DVA. This is known as surrendering your licence and once you have surrendered your licence, you must stop driving.

Once you've informed the DVLA or DVA about your brain tumour diagnosis, they will start an enquiry into your fitness to drive. This involves sending a form to you and your doctor, asking about your health, your tumour, any treatment you're receiving and any side-effects you’re experiencing.

If you don’t surrender your licence and the DVLA or DVA find you unfit to drive, they will take away your licence. This is known as having your licence revoked.

Having your licence revoked may feel more distressing than surrendering it yourself. Additionally, you may find it more difficult to get your licence back if your licence has been revoked, rather than surrendered. It also takes longer before you can drive again.

What if my doctor thinks I'm currently fit to drive?

You must still tell the DVLA or DVA about your brain tumour, but you can legally continue to drive until they have finished their enquiries.

If the DVLA or DVA are satisfied you meet the standard to drive then you can continue driving, although they may change your licence to a short-term medical review licence. This is most often for between one and three years, at the end of which you’ll need to reapply to keep your licence.

If the DVLA or DVA aren't satified you meet the standard to drive, then they will revoke the licence and give you information about how long you can’t drive for. Unfortunately, the process of reapplying for your licence after this time will be more complicated because your licence was revoked.

How do I get my licence back?

The DVLA or DVA will have sent you a letter when your licence was surrendered or revoked, this will have contained information about how long you needed to wait before getting a new licence.

If you surrendered your licence, you can apply to have it back eight weeks before the end of the period for which you’ve been disqualified to drive. You will need to check with your doctor first that they think you’re fit to drive before applying to get your licence back.

If you voluntarily surrendered your licence and have now applied for a new one, you may be able to drive under Section 88 of The Road Traffic Act 1988, while the DVLA are processing your application. Similar rules apply in Northern Ireland and you may be able to drive under the Road Traffic (NI) Order 1981 while the DVA process your application.

If your licence was revoked, the same application process will apply, but you can’t start driving until the DVLA or DVA decides you’re medically fit to drive. This means you can’t drive under Section 88 or the Road Traffic (Northern Ireland) Order 1981.

To reapply for your licence in England, Wales and Scotland, you’ll need to fill in a D1 application form and form B1. The D1 form and additional information you need to make an application (the D1 Pack) can be ordered online and are also available from the Post Office.

In Northern Ireland, you need to complete the form DL1 and form B1. The DL1 form is available from main post offices and MOT test centres.In all countries of the UK, you may need to send evidence of your fitness to drive. The letter you received when your licence was revoked or surrendered, will tell you if this is the case.

Will I get a full licence back?

When you get your driving licence back, it may be medically restricted and only be valid for a short period of time.A medically restricted licence still counts as a full UK licence, they are normally valid for between one and three years.

At the end of this time period you need to check with your doctor that you are still fit to drive. If your doctor thinks you’re fit to drive, you can then apply for your licence to be renewed.

Having a medically restricted licence doesn’t necessarily mean you can drive legally for the length of time the licence covers. If your tumour regrows or you experience side effects that affect your ability to drive, you must tell the DVLA or DVA. This may lead to your licence needing to be surrendered or revoked again.

Can I appeal against a decision made by the DVLA or DVA?

If you disagree with the decision by the DVLA or DVA to not to give your licence back, you can write to them and ask for your case to be reviewed. Make sure you include your reference number and any new medical evidence to support your claim.

If your request for a review isn’t successful, you can then make a formal appeal. The DVLA or DVA should've sent you details of the appeals process when they told you of their decision to not give your licence back.

It’s important to remember that if you don’t meet the driving rules for people with a brain tumour (including those concerning epilepsy or visual impairment), the DVLA or DVA can’t legally re-issue your licence.

