Can You Drive with Epilepsy in NSW? The Rules and the Assessment Explained

Epilepsy and driving is a topic with strict rules, and for good reason. A seizure behind the wheel is dangerous, not just for the person having it but for everyone on the road.

That said, many people with epilepsy drive safely their whole lives. The key is understanding the rules, working with your neurologist, and (in some situations) completing an OT driving assessment.

This article explains how epilepsy and driving are managed in NSW.

You must report epilepsy to Transport for NSW

Like all medical conditions that can affect driving, epilepsy must be declared to Transport for NSW. In practice, this is usually done through your neurologist or GP, who completes the Transport for NSW Fitness to Drive form.

Failing to declare epilepsy has serious consequences. If you have a crash and it's found that you had an undeclared condition, you may be uninsured and face legal action.

The non-driving period after a seizure

The Austroads Guidelines (the national medical standards for driving) set out specific non-driving periods after a seizure. These are determined by your neurologist based on your individual circumstances, but as a general rule:

Private (Class C) licence holders typically need to be seizure-free for a minimum of 6 months before returning to driving. Longer periods may apply depending on the type of seizure, the cause, and your treatment response.

Commercial licence holders face stricter rules, generally requiring a significantly longer seizure-free period.

These are minimums. Your neurologist may recommend longer based on your specific situation, particularly if seizures have been difficult to control or if there are additional risk factors.

Steer Driving assesses private vehicle drivers only. If you hold a commercial licence, you'll need to speak with a provider that specifically assesses heavy vehicle or commercial drivers.

When is an OT driving assessment required?

Not every person with epilepsy needs an OT driving assessment. If your seizures are well-controlled, you've met the required seizure-free period, and there are no other driving-related concerns, your neurologist may clear you to return to driving without an OT assessment; however, this is not always the case.

An OT driving assessment is typically recommended when:

• Your epilepsy is associated with other conditions that may affect driving

• Your medications are causing side effects that may impact driving (for example, drowsiness, slowed reaction time, or cognitive effects)

• There are additional medical conditions that warrant a comprehensive driving assessment

• Transport for NSW has specifically requested an assessment

• There are additional complexities related to your epilepsy type and driving

In these situations, your neurologist and/or GP will refer you for an OT driving assessment as part of your return-to-driving process.

What the OT driving assessment involves

The assessment is the standard two-part evaluation used for all fitness-to-drive referrals.

Part 1: Off-road (clinical) assessment

This is conducted at your home and covers:

Medical and driving history. A conversation about your epilepsy (type, frequency, triggers if known), your medications, when you last had a seizure, and your current driving situation.

Vision screening. Visual acuity, visual fields, and related visual skills.

Cognitive assessment. Attention, processing speed, decision-making, and spatial awareness. This is particularly relevant if your medications may be affecting cognition, or if there's an underlying condition (like a brain injury causing the epilepsy).

Physical assessment. Strength, range of motion, coordination, and reaction time.

Part 2: On-road assessment

You'll drive for approximately one hour with the OT and a specialist driving instructor in a dual-controlled vehicle, in your local area.

The OT observes your general driving performance, looking for any signs that your medical situation (including medication effects) is affecting your ability to drive safely.

Possible outcomes

Fit to drive with no restrictions. Your epilepsy is well-managed and there are no additional concerns. You can return to driving (assuming you've met the required seizure-free period set by your neurologist).

Fit to drive with conditions. Licence conditions may be applied based on your situation.

Not fit to drive. If the assessment identifies safety concerns, the OT may recommend that you don't return to driving at this time. This may be reviewed in the future if your situation improves.

The OT report goes to Transport for NSW, your neurologist or GP, and you.

Ongoing responsibilities

Even after you return to driving, you have ongoing responsibilities:

Report any further seizures to Transport for NSW. If you have a seizure after returning to driving, you must stop driving immediately and notify Transport for NSW through your doctor. The non-driving period resets.

Attend your medical reviews. Most people with epilepsy are required to have periodic reviews with their neurologist or GP. These reviews inform whether your driving status should continue unchanged.

Be honest about triggers. If you know your seizures are more likely in certain situations (sleep deprivation, alcohol, specific triggers), managing these isn't just about your general health. It's about your legal responsibility as a driver.

Don't miss medication doses. Missed or inconsistent medication is one of the most common causes of breakthrough seizures. Taking your medication reliably is part of being a safe driver with epilepsy.

A word on driving early after diagnosis

One of the hardest parts of a new epilepsy diagnosis is the immediate impact on driving. For many people, particularly working adults, the loss of driving (even temporarily) has significant practical consequences.

If this applies to you, some practical considerations:

• Talk to your employer early. Many workplaces can accommodate temporary changes if they know about them.

• Explore alternative transport options. Public transport, rideshare, lifts from family and friends, and community transport services can fill the gap.

• Focus on getting your seizures under control. The faster you achieve good seizure control, the sooner you can return to driving.

• Work closely with your neurologist. They're your best guide through this process.

How to get an assessment

If your neurologist or GP has referred you for an OT driving assessment, you can start the process at steerdriving.com.au/referral.

If you're unsure whether you need an OT assessment or just medical clearance, your first step is to talk with your neurologist. They'll determine what's required for your return to driving.

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

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