A Parkinson's diagnosis does not mean you have to hand in your keys.

Plenty of people drive safely for years after they are diagnosed. What does change is that you now have to tell Transport and Main Roads about it, and your driving will be reviewed from time to time as things change.

This guide explains what you need to do in Queensland, how Parkinson's can affect driving, and when a driving assessment is worth doing.

Do I have to tell Transport and Main Roads?

Yes.

In Queensland you must tell Transport and Main Roads (TMR) about any long-term medical condition that could affect your driving. Parkinson's counts. You also have to tell them if your symptoms get noticeably worse.

This is not optional. There are large fines for not reporting, and your insurance may not cover you if you have a crash.

You can report it in three ways:

• Online, through the TMR medical condition notification service

• By filling in Form F4355 and emailing it to mcr@tmr.qld.gov.au

• In person at a Transport and Motoring Service Centre

You will usually also need a Medical Certificate for Drivers (Form F3712) from your GP or neurologist. There is more detail in Reporting a Medical Condition to Queensland Transport.

Will I lose my licence?

Reporting does not cancel your licence.

What it does is put a medical note against your licence, so your fitness to drive gets checked at intervals your doctor sets, usually somewhere between six months and two years.

Most people keep driving after they report. Some drive with rules attached, such as automatic only or daylight only.

How does Parkinson's affect driving?

It is not just the tremor. In fact, tremor is often the least of it.

Slowness of movement. This is usually the biggest one. Parkinson's slows how quickly you move your foot from the accelerator to the brake, and how fast you can turn the wheel in an emergency.

Stiffness. Stiff neck and shoulders make it harder to turn and check your blind spot. Stiff arms reduce how quickly you can steer.

Thinking and attention. Parkinson's can affect planning, judging gaps, and doing two things at once. This matters at busy intersections and roundabouts. See How Do Cognitive Skills Affect Driving.

Vision. Some people find it harder to pick out shapes in low light, which makes dusk, night and rainy driving harder.

Medication. Parkinson's medications can make you very sleepy, and in some people can cause sudden sleep with no warning. Some medications can also affect impulse control. Both matter for driving, and both are worth raising with your neurologist.

"On" and "off" times. Most people have periods where the medication is working well and periods where it is wearing off. Driving is only appropriate during reliable "on" times.

Dizziness on standing. Parkinson's can cause a drop in blood pressure when you stand up, which can lead to fainting. That is a driving issue in its own right.

What are the rules?

Queensland uses the national medical standards published by Austroads. The same standards apply in every state.

For Parkinson's, the short version is this. You can usually keep a licence with conditions and regular reviews, as long as your symptoms are controlled and you are not showing signs that make driving unsafe. Your doctor may ask for a practical driving assessment to help them decide.

The rules are stricter for truck, bus and taxi licences.

When should I have an OT driving assessment?

An OT driving assessment is worth doing when:

• Your symptoms have moved on since you were diagnosed

• You have had near misses, small crashes, or you feel less confident in traffic

• Your neck movement has reduced

• Your doctor is unsure and needs real information before filling in your form

• You are wondering whether a modification like a steering knob would help

• You and your family disagree about whether you are still safe

What actually happens on the day?

Two parts, around two to three hours in total.

Off road. I come to you. We check vision, neck and limb movement, reaction time, grip and foot speed. Then some pen and paper tasks looking at attention, memory and planning. This is not a test you can fail. It tells me what to keep an eye on when we drive.

On road. You drive a car with dual controls, with a driving instructor beside you and me in the back. We start easy and build up. I am watching your speed, positioning, head checks, gap judgement, and how you handle busy traffic.

Timing matters with Parkinson's. We book the assessment during your best "on" period, and I record when you last took your medication. Assessing you during an "off" period is not a fair reflection of how you drive, so we avoid it. Tell me your medication timing when you book.

See What to Expect on the Day.

What are the possible outcomes?

I write a report and send it to your referring doctor. They then complete or update your F3712 and send it to TMR.

Keep driving as you are. Common in the earlier years, usually with a review date set.

Keep driving, with conditions. Automatic transmission, daylight only, staying within a set area, avoiding motorways, or fitting something like a steering knob or extra mirrors. Every condition I recommend is tied to something specific I saw. See Licence Conditions After an OT Driving Assessment.

Some lessons, then a re-check. Useful when the problems are habits that can be retrained rather than symptoms that will progress.

Stop driving. Recommended when what I saw on the road cannot be made safe with conditions. The report names the specific errors. See What Happens If You Fail an OT Driving Assessment.

Common questions

Can I drive if my medication makes me drowsy? No, not while that is happening. Sudden sleepiness is a clear reason not to drive. Speak to your neurologist, because it can often be sorted with a change in medication.

How often will I need to be reviewed? Your doctor decides, usually every six to 24 months depending on how you are going.

Should I be assessed on my medication or off it? On. We want to see how you normally drive.

My tremor is mild. Do I still need to report it? Yes. Reporting is based on the diagnosis, not on how bad your symptoms are today.

Can vehicle modifications help? Sometimes. Lighter steering, a steering knob, or extra mirrors can help with stiffness and reduced neck movement. See Vehicle Modifications for Driving with a Disability.

Who pays for the assessment? Most people pay privately. Some use DVA funding, or NDIS if they are under 65 and have driving in their plan. See OT Driving Assessment Cost in Queensland.

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