Decree No. 277 / 2004 Coll.
Ordinance on medical fitness to drive motor vehicles, medical fitness to drive motor vehicles with the condition and formalities of a medical certificate certifying medical reasons for which the seat of a motor vehicle cannot be restrained by a safety belt (Ordinance on medical fitness to drive motor vehicles)
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Effective from 01.06.2004
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277
DECLARATION
of 26 April 2004
on the determination of medical fitness to drive motor vehicles, medical fitness to drive motor vehicles with the condition and essentials of a medical certificate certifying medical reasons for which a safety belt cannot be fastened to the seat of a motor vehicle while driving (Ordinance on fitness to drive motor vehicles)
According to § 137 (3) for the implementation of § 6 (2), § 9 (2), § 84 (7), § 85 (7), § 87 (7) and § 88 (6) of Act No. 361 / 2000 Coll., on road traffic and on amendments to certain laws, as amended by Act No. 478 / 2001 Coll. and Act No. 53 / 2004 Coll., ("the Act '):
This decree implements European Union1) and regulates the details of medical fitness to drive motor vehicles and the particulars of medical certificates certifying health reasons for which the seat of a motor vehicle cannot be restrained while driving.
Medical fitness and assessment
(1) The medical fitness assessment for motor vehicles (hereinafter referred to as the "assessment") is issued by the medical assessor after assessing the health status of the applicant for a driving licence (hereinafter referred to as the "applicant") or the holder of a driving licence (hereinafter referred to as the "driver") identified by the medical examination and, on the basis of an evaluation of the applicant's or the driver's declaration (hereinafter referred to as "the person under assessment") for medical fitness, previous records in the medical file kept on the person under consideration, information on the health status of the person under assessment communicated by its registered health service provider in the field of general medical practice or in the field of practical medicine for children and training (hereinafter referred to as the "register provider" other professional examinations ")," which it has requested.
(2) The content of the declaration referred to in paragraph 1 is set out in Annex 1.
A person under assessment may be recognised as fit to drive a motor vehicle or as fit to drive a motor vehicle, subject to the conditions laid down in the law, provided that, on the basis of a medical examination or periodic medical examination, that person has not been found to have a defect, condition or disease (hereinafter referred to as "disease ') which excludes medical fitness to drive a motor vehicle.
(1) The report must be clear and must not contain a diagnosis of the disease; it always contains the elements listed in the opinion referred to in Annex 2 to this Decree. The opinion may also be given in a format and arrangement other than that shown in the model.
(2) The assessment shall indicate the period of validity of the medical examination if, on the basis of the medical condition of the person under assessment, the assessor determines the medical examination before the date of the periodic medical examination under the law,
(a) in the case of a progressive disease which may be expected in the course of a further development of a health change affecting road safety;
(b) if, as a condition of medical fitness, Annex 3 indicates a medical check on the health status of the person under assessment; a medical check shall be carried out within a medical examination of at least 1 in 5 years; or
(c) if, at the end of the expert examination referred to in Article 6 (2) (c), an earlier date by which the person to be assessed is to undergo another expert examination than that of a regular medical examination.
(3) The same copy of the opinion and the record of its receipt by the person under examination, certified by the signature of the assessor and the assessor, where appropriate, by the receipt of the opinion by the person under examination, are an integral part of the medical file kept on the assessor.
(4) A judgment under this decree may be replaced by an opinion on fitness to perform work, including the driving of a motor vehicle which is a type of work agreed in the contract of employment, provided that, in addition to the requirements laid down by the legislation governing the content and formalities of the health documents4), it also contains the elements referred to in paragraph 2, § 5 (1).
(1) Where an assessment with a conclusion is issued
(a) the medical fitness to drive motor vehicles, subject to the condition, shall be indicated in the opinion by this condition resulting from the established state of health of the person under assessment; the condition consists of the use of the necessary medical device, technical modification of the motor vehicle or other limitations of the person under consideration; another restriction of the person under consideration shall also be considered to be the date by which the person under assessment is to undergo further medical examination,
(b) the medical incapacity to drive motor vehicles shall be reported in the opinion of the conclusion of the medical incapacity resulting from the assessed person's established state of health.
(2) The medical assessor shall record the diseases that led to the assessment referred to in paragraph 1 in the medical file of the person under assessment.
