If you live at Tweed Heads, Coolangatta, Kingscliff, Pottsville, Byron Bay, Ballina or Lismore, this comes up constantly. You shop in Queensland, you see a specialist in Queensland, and your licence says New South Wales. So whose rules apply when a medical condition affects your driving?
The answer is simpler than the confusion suggests, and getting it right saves you weeks.
The short answer
Your licence decides. Whichever state issued your driver licence is the state whose process you follow.
A New South Wales licence means you deal with Transport for NSW, even if every doctor you see is on the Gold Coast. A Queensland licence means you deal with Transport and Main Roads, even if you live south of the border and drive north for everything.
The medical standards themselves are identical. Australia uses one national set, the Austroads Assessing Fitness to Drive standards, and both states apply them. So the clinical question, are you safe to drive, is answered exactly the same way on either side of the Tweed River.
What differs is the paperwork, the forms, and who receives the report.
What that means in practice
If you hold a New South Wales licence:
Your doctor completes the Fitness to Drive form electronically and it goes to Transport for NSW. If a driving assessment is required, the occupational therapist's report goes directly to Transport for NSW.
We have explained that form in what is the Fitness to Drive form, and the reporting duty in do I need to report my medical condition to Transport for NSW.
If you hold a Queensland licence:
Your doctor completes a Medical Certificate for Drivers (Form F3712). You keep the tear-off section, which is your evidence that a certificate exists. If a driving assessment is required, the occupational therapist's report goes to your doctor, who then submits an updated certificate to TMR.
That process is set out in reporting a medical condition to Queensland Transport.
Notice the difference in who gets the report. In New South Wales it goes straight to the licensing authority. In Queensland it goes via your doctor. This is the single most common thing that gets muddled at the border, and it can add weeks if the report is sent to the wrong place.
Which doctor should fill in the form?
Your usual GP, wherever they are.
A Queensland GP can complete a New South Wales Fitness to Drive form, and a New South Wales GP can complete a Queensland F3712. The forms are administrative, and the clinical standard behind them is national. What matters is that the doctor knows you and your history.
If your GP has not done one before, there is a walkthrough written for clinicians at a GP's guide to referring in Queensland and a GP's guide to referring in NSW.
Do I have to be assessed in the state that issued my licence?
No. The assessment is a clinical service, not a state-based test.
An occupational therapy driving assessment can be conducted wherever you live and drive. In fact, doing it in your own area is the point. We drive the roads you actually use, in your local traffic, at the times of day you would normally be out. Assessing a Kingscliff resident on Gold Coast arterials would tell us less about your everyday driving, not more.
We cover the Gold Coast and Northern New South Wales, including Tweed Heads, Kingscliff, Pottsville, Ocean Shores, Byron Bay, Ballina and Lismore.
Turning 75 or 85: the rules are not the same
This is where the two states genuinely diverge, and it catches border residents out.
Queensland. From 75, you must carry a current Medical Certificate for Drivers, renewed as often as your doctor specifies. There is no automatic practical driving test attached to age. Detail in driving over 75 in Queensland.
New South Wales. Annual medical reviews start at 75. From 85, holding an unrestricted licence requires a practical driving assessment every two years, and there is the option of taking a modified licence instead. Detail in older driver licence renewals versus OT driving assessments.
So two neighbours on either side of the border, both 86, face quite different requirements. If you moved across the border in recent years, check which set applies to you now rather than assuming.
Should I transfer my licence?
If you have moved permanently, yes, and there are usually time limits attached to doing so. That is a licensing question rather than a medical one, and TMR or Transport for NSW will tell you what applies.
One point worth knowing: transferring a licence while a medical review is underway can complicate things, because your file may need to move with you. If you are mid-process, finish it first where possible, or tell both authorities what is happening.
If your licence is cancelled
The alternatives differ by state, and border residents are entitled to whatever their state of residence offers.
Queensland residents can look at the Taxi Subsidy Scheme and Gold Coast council community transport. New South Wales residents in the Tweed and Byron shires have their own community transport services, and the Taxi Transport Subsidy Scheme operates there.
What is genuinely harder at the border is that public transport does not cross it well. If you are helping someone plan for life after driving in this area, do that mapping early. What happens if you fail an OT driving assessment covers the outcomes themselves.
Frequently asked questions
I live at Tweed Heads and have a NSW licence, but my specialist is at Southport. Is that a problem?
No. Your specialist can write to your GP as normal, and your GP completes the New South Wales form. The state your doctors practise in does not change your licensing pathway.
Can you assess me if I have a NSW licence but want to be assessed on the Gold Coast?
Yes. Where the assessment happens does not have to match where your licence was issued. We would normally assess you in your own area, which for most border residents is Northern New South Wales.
Which state's report format do you use?
Whichever your licensing authority requires. The clinical content is the same, because the standards are national. The addressing, the form references and the submission route change.
I have just moved from Sydney to the Tweed. What do I need to do?
If you have kept your New South Wales licence and are staying in New South Wales, nothing changes. If you have moved to the Queensland side, you will need to transfer your licence and follow the Queensland process from that point.
Do the medical rules for my condition change if I cross the border?
No. Non-driving periods after a seizure, stroke or cardiac event are set nationally by Austroads and apply identically in both states.
Is a report to Transport for NSW slower than one to TMR?
Not inherently, but the Queensland route has an extra step, since the report goes to your doctor before an updated certificate reaches TMR. Build a little more time in for that.
Ready to book an OT driving assessment? Steer Driving is a mobile assessment service covering the Gold Coast, Northern NSW, and Sydney. 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 (6th ed.). Austroads. https://austroads.gov.au/publications/assessing-fitness-to-drive/ap-g56/about-this-publication
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
