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At-Risk Driver Program for Medical Professionals


What is a Medically At-Risk Driver?

Oregon’s At-Risk Driver Program is charged with balancing both public safety and the need for transportation independence and self-sufficiency. The goal of the program is to prevent injury or death that may result from impairments affecting a person’s ability to drive safely (OAR 735-074-0060).

Medical Professionals are statutorily required to report…

  • Drivers 14 years of age or older who may no longer be able to drive safely due to “severe and uncontrollable” functional and/or cognitive impairments resulting from a medical condition. See Whom to report... for more information.

Medical Professionals may report…

  • A person whose cognitive or functional impairment affects their ability to safely operate a motor vehicle, whether or not it is “severe and uncontrollable”. See When to report... for more information.

If you are not a medical professional but have a concern about someone’s ability to drive safely, visit our page about Reporting an Unsafe Driver for more information.


Oregon licensed physicians and health care providers “required to report to the department a person whose cognitive or functional impairment affects that person’s ability to safely operate a motor vehicle” (ORS 807.710(2)​) include:

  • Physicians licensed in Oregon who hold a degree of Doctor of Medicine, Doctor of Osteopathic Medicine, or Doctor of Naturopathic Medicine, specifically:
    • ​Primary Care Providers;
    • Physicians, physician assistants or nurse practitioners providing specialist evaluation or ongoing care based on a referral from the patient’s primary care provider related to a cognitive or functional impairment; and
    • Physicians or health care providers providing emergency health care services to a person who does not have a primary care provider.
  • Health care providers “licensed, certified or otherwise authorized or permitted by the laws of this state to administer health care,” specifically:
    • ​Chiropractic Physicians, 
    • Nurse Practitioners, 
    • Occupational Therapists, 
    • Physical Therapists, 
    • Optometrists, 
    • Physician Assistants, and 
    • Podiatric Physicians or Surgeons.
A designated physician or health care provider may at any time report to the department a person whose cognitive or functional impairment affects that person’s ability to safely operate a motor vehicle, without regard to whether that report is required by rules of the department. (ORS 807.710(5)​).
Drivers must be reported whose impairment(s) is both:
  • ​“Severe” – “the impairment substantially limits a person’s ability to perform activities of daily living, including driving, because it is not controlled or compensated for by medication, therapy, surgery or adaptive devices.” (OAR 735-074-0080(11)); and
  • Uncontrollable” – “the impairment persists despite efforts to control or compensate for it by medication, therapy, surgery, or adaptive devices.” (OAR 735-074-0080(12)
​Please also report any driver whom you have serious concern about their ability to drive safely, regardless of severity or control.

Note: DMV can process a Mandatory Impairment Referral as a non-mandatory report when it does not meet the requirements for a Mandatory report.

Whom not to report…
On a Mandatory Impairment Referral – drivers whose impairment(s):
  • ​Is a “temporary impairment for which the person is being treated by a physician or health care provider and which is not expected to last more than six months” (OAR 735-074-0080(11))
  • “…Treatment by medication, therapy, surgery or adaptive devices is currently under evaluation” (OAR 735-074-0080(12)); or
  • Is of concern to their family but you have not seen evidence of it/(them).

    ​When family reports an impairment(s) you are not seeing
    , consider:
    • ​​​A referral to a Driver Rehabilitation Specialist for assessment (see Related Resources below); or
    • ​Recommending submission of a Driver Evaluation Request​ by concerned family members as anyone can report (see Confidentiality and Liability​ below).​

      Note:  As DMV is statutorily prohibited from taking action on diagnosis or medications alone, the Driver Evaluation Request must include specific driving behaviors as well as examples of the behaviors – such as when, where and under what circumstances those behaviors occurred – in order for DMV to take action on a Driver Evaluation Request. 

Report your patient when you become aware that they may no longer be able to drive safely, even:
  • ​If you think or expect another provider or family member has, will, or should; or
  • When you are concerned they may no longer be able to drive safely though the condition(s) may not meet the criteria for “severe and uncontrollable”.  
Note: DMV can process a Mandatory Impairment Referral as a non-mandatory report when it does not meet the requirements for a Mandatory report.