Medical examinations, regular medical examinations, professional examinations
(1) The necessary scope of medical examinations and periodic medical examinations is:
(a) findings on the state of health of the person under assessment with a targeted focus on diseases which exclude or make subject to the health status of motor vehicles; diseases which exclude or condition the medical fitness to drive motor vehicles are set out in Annex 3;
(b) a comprehensive physical examination, including an indicative examination of hearing, visual acuity and colour cites, an indicative examination of the visual field and balance and an indicative neurological examination, with a targeted focus on the detection of the symptoms of the disease listed in Annex 3;
(c) other necessary professional examinations (hereinafter referred to as "professional examinations") carried out by a doctor of the relevant specialised competence, a clinical psychologist or a transport psychologist under § 87a to 87c of the law requested by the assessor, where it is necessary for the person under examination to rule out the suspicion of the disease, or to establish the stage of the disease referred to in Annex 3, or other diseases which might restrict the medical fitness to drive motor vehicles, the professional examination may be replaced by an examination of the assessor if it is able to assess the stage of the disease referred to in Annex 3 and is able to assess the medical fitness to drive vehicles;
(d) a professional examination requested by the assessor, if the assessor is in the continuous care of another doctor or clinical psychologist for the disease referred to in Annex 3, or another disease which excludes or limits the medical fitness to drive motor vehicles, if this fact is known to the assessor, the professional examination may be replaced by an examination of the assessor, provided that he has the necessary information on the health status of the medical or clinical psychologist in whose continued care the assessor is, and is able to assess the medical fitness to drive motor vehicles on the basis of that report and his examination;
(e) a specialist examination by a neurologist requested by or suspected of being diagnosed with epilepsy by a medical assessor; the condition of epilepsy or other disorders of consciousness, clinical form and procedure of the disease, treatment and its results, including the risk of recurrence of an epileptic seizure or impaired consciousness, may be assessed by a medical assessor's examination if he has the necessary information on the medical condition of the neurologist's report, and on the basis of this report and his examination he is able to assess the medical fitness to drive motor vehicles,
(f) a professional examination of persons with pervasive developmental disorders without an intellectual disorder in the assessment of medical fitness before being admitted to teaching and training for a driving licence, if this is known to the assessor.
(2) The professional examination shall be carried out to the extent necessary to assess the medical fitness of the person under assessment to drive motor vehicles. At the end of each expert examination, the medical fitness of the person assessed to drive motor vehicles in relation to the focus of the professional examination shall be defined and the condition allowing the driving of the motor vehicle shall be proposed if the need for its determination has been established,
(a) the use of the necessary medical device;
(b) technical adaptation of the motor vehicle; or
(c) other restrictions on the person under consideration; where any other restriction allowing the steering of a motor vehicle consists of a condition for undergoing a further expert examination, the date by which the person to be assessed shall also be indicated at the end of the expert examination.
(1) The professional examination of the person to be assessed, which is carried out at the request of the assessor pursuant to Article 6 (1) (c) to (f), shall be based on the medical file kept by the assessor or on his information; the information from the medical file processed by the medical assessor contains the reasons for the request for the medical examination, the results of the examinations carried out so far and other information relevant to the professional examination.
(2) For the purpose of assessing the medical fitness of the person under assessment for driving motor vehicles, the assessor, unless he is a registered provider at the same time, shall request information on the health status of that person with the registrant,
(a) whether the person concerned has suffered or suffered from the diseases listed in Annex 3 or has been suspected in the past; and
(b) other information relevant to the assessment of the medical fitness of that person.
(3) The person who has carried out the expert examination shall provide information on the conclusions of the expert examination to the medical assessor, who shall record the expert examination, including any conclusions or observations, in the full extent of the findings in the medical file.
The registrant shall indicate in the health file and in the statement from the medical file in the event of the transfer of the patient to the care of another registrant that the person for whom the medical file is being kept is the applicant or the driver, or that the person has been given an opinion with a conclusion on the medical incapacity to drive motor vehicles or fitness to drive motor vehicles on condition. Where the medical fitness of the applicant or the driver is assessed with the occupational health service provider, it shall communicate the facts according to the sentence of the first registrant for the purpose of indicating them in the medical documentation, by the medical assessor of the occupational health service provider. Where the person concerned does not have a registrant or a provider of occupational medical services, he shall indicate in the first sentence in the medical file the medical examiner of the health service provider for which the medical fitness of the applicant or driver is assessed.
Requirements for medical certificates certifying health reasons for which the seat of a motor vehicle cannot be restrained while driving
(1) A medical certificate issued by law to the driver or transported to a person who, for medical reasons, cannot be restrained to the seat by safety belts shall contain the particulars set out in Annex 4. A copy of the medical certificate shall be included in the medical documentation of the driver or the person transported.