If you do decide to appeal, it's advisable to get legal advice and there are a number of things to keep in mind:

• Before you appeal, you must let the DVLA or DVA know you’re going to appeal
• If you don’t win, you have to pay the DVLA’s costs
• There’s a time limit on when you can appeal, this is measured from the date of the DVLA or DVA’s decision. In England and Wales this is six months, in Scotland it's 21 days and in Northern Ireland it's three months.
• If you live in England or Wales, you need to appeal to your local magistrate’s court.
• If you live in Scotland, you need to appeal to the Sheriff’s Court.
• In N. Ireland, you must appeal to the Clark of Petty Sessions in the area where you live. You also need to send a copy of the Notice to Appeal to the Departmental Solicitors Office in Belfast at least 14 days before the hearing.

Practical support for driving with a brain tumour diagnosis

There are various concessions that you can apply for if you're still able to drive with your diagnosis. You may still be able to apply for these, if you’re being driven by a carer rather than driving yourself.

Blue Badge scheme

Blue Badge parking permits let disabled drivers and passengers park nearer to where they're going. You can also display the badge in other cars or taxis when you’re using them.

The Blue Badge scheme is available to people who are disabled or have a health condition that affects their mobility long-term and are given by your local council following a disability assessment. The Blue Badge scheme operates throughout the UK and is also recognised in some European countries.

It's important to note that eligibility will differ in some areas of the UK.

You can apply for a Blue Badge and find full information about eligibility requirements from your local council.

London Congestion Charge

If you’re being treated in London and you’re a Blue Badge holder, you can also register for 100% discount off the congestion charge. Even if you don’t drive or own a car. You can get a discount on up to two cars that you normally travel in, for example for carer's car.

You can apply online, but need to send copies of certain documents to show you’re entitled to the discount. These include your Blue Badge and proof of identity. The copies can be sent as images online or by post.

You can find more information on the Transport for London website.

Toll concessions

Toll concessions are available for people classed as disabled at some river crossings, bridges and tunnels.

However, the qualifying conditions vary from applying for vouchers if you receive certain benefits, holding a Blue Badge, or having a registered disabled vehicle.

Vehicle tax exemption

You can get vehicle tax exemption or reduction if you get the following benefits:

• higher rate mobility component of Disability Living Allowance (DLA)
• enhanced rate mobility component of Personal Independence Payment (PIP).

The car must be registered in your name or that of your nominated driver. It can only be used for your personal needs, not the nominated driver’s personal use and you can only have exemption on one car at a time.

Making driving easier

Depending on how your brain tumour diagnosis affects your ability to drive, it may be possible to have your car adapted to help reduce the effect on your daily life. Adaptations can include hand controls instead of foot controls, left-foot accelerators, adapted mirrors and wheelchair hoists.

The Research Institute for Disabled Consumers (RiDC) and DrivingMobility provide more information about choosing an adapted car or having your car adapted.

What if I don’t get my licence back?

For many people, driving is an essential part of their daily life. Not being able to drive can impact all areas of your life, including employment, how to pick up the children, taking part in leisure activities, getting to a medical appointment and even where you live.

It's not surprising then that people living with a brain tumour often report the loss of their licence as one the most difficult changes to deal with.

Emotional support

It can be helpful to know this is a common way to feel and that you aren't alone. Joining a support group or online community can help you ‘meet’ others in a similar situation and discuss your worries and share ideas.

You can also talk to your Clinical Nurse Specialist (CNS) or key worker for psychological and emotional support. They may be able to signpost other forms of help.

Being driven by a carer

After surrender your licence or having it revoked, you may find that a carer or loved one becomes your driver. You can still apply for the Blue Badge Scheme, even if you’re not driving, and your carer can use it when they take you out.

People in this situation have said that, if it’s possible and after discussion with the driver, it can be helpful to change your car for one with more doors and more room for carrying mobility equipment.

Help when using public transport

You may also be entitled to financial or practical support when using public transport, including free or concessionary fares.

Many areas also have community transport or charities that provide door-to-door trips to shopping centres or medical appointments.

Access to Work

If you are working, you may also be able to apply for an Access to Work grant to help you get to and from work if your diagnosis means you're unable to drive or use public transport.