The surgery is behind you. The prosthetist has fitted you, or you are waiting. And somewhere in the back of your mind is a question you may not have asked out loud yet. Will I be able to drive?

Many people with a leg amputation do return to driving. How that looks depends on which leg, what kind of car you drive, and whether you use a prosthesis. This article explains the process in Queensland.

Which leg makes a difference?

A lot of the answer depends on which leg is affected and what the car needs you to do.

• Left leg, automatic car: you may need little or no change, because an automatic car does not use the left foot.

• Right leg, automatic car: the right foot works the accelerator and the brake. You may need a left-foot accelerator or hand controls.

• Either leg, manual car: a manual car needs a clutch. Moving to an automatic is usually part of the answer.

• Both legs: hand controls are the usual solution.

These are starting points, not promises. An OT works out what suits you.

What do the vehicle changes look like?

The modifications you may hear about include:

• a left-foot accelerator, which lets you work the accelerator and brake with your left foot

• hand controls, a push-pull or lever system that lets you brake and accelerate with your hands

• a steering aid, such as a spinner knob, for one-handed steering

• a pedal guard, which stops you hitting the original accelerator by mistake

Our guide to vehicle modifications for drivers in Queensland explains who does what, and in which order.

What about driving with a prosthesis?

Some people drive using their prosthesis. Others prefer to drive without it and use vehicle modifications instead. Both are options.

Austroads, the national guidance, says a prosthesis can be an alternative to vehicle modification only when an occupational therapist with the right expertise confirms that it is suitable, and you have shown you can drive safely using it. That includes keeping uninterrupted observation of the road. An OT also checks strength, endurance and sensation in the residual limb.

What happens in an OT driving assessment?

There are two parts. Off the road, the OT looks at strength, coordination, reaction time and how you move between the pedals and controls. If you use a prosthesis, the OT looks at how it works for driving.

On the road, you drive in a driving instructor’s car fitted with dual controls. If modifications are needed, they are usually fitted and you have some practice before the on-road part. Our post on what to expect on the day goes through a typical session.

The OT report goes to your doctor. Your doctor submits an updated Medical Certificate for Drivers to Transport and Main Roads (TMR). TMR then decides about your licence. See what happens after your OT driving assessment.

What will my licence say?

If you need modifications, TMR may add conditions to your licence. Two common ones are automatic transmission only, and a condition listing the specific vehicle aids you must use. TMR gives examples of conditions in its guidance for people with leg disabilities and loss of limb use. Our post on licence conditions after an OT driving assessment in Queensland explains each code.

Do I have to tell TMR?

In Queensland you must tell TMR about a long-term medical condition that is likely to affect your ability to drive safely. A leg amputation is likely to meet that test for many people. Your doctor can confirm and complete the Medical Certificate for Drivers. See reporting a medical condition to Queensland Transport.

When you may not need a full assessment

Not everyone does. If you are driving an automatic car and your left leg is affected, your doctor may be satisfied with the medical certificate alone. If you are unsure, ask your doctor what they need to complete it.

When you are in the early weeks after surgery, your surgeon and rehabilitation team decide when it is safe to begin thinking about driving. An assessment comes after that.

How long does it take?

It varies. The steps are medical clearance, assessment, any modifications, practice in the modified vehicle and a final check. We will not give you a fixed timeline, because it depends on your recovery, prosthesis fitting and how long modifications take to arrange.

Who pays?

It depends on how your amputation happened and what funding you have. Our guide to what an OT driving assessment costs in Queensland explains the options.

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.