Persons applying for or holding a Texas drivers license and having a physical or mental condition, the extent of which cannot be determined by the department, are referred to the Medical Advisory Board for further evaluation.

1. (1) Guidelines for referral for physical conditions are as follows.

   1. (A) Eye diseases:

      1. (i) under the care of a physician, excluding the fitting of lenses when no disease is present;
      2. (ii) applicants requiring the use of telescopic lenses to pass the vision test must successfully complete a comprehensive road test before licensure.

   2. (B) Cardiovascular diseases:

      1. (i) heart diseases;

         1. (I) if applicant for Class A or Class B license has had a heart attack within the past three years;
         2. (II) if applicant for Class C license has had a heart attack during the past year or is under the care of a physician;

      2. (ii) cerebral vascular diseases--strokes, cerebral hemorrhage, or clots;

         1. (I) if applicant for Class A or Class B license has had an episode of loss of consciousness with or without convulsions within the past three years, has blacked out for any reason within the past three years, or is under the care of a physician;
         2. (II) if applicant for Class C license has had a single episode, or recurrent episodes, of loss of consciousness with or without convulsions in the past year, has blacked out for any reason in the past year, or is under the care of a physician;
      3. (iii) hypertension--high blood pressure. All applicants, if under the care of a physician;
      4. (iv) blood vessel disorders (aneurism-abnormal dilation of the blood vessels). All applicants, if under the care of a physician and a qualifying road test has confirmed considerable interference with braking or acceleration.

   3. (C) Diabetes mellitus:

      1. (i) if applicant for Class A or Class B license is taking insulin injections, has blacked out or lost consciousness within the past three years, or is under the care of a physician;
      2. (ii) if applicant for Class C license has had an insulin or hypoglycemic reaction (insulin shock) in the past year, has blacked out or lost consciousness in the past year, or is under the care of a physician.
   4. (D) Respiratory conditions (advanced emphysema or corpulmonale-heart disease which is secondary to the disease of the lungs). All applicants, if under the care of a physician and a qualifying road test has confirmed that shortness of breath or audible wheezing considerably affects safe driving ability.
   5. (E) Impairments of upper or lower extremities, or both (partial or complete paralysis; loss of any of the extremities-hand, arm, foot, leg; stiffness of joints from arthritis or other conditions). All applicants under the care of a physician, and a qualifying road test has confirmed that the impairment considerably affects safe driving ability.
   6. (F) Neurological disorders. All applicants who have had an epileptic seizure within the past three years or are under the care of a physician for any other seizure, dizzy spell, or similar disorder.

   7. (G) Musculoskeletal disorders. All applicants unless previously licensed after successful completion of a road test and:

      1. (i) appropriate restrictions have been applied to the license, if necessary; and
      2. (ii) the applicant's condition has not deteriorated since the last road test as determined by observation, questioning, and license restrictions.

2. (2) Guidelines for referral for mental or emotional disorders are as follows:

   1. (A) Mental patients. All applicants, as follows:

      1. (i) involuntary mental patient committed for indefinite hospitalization;
      2. (ii) involuntary mental patient with a guardian appointed;
      3. (iii) all other mental patients if treated for mental, nervous, or emotional conditions within the past three years.

   2. (B) Alcoholism. All applicants, as follows:

      1. (i) three or more convictions for offenses involving drinking, the last offense occurring within past two years;
      2. (ii) involvement in two or more accidents while drinking, the last incident occurring within past two years;
      3. (iii) a reliable report that applicant has had an active drinking problem within the past two years;
      4. (iv) admits to an active drinking problem within the past two years;
      5. (v) under the care of a physician.

   3. (C) Drug abuse. All applicants, as follows:

      1. (i) addiction to any drug affecting safe driving ability;
      2. (ii) a reliable report that applicant has had an active drug problem in the past two years;
      3. (iii) admits to an active drug problem in the past two years;
      4. (iv) under the care of a physician.
   4. (D) Multiple impairments, which in combination affect safe driving ability although a single impairment might not. All applicants, if under the care of a physician and a qualifying road test has confirmed considerable interference with safe driving ability.
3. (3) Guidelines for referral for other conditions are as follows for other serious mental or physical condition: All applicants, if under the care of a physician, and a qualifying road test has confirmed that safe driving ability is considerably affected by the condition.

4. (4) Terms defined.

   1. (A) Under the care of a physician--having been referred to for treatment or having received treatment from a physician for the medical condition or conditions indicated in the past 12 months without a release from further treatment. This does not apply to a condition(s) diagnosed over 12 months ago and treatment consisting of only periodic visits to a physician for check up and maintenance.

   2. (B) Active drinking problem--use of alcoholic beverages to the extent of interfering with driving, working, social, or family responsibilities as confirmed by any one of the following occurring in the past six months:

      1. (i) an arrest involving alcohol;
      2. (ii) a reliable family report of excessive use of alcohol;
      3. (iii) a contact with a social agency because of the use of alcohol;
      4. (iv) demonstrated psychological dependence on alcohol.

   3. (C) Active drug problem--use of drugs to the extent of interfering with driving, working, social, or family responsibilities as confirmed by any one of the following occurring in the past six months:

      1. (i) an arrest involving drugs;
      2. (ii) a reliable family report of use of drugs;
      3. (iii) a contact with social agencies because of use of drugs;
      4. (iv) demonstrated psychological dependence on drugs.
5. (5) Guidelines for referral of alcohol or drug dependency. An applicant whose presents a written statement from the attending physician, hospital administrator, or treatment center administrator verifying successful completion of an alcohol or drug treatment program (except the DWI Education Program required under the Code of Criminal Procedure, Article 42.12, §6f) dated subsequent to the last known report or episode shall not be referred to the Medical Advisory Board.

Source Note:The provisions of this §15.58 adopted to be effective January 1, 1976; amended to be effective September 19, 1978, 3 TexReg 3109; amended to be effective May 23, 1980, 5 TexReg 1795; amended to be effective January 29, 1985, 10 TexReg 173; amended to be effective September 13, 1989, 14 TexReg 4472.