Getting your licence back after a brain injury is one of the biggest steps in recovery. For most people it means being able to get to work, see family, and stop relying on lifts.

It is also the step people are most often told to "wait and see" about, without anyone explaining what they are waiting for.

This guide explains what happens in Queensland, what actually gets checked, and how to know when you are ready.

What counts as a brain injury?

Anything that has damaged the brain. That includes:

• A knock to the head from a car crash, fall, assault or sport

• Bleeding on the brain

• Lack of oxygen, for example after a cardiac arrest

• Infection such as meningitis or encephalitis

• Surgery for a brain tumour

Stroke is handled a little differently. If you have had a stroke, read Driving After a Stroke in Queensland.

Do I have to tell Transport and Main Roads?

Yes, if the effects are long-term.

In Queensland you must tell Transport and Main Roads (TMR) about any permanent or long-term condition that could affect your driving. A brain injury with ongoing effects on thinking, movement, vision or seizures falls squarely into that.

You can report:

• Online through the TMR medical condition notification service

• By emailing Form F4355 to mcr@tmr.qld.gov.au

• In person at a Transport and Motoring Service Centre

Your doctor will usually complete a Medical Certificate for Drivers (Form F3712) as well. See Reporting a Medical Condition to Queensland Transport.

If you were in hospital, the hospital team has often already started this. It is worth checking rather than assuming.

How long do I have to wait?

There is no single number, and anyone who gives you one without knowing your case is guessing.

What drives the timing is:

• How severe the injury was. More severe injuries mean longer recovery and later assessment.

• Whether you have had a seizure. Seizures after a brain injury are common and come with their own non-driving periods. Your doctor will advise based on the national standards.

• How fast you are still improving. There is no point assessing someone who is changing week to week. We want a stable picture.

• Whether your specialist has cleared you to be assessed.

For a moderate to severe injury, an assessment is often somewhere between six and 12 months after the injury, once things have settled. Your treating team will guide you.

Why can I not just do a normal driving test?

Because a driving test checks whether you know the road rules and can control a car. That is rarely the problem after a brain injury.

The problems that show up are things a standard test does not look for:

• Reacting slowly when something unexpected happens

• Missing things on one side, often the left

• Tiring quickly, so the first 10 minutes look fine and the next 20 do not

• Getting stuck when the plan changes, such as a closed road or a detour

• Not noticing your own mistakes

• Acting on impulse, or the opposite, freezing when a decision is needed

An OT driving assessment is designed to find exactly these things.

What happens in the assessment?

Two parts, usually two to three hours.

Off road. I come to you. We check your vision including your side vision, your neck and limb movement, and your reaction time. Then we do a set of tasks that look at attention, memory, planning, and how well you cope when you have to do two things at once.

These tasks are not an IQ test and there is no pass mark. They tell me what to watch for once we get in the car.

On road. You drive a car with a second set of pedals, with a driving instructor beside you. We start on quiet streets and work up to busier roads and roundabouts. I deliberately keep you driving long enough to see whether fatigue changes anything, because it often does.

I also give you unexpected instructions along the way. That is not to catch you out. It is because real driving involves changes of plan, and how you handle them tells me a lot.

See What to Expect on the Day.

What are the possible outcomes?

The report goes to your referring doctor, who completes or updates your F3712 for TMR.

Cleared to return to driving. No restrictions.

Cleared with conditions. Common ones after brain injury include automatic transmission only, daylight only, staying within a set area, avoiding motorways, or a limit on how long you drive at a stretch. See Licence Conditions After an OT Driving Assessment.

Driving lessons, then re-assessment. This is a very common outcome after a brain injury, and a positive one. Specific skills are retrained over a set number of lessons with a specialist instructor, then we drive again. Many people who are not ready at the first assessment get their licence back this way.

Not ready yet. Sometimes the answer is that more recovery is needed before another attempt. That is different from never.

Stop driving. Where the difficulties are not likely to improve enough for safe driving. The report sets out exactly what happened and why. See What Happens If You Fail an OT Driving Assessment.

Who pays for it?

It depends on how the injury happened.

• A car crash in Queensland is usually covered by CTP insurance through the at-fault driver's insurer.

• A workplace injury is usually covered by WorkCover Queensland.

• A very serious injury may be covered by the National Injury Insurance Scheme Queensland (NIISQ).

• NDIS may fund it if you are under 65, are self-managed or plan-managed, and have driving in your plan.

• DVA may cover it for eligible veterans.

• Otherwise it is privately funded.

See How Much Does an OT Driving Assessment Cost in Queensland.

Common questions

Can I drive while I am waiting for the assessment? Not unless your doctor has told you it is safe to. If your licence is under medical review, driving before you are cleared can affect your insurance.

I feel completely back to normal. Do I still need this? Often yes. One of the effects of brain injury is that you may not notice your own difficulties. That is not a criticism, it is how the injury works, and it is one of the reasons an outside assessment matters.

Will I have to relearn to drive from scratch? No. You keep the skills you had. What is being checked is whether the injury has affected how you apply them.

What if I have had a seizure since my injury? There is a set non-driving period after a seizure. Your doctor or neurologist will tell you how long it is in your case, and you cannot be assessed until that period is finished.

Can I use my own car? The on-road drive uses a dual control car for safety. If you need modifications, we work that out separately.

How soon can I be seen on the Gold Coast? Steer Driving comes to you across the Gold Coast and surrounding areas. Get in touch and we will let you know current availability.

Ready to book an OT driving assessment on the Gold Coast? Steer Driving is a mobile assessment service covering the Gold Coast and surrounding areas. Whether you already have a referral or you're just getting started, get in touch and we'll guide you through the next steps.

This article was written by Elise, an AHPRA-registered Occupational Therapist and driver assessor. Elise is the founder of Steer Driving, a mobile OT driving assessment practice.

References

Austroads. (2022). Assessing fitness to drive for commercial and private vehicle drivers. Austroads. https://austroads.gov.au/publications/assessing-fitness-to-drive

Queensland Government. (2024). Reporting your medical condition. Department of Transport and Main Roads. https://www.qld.gov.au/transport/licensing/healthy-to-drive/report-medical-condition