By: Clara O’Hara
Transportation and Epilepsy
In the U.S., 700,000 licensed drivers have epilepsy. For people with epilepsy, taking the wheel means considering the need for independence against the need for safety. However, all states allow some people with epilepsy to drive. Twenty-eight states have laws requiring patients with epilepsy to be free of seizures for a single fixed period, with a median restriction of six months. The range is between 3-12 months. Twenty-three states have more flexible approaches to restricting driving, such as varying seizure-free restrictions on individual clinical factors. Many states allow patients to drive after shorter seizure-free periods than stated in their laws.
Procedure for DMV Licensure
Each state has its own regulations, varying greatly. You can visit the website of your state’s department of motor vehicles (DMV) to find out the requirements. In all cases, people with epilepsy must report their condition to their state’s DMV. However, some states may require different people to do the reporting.
Some states will require the person with epilepsy to fill out an application for a license, potentially with a special form. At the time of application for a license or renewal, it will ask the person with epilepsy to notify the DMV of changes in their health status or driving ability. When someone who already holds a driver’s license is diagnosed with epilepsy, that person must notify the DMV.
However, there are some states that want the doctor to contact the DMV, having a significant role in determining driving rights. The doctor may recommend a period of seizure freedom or other requirements before licensing, yet these doctors generally recommend similar seizure-free intervals and other standards similarly to the states with less discretionary rules. Additionally, they should inform their patients of the laws in their state. They also have an important role in informing the patients about the risks as well as alternatives to driving, such as public transportation and other services.
Impact of Transportation on Living
In modern society, driving privileges constitute economic necessity while driving restrictions limit autonomy, restrict access to employment, and reduce self-esteem.
For people with epilepsy, where restrictions prevent license to drive, lack of transportation can affect their daily life. The issues from lack of transportation cause a lower quality of life, socially, psychologically, and economically. In a study of driving among people with epilepsy, 80% of all people stated that driving restrictions reduced quality of living, and 70% believed that they carry a social stigma. It seemed that employment was most affected by the driving restrictions. The lack of public transportation was also regarded as a hurdle by more than 60% of patients in each group with greater than two-thirds of patients relying on other drivers for transportation. This may be the result of workplace safety concerns and employer-employee discrimination, carrying a social stigma.
Lack of transportation in healthcare access also negatively impacts quality of life on people with epilepsy. If a person with epilepsy is unable to drive, or does not have access to transportation, their access to health care may decline. A person with epilepsy will miss appointments, group support meetings, and other important health care (Lea, Rose, May, Winterbauer, Miller and Fitzgerald 2013; Okoro, Strine, Young, Balluz and Mokdad 2005; Silver, Blustein and Weitzman 2012). Not having reliable transportation can cause a PWE to have to reschedule appointments, leading to a lapse in care. Without the ability and licensure to drive, filling new prescriptions or refilling prescriptions can be difficult (Syed, Gerber and Sharp 2013; Welty, Willis and Welty 2010). Often, due to insurance limitations, a PWE has only a small window of time to refill a medication before running out. Transportation issues have been cited as a reason for twenty-five missing medications and increased seizures (Welty, Willis and Welty 2010). If they cannot secure transportation during that time, they may receive their medications late, causing them to miss doses of medication, therefore increasing negative impact on seizures.
Transportation Services for People with Epilepsy
There are many programs and resources available to help people with epilepsy find transportation. Many of the companies or organizations below offer free transportation services in select cities for job interviews or wherever you need to go. Some are community or state-based for people with medical disabilities:
-Uber
-LyftUp
-Volunteer Driver Programs
-Independent Transportation Network America
-Non-Emergency Medical Transportation Services
-State Paratransits
People with epilepsy also may face problems with automobile insurance because insurance companies may not insure them or may charge high rates. Some states offer high-risk insurance pools that provide better access and lower costs for people with disabilities like epilepsy. People with epilepsy are best advised to be truthful on applications for automobile insurance because falsifying information would give an insurer cause to void coverage and might jeopardize claims.
Conclusion
In conclusion, in following DMV regulations, many states allow people with epilepsy to drive, providing autonomy, independence, and easy access to many places; however, some are restricted due to physician stated restrictions or how the state interprets their epileptic seizures. For people with these limitations, it impacts their quality of life, psychologically, socially, and economically. Many programs and resources can help and confront the limitations in receiving transportation, such as volunteer ride programs, rider apps, or state riding programs.
Resources:
Bautista, R. E. D., & Wludyka, P. (2006). Driving prevalence and factors associated with driving among patients with epilepsy. Epilepsy & Behavior, 9(4), 625–631. https://doi.org/10.1016/j.yebeh.2006.08.020
If I Have Epilepsy, Can I Drive? (2004, May 27). WebMD. https://www.webmd.com/epilepsy/guide/seizures-driving
Jayagopal, L. A., Samson, K. K., & Taraschenko, O. (2018). Driving with drug-resistant and controlled seizures from a patient’s perspective: Assessment of attitudes and practices. Epilepsy & Behavior, 81, 101–106. https://doi.org/10.1016/j.yebeh.2018.01.023
Krauss, G. L., Ampaw, L., & Krumholz, A. (2001). Individual state driving restrictions for people with epilepsy in the US. Neurology, 57(10), 1780–1785. https://doi.org/10.1212/wnl.57.10.1780
Krumholz, A. (2009). Driving Issues in Epilepsy: Past, Present, and Future. Epilepsy Currents, 9(2), 31–35. https://doi.org/10.1111/j.1535-7511.2008.01283.x
Thorbecke, R., & Pfäfflin, M. (2012). Social aspects of epilepsy and rehabilitation. In Handbook of Clinical Neurology (pp. 983–999). Elsevier BV. https://doi.org/10.1016/b978-0-444-52899-5.00042-3