(2) A medical certificate or certificate issued by the competent authorities in another Member State of the European Union shall be deemed to be a medical certificate issued under this Order; it shall indicate the period of validity of the certificate and shall be submitted on request to all persons authorised to check pursuant to specific legislation2) compliance with the obligations of participants and road traffic rules.
Final provisions
If the driver has obtained a driving licence under existing legislation and if the doctor finds or suspects that his medical fitness for driving motor vehicles does not correspond to the medical fitness under this Regulation, he shall draw the attention in writing to this fact of the driver and the judging doctor, if known.
The Ministry of Health Directive No. 8 / 1986 Ú. v. ČSR is hereby repealed, for the assessment of fitness to drive motor vehicles, trolleybuses and trams, registered in the amount of 7 / 1986 Coll.
This Decree shall take effect on 1 June 2004.
Minister:
Dr. Kubinyi, Ph.D. v. r.
Příloha č. 1
Annex No 1 to Decree No 277 / 2004 Coll.
Declaration by the person under assessment on his medical fitness
Příloha č. 2
Annex No 2 to Decree No 277 / 2004 Coll.
Medical assessment on fitness to drive motor vehicles
Příloha č. 3
Annex 3 to Decree No 277 / 2004 Coll.
Diseases, defects or conditions which exclude or make subject to medical fitness to drive motor vehicles
For the purposes of the Annex, they shall be included in:
- Group 1
applicants and holders of driving licences for categories of vehicles AM, A1, A2, A, B1, B and B + E (Section 80a of Act No. 361 / 2000 Coll.).
- Group 2
(a) drivers who drive a motor vehicle in an employment relationship and where driving a motor vehicle is a type of work agreed in the employment contract;
(b) drivers of a vehicle who, when performing tasks relating to the performance of specific duties, use a special blue warning light, accompanied, where appropriate, by a special audible warning signal;
(c) drivers in respect of whom the driving of a motor vehicle is the subject of a self-employment activity carried out under specific legislation;
(d) applicants and holders of certificates for train teachers in motor vehicle driving under special legislation, 3); or
(e) applicants and holders of driving licences for categories of vehicles C1, C1 + E, C, C + E, D1, D1 + E, D, D + E and T (§ 80a of Act No. 361 / 2000 Coll.).
I. Diseases, defects or visual defects excluding or contingent upon medical fitness to drive motor vehicles
1. Diseases, defects or visual defects which exclude medical fitness for the driving of motor vehicles are diseases, defects or visual defects which cause health complications or variations which are dangerous for road traffic, in particular:
Group 1
(a) binocular visual acuity, including using corrective lenses, *) less than 0,5;
(b) visual acuity of less than 0,5 at complete functional loss of vision on one eye or in the case of use of only one eye, for example in the case of diplopia, including using corrective lenses;
(c) total functional loss of vision on one eye or use of only one eye if this condition lasts less than 6 months;
(d) a horizontal field of vision of both eyes of less than 120 degrees, at the same time a range of less than 50 degrees to the left and the right, a range of the vertical field of vision of less than 20 degrees up and down;
(e) changes in the central field of vision up to 20 degrees; or
(f) intolerance to corrective lenses if necessary to achieve visual acuity.
Group 2
(a) the diseases, defects or conditions laid down for Group 1, unless otherwise specified;
(b) visual acuity in a better eye of less than 0,8 and in a worse eye of less than 0,1, even using corrective lenses;
(c) achieving the minimum visual acuity referred to in (a) or (b) using glasses with a force exceeding the spherical equivalent + 8 dioptrias;
(d) a horizontal field of vision of both eyes of less than 160 degrees, at the same time a range of less than 70 degrees to the left and right,
(e) a vertical field of vision of less than 30 degrees upwards and downwards;
(f) changes in the central field of vision up to 30 degrees;
(g) diplopia; or
(h) severe contrast sensitivity disorder.
*) Note: For the purpose of the decree, intraocular lenses are not considered to be corrective lenses.
2. Diseases, defects or visual defects affecting road safety and for which the applicant or the driver can be recognised as fit to drive a motor vehicle only on the basis of the conclusions of the expert examination, in particular:
Group 1
a) binocular visual acuity less than 0.7 using correction lenses;
(b) visual acuity of less than 1,0 in the case of complete functional loss of vision on one eye or in the case of use of only one eye, for example in the case of diplopia, and this condition lasts for more than 6 months;
(c) a change in the field of vision;
(d) diseases of the eye and eye adnex, if they cause a reduction in visual acuity or change the range of field of vision referred to in (a), (b) or (c);
(e) visual disturbances beyond light non-serious forms; or
(f) severe colour disturbances in the field of basic colours.