Complete a Mandatory Impairment Referral and submit it to DMV according to the instructions included on the form.  For DMV to accept and take action on a Referral, the following fields must be completed:
  • ​Patient name, address, date of birth, and sex.
  • Impairment checkboxes.  See Impairment Definitions (OAR 735-074-0130​) on the second page of the form if you’re unsure which boxes apply.
  • A description of how the driver is affected by the impairments, since DMV is statutorily prohibited from taking action on diagnosis or medications alone.
    • ​Please ensure the description is likely to make sense to a lay person such as a DMV staff member, or an Administrative Law Judge who would see the referral should a driver exercise their right to a hearing. 
    • Descriptions under Impairment Definitions on the second page may be helpful with this.  
  • ​How you qualify as a mandatory reporter.
  • Provider’s information, including a legible phone number and license number.
  • Provider’s signature.
Tip: 
  • ​Use plain language. Audiences for the Referral do not include medical professionals. DMV staff make initial determinations based on what they are able to understand at face value from the Referral, along with any attached documentation (i.e., progress notes, test results, …). Similarly with Administrative Law Judges when a driver requests a hearing.  DMV’s Medical Determination Officers see the initial reports only after being processed by staff.​

  • The report is received and screened by Driver Specialty Services against required report content (OAR 735-074-0120​).  This can take several days to complete.
  • The reporter is notified of acceptance or rejection by mail. When rejected, the reason for the rejection is included in the letter. The most common reason for rejection is failure to meet statutorily set minimum reporting requirements.  This often looks like:
    • ​Incomplete fields;
    • Incomplete or unclear descriptions of how a patient is affected, where a lay person is unable to determine how the patient’s ability to drive safely is impacted (i.e., a diagnostic term such as “Mild Cognitive Impairment” which may have severe affects that a lay person wouldn’t be aware of; or a description of ‘unsteady and falls’ that is not immediately apparent to non-medical readers how that affects the patient’s ability to drive safely); and
    • Diagnosis or medication only with no description of how the patient is affected.
  • When accepted as a Mandatory report:
    • ​An Immediate Suspension is issued giving the driver five days’ notice before taking effect.
    • A Driver Medical Report (DMR) is included with the Suspension Notice for a provider to complete, requesting additional information about the driver’s medical condition(s) for use by DMV’s Medical Determination Officer (MDO) to determine eligibility to test. The Medical Determination Officer may request additional information subsequent to the DMR and prior to making a determination.
    • Once medical eligibility is achieved, testing can be scheduled.
    • Until a driver is denied further testing (for safety reasons), they will continue to be able to attempt to regain their driving privileges.
  • When accepted as a non-mandatory report:
    • ​An immediate suspension will be issued (as described above) only when the report gives DMV reason to believe a person may endanger people or property if not immediately suspended, such as more than one recent Loss of Consciousness or Control (i.e., seizure, TIA, …) or a problem condition involving alcohol or drug abuse.
    • Otherwise, a suspension will be issued that will take effect 60 days from the date of the notice – with the right to request and receive a 30 day extension – to give the driver time to obtain any required documents and/or re-take DMV tests before the suspension becomes effective.
  • Drivers have a right to a hearing. The report and related documentation become hearing exhibits when a hearing is requested so cannot be kept confidential.

  • Submission of a Mandatory Impairment Referral complies with HIPAA regulations for the release of medical information.
  • Reports are confidential and used by the department only to determine the qualifications of persons to drive safely. (ORS 807.710(6)).
  • When a driver requests a hearing or files a lawsuit against DMV, DMV may not be able to keep a report and corresponding documentation confidential.
  • A designated physician or health care provider is immune from civil liability:
    • ​When a report is made in good faith; or
    • For failure to make a report under this section, without regard to whether that report is required by rules of the department. (ORS 807.710(5)​)​.
  • Submit an online inquiry​.
  • Contact the At-Risk Program Coordinator: 503-945-5295.​