STEER DRIVING · SYDNEY
Driving is often the thing that turns a spinal cord injury from something that controls your week into something you work around.
Once you can drive again, you can get to appointments without booking transport, go to work, and leave the house when you feel like it rather than when someone is free to take you.
Most people with a spinal cord injury can drive again. What changes is how the car is set up.
Can I drive with a spinal cord injury?
In most cases, yes.
People with paraplegia commonly drive using hand controls. Many people with lower level tetraplegia also drive, using more advanced controls.
What matters is not the level of your injury on paper. It is what you can actually do with your arms, hands and trunk, how well you can hold yourself upright, and what equipment can bridge the gap.
That is what a driving assessment works out.
Do I have to tell Transport and Main Roads?
Yes.
In Queensland you must tell Transport and Main Roads (TMR) about any permanent or long-term condition that affects your driving. A spinal cord injury does.
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 complete a Medical Certificate for Drivers (Form F3712). See Reporting a Medical Condition to Queensland Transport.
When you start driving with modifications, a code goes on your licence saying you can only drive a car set up that way. That is normal and expected.
When is the right time?
Not straight after discharge, usually.
Before an assessment is useful, you generally want:
Your medical situation to be stable
Enough sitting balance to hold yourself steady in a car seat
Enough arm and hand strength and movement to manage controls
Pressure care sorted, including how long you can sit
Any spasticity reasonably managed
Your rehab team happy for you to be assessed
If you are not there yet, that is fine. It is worth having a conversation early anyway, because it shapes what you work on in rehab and stops you buying the wrong car.
What equipment is available?
There is a lot, and it goes well beyond a basic hand control.
For the pedals
Hand controls, either mechanical push-pull levers or electronic controls
Left foot accelerator, if one leg works and the other does not
For steering
A steering knob, tri-pin or palm grip so you can steer one-handed
Reduced effort steering, where the car needs far less force to turn
Smaller secondary steering wheels
For everything else
Remote controls on the steering wheel or a satellite panel for indicators, wipers, lights and horn
Electronic parking brake conversion
Push button start
For getting in and out
Transfer boards and swivel seats
Person hoists
Wheelchair loaders that put your chair in the boot
Wheelchair accessible vehicles with a lowered floor and ramp, for people who drive from their wheelchair or travel as a passenger
You do not choose from this list on your own. Getting it wrong is expensive and sometimes unsafe. Read Vehicle Modifications for Driving with a Disability.
What happens in the assessment?
Off road, at your place. We look at your vision, arm and hand strength, grip, range of movement, sitting balance, trunk control, transfers, and how you currently get in and out of a car. We also talk about what you need the car to do, including whether you carry a wheelchair, drive with passengers, or need to do long trips.
On road. You drive a car fitted with the controls we think will suit you, with a specialist driving instructor beside you. Often this involves trying more than one setup. A control that feels right sitting still in a driveway can feel very different at 80 kilometres an hour.
If you are new to hand controls, you will not be expected to be good at them on day one. The assessment works out whether the setup suits you, then lessons build the skill.
Then the recommendation. I write a report listing the specific equipment you need, with the reasons for each item. That report is what your funder needs, and what the modifier works from.
See What Is an OT Driving Assessment and What to Expect on the Day.
How do the modifications actually get fitted?
In Queensland, modifications for drivers with a disability are covered by the Queensland Code of Practice: Vehicle Modifications. The relevant codes are LC3 and LC4, which cover vehicle controls for people with a disability.
The work is done by an Approved Person, who is a certified modifier, working with your occupational therapist. TMR expects the decision to be made jointly by you, the modifier and the OT. Some non-standard modifications need individual approval from TMR.
The practical order of events is usually:
Driving assessment and equipment recommendation
Quote from a modifier
Funding approval
Modifications fitted
Lessons in the modified car
Final on-road check and report
Licence code updated by TMR
You can read TMR's information on vehicle modifications.
Who pays?
This depends entirely on how your injury happened.
Car crash in Queensland. CTP insurance usually covers assessment, modifications and lessons.
Very serious injury from a crash. The National Injury Insurance Scheme Queensland (NIISQ) may fund it, regardless of who was at fault.
Workplace injury. WorkCover Queensland.
NDIS. Vehicle modifications and driving assessments can be funded if you are under 65 and it is in your plan. Steer Driving works with self-managed and plan-managed participants.
DVA. For eligible veterans.
Injured in New South Wales. iCare may apply. See iCare and OT Driving Assessments.
Full detail is in How Much Does an OT Driving Assessment Cost in Queensland.
Common questions
Do I need to buy a special car first? No, and please do not. Get assessed first. The assessment tells you what the car has to be capable of, which stops you buying something that cannot take the equipment you need.
Can I use my current car? Sometimes. It depends on the make, model, transmission and whether there is room for the controls. We check this as part of the assessment.
How long does the whole process take? From assessment to driving a modified car is commonly several months, and longer for a wheelchair accessible vehicle. Funding approval is usually the slowest part.
Will I need lessons? Almost always, and that is normal. Hand controls use a different set of habits to pedals. Most people need a handful of lessons before it feels natural.
Can I drive from my wheelchair? Some people do, in a vehicle converted for it. It requires the right chair, the right restraint system and a suitable vehicle, and it is assessed carefully.
What if I live in Tweed Heads or Northern New South Wales? Steer Driving covers both sides of the border. The clinical process is the same, but the paperwork and funding differ, and we will walk you through which system applies to you.
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. (2021). Queensland code of practice: Vehicle modifications. Department of Transport and Main Roads. https://www.publications.qld.gov.au/dataset/queensland-code-of-practice-vehicle-modifications-qcop
STEER DRIVING · GOLD COAST & SYDNEY
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