Group 2
(a) the diseases, defects or conditions laid down for Group 1, unless otherwise specified below;
(b) severe colour disturbances,
(c) visual disturbances; or
(d) visual disturbances in the dark.
II. Diseases, defects or hearing conditions excluding or contingent upon medical fitness to drive motor vehicles
Group 1
Diseases of the middle ear or nipple point if they restrict the ability to drive a motor vehicle.
Group 2
(a) diseases of the middle ear or nipple tip if they restrict the ability to drive a motor vehicle; or
(b) hearing loss exceeding 40% (according to Fowler); an applicant or a driver with a hearing loss of more than 40% may be recognised as fit to drive a motor vehicle if they are able to perceive sounds presented in a free field of an average intensity of 40 dB HL and less at frequencies of 500, 1,000, 2,000 and 4,000 Hz, including by means of hearing or communication aids.
III. Diseases, defects or states of the muscle and skeletal system and connective tissue, excluding or contingent upon medical fitness to drive motor vehicles
Group 1 and 2
1. Diseases, defects or states of the muscle and skeletal system and connective tissue excluding medical fitness for driving motor vehicles are diseases, defects or states of the muscle and skeletal system and connective tissue which restrict the ability to drive a motor vehicle and are dangerous for road traffic and which cannot be compensated by the necessary medical device or technical modification of the motor vehicle.
2. Diseases, defects or states of the muscle and skeletal system and connective tissue which affect road safety and for which the applicant or driver can be recognised as fit to drive a motor vehicle only on the basis of the conclusions of the expert examination, in particular:
(a) diseases, defects or conditions which reduce mobility and the functional ability to drive a motor vehicle; or
(b) diseases, defects or conditions where functional incapacity affecting road safety can be assumed in future developments.
During the technical examination attention shall be paid to the possibility of compensation by means of the necessary medical device or technical modification of the motor vehicle.
IV. Diseases, defects or states of the cardiovascular system excluding or contingent upon medical fitness to drive motor vehicles
1. Diseases, defects or state of the cardiovascular system which exclude medical fitness to drive motor vehicles and which cause such health complications or derogations which are dangerous for road traffic, in particular:
Group 1
(a) peripheral vascular disease, which means an aneurysm of the thoracic and abdominal aorta, the maximum diameter of the aorta being such that there is a serious risk of sudden rupture, thereby causing the driver to suddenly become unfit to drive the vehicle;
(b) heart valve disease including aortic regurgitation or aortic stenosis, mitral regurgitation or mitral stenosis, if the functional capacity is estimated to be New York Heart Association (NYHA) IV or if a syncope occurred,
(c) Brugado syndrome with syncope or after circulatory arrest,
d) Heart failure with NYHA IV classification.
Group 2
(a) the disease of large (central) arteries, which means an aneurysm of the thoracic aorta, abdominal aorta and pelvic arteries, the maximum diameter of the aorta or pelvic artery being such that there is a serious risk of sudden rupture, which in turn causes the driver to suddenly become incompetent to drive the vehicle;
(b) heart valve disease in NYHA III or IV or with ejection fraction below 35%, mitral stenosis with severe pulmonary hypertension, echocardiographically diagnosed serious aortic stenosis or aortic stenosis causing syncope; the exception is fully asymptomatic severe aortic stenosis if a stress test has been performed without an abnormal result;
c. Hypertrophic cardiomyopathy with syncope in the past, or if two or more of the following conditions are met:
1. the thickness of the left ventricle wall is more than 3 cm;
2. non-sustained ventricular tachycardia has been documented;
3. sudden death of a relative at first instance,
4. there is no increase in blood pressure during exercise,
(d) long QT syndrome with syncope or documented torsade des pointes or QTc greater than 500 ms;
(e) Brugado syndrome with syncope or after circulatory arrest,
(f) heart failure with NYHA classification III and IV;
(g) implantation of the defibrillator;
(h) the presence of mechanical cardiac support.
2. Diseases, defects or state of the cardiovascular system affecting road safety and for which the applicant or driver can be recognised as fit to drive a motor vehicle only on the basis of the conclusions of the expert examination and the establishment of adequate treatment, in particular:
Group 1
(a) bradyarrhythmias which mean damage to the sinus node function and transfer disorder, or tachyarrhythmias which mean supraventricular and ventricular arrhythmias that caused syncope;
(b) symptoms of angina,
(c) after implantation or replacement of a defibrillator or after adequate or disproportionate discharge of the defibrillator,
(d) a syncope which means temporary loss of consciousness and muscle tone characterised by rapid onset, short duration and spontaneous recovery, which occurs as a result of total underblood flow of brain tissue which is caused by reflexive or unclear aetiology;
(e) acute coronary syndrome,
(f) stable angina pectoris if symptoms do not show up in mild exercise,
(g) percutaneous coronary intervention (PCI),
h) coronary arterial bypass (CABG),
(i) transient ischemic attack (TIA);
(j) heart failure with NYHA classification I, II or III;
(k) heart transplantation;
(l) implanted mechanical support for cardiac activity;
(m) heart valve surgery,
(n) inadequately corrected arterial hypertension, which means an increase in systolic blood pressure to greater than or equal to 180 mmHg or diastolic blood pressure to greater than or equal to 110 mmHg associated with imminent or progressive organ damage,
o) congenital heart defect,
(p) hypertrophic cardiomyopathy if there is no evidence of syncope,
q) Long QT syndrome with syncope, torsade des pointes or QTc greater than 500 ms;
(r) sustained ventricular tachyarrhythmias associated with structural heart disease.
Group 2
(a) bradyarrhythmias which mean damage to the sinus node function and transfer disorder, or tachyarrhythmias which mean supraventricular and ventricular arrhythmias that caused syncope;
(b) bradyarrhythmias which include impairment of the sinus node function, atrioventricular block of grade II Möbitz type, atrioventricular block of the third degree or alternating arm block,
(c) tachyarrhythmias which include sustained ventricular tachycardia or persistent polymorphic ventricular tachycardia with an indication for implantation of the defibrillator;
(d) symptoms of angina,
(e) implantation of a pacemaker;
(f) a syncope which means temporary loss of consciousness and muscle tone, characterised by rapid onset, short duration and spontaneous recovery, which occurs as a result of total underblood supply of brain tissue which is caused by reflexive or unclear aetiology;
(g) acute coronary syndrome,
(h) stable angina pectoris, if symptoms are not present in mild exercise
(i) percutaneous coronary intervention (PCI),
j) coronary arterial bypass (CABG),
(k) transient ischemic attack (TIA);
(l) significant carotid stenosis,
(m) the maximum aorta diameter exceeds 5,5 cm;
n) Heart failure with NYHA classification I and II,
o) heart transplant,
(p) heart valve surgery,
(q) Grade III elevated blood pressure which means diastolic blood pressure greater than or equal to 110 mmHg or systolic blood pressure greater than or equal to 180 mmHg,
(r) congenital heart defect.
3. Other cardiomyopathy
For applicants or drivers with specific cardiomyopathy, such as arrhythmogenic cardiomyopathy of the right ventricle, non-compact cardiomyopathy, catecholinergic polymorphic tachycardia and short QT syndrome, or other new cardiomyopathy that may be defined, the individual risk of situations causing sudden inability to drive shall be assessed.
V. Diabetes mellitus disease excluding or contingent upon medical fitness to drive motor vehicles
1. The diabetes mellitus disease excludes medical fitness to drive motor vehicles if it causes health complications that are dangerous for road traffic, in particular:
Group 2
(a) second and other hypoglycaemia that occurs within 12 months of the first hypoglycaemia and that need to be managed by another person, or
(b) a second and other hypoglycaemia that occurs within 12 months of the first hypoglycaemia and which the applicant or driver is unable to recognise ("non-recognition syndrome").
2. Stations related to diabetes mellitus disease affecting road safety and for which the applicant or driver can be recognised as fit to drive a motor vehicle only on the basis of the conclusions of a professional examination
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Regulation Information
| Citation | Decree No. 277 / 2004 Coll., on the determination of medical fitness to drive motor vehicles, medical fitness to drive motor vehicles with the condition and formalities of a medical certificate certifying medical reasons for which the seat of a motor vehicle cannot be restrained by a safety belt (Ordinance on medical fitness to drive motor vehicles) |
|---|---|
| Regulation Type | Order |
| Author | - |
| Collection | Code of Laws |
| Date of Promulgation | 05.05.2004 |
|---|---|
| Effective from | 01.06.2004 |
| Effective until | - |
| Status | Valid |
The regulation text is for informational purposes only.
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