Decree No. 445 / 2024 Coll.
Ordinance amending 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 necessity of a medical certificate certifying health reasons for which safety belts cannot be fastened on the seat of a motor vehicle, as amended
Valid
Order
Effective from 01.01.2025
445
DECLARATION
of 19 December 2024
amending 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 requirements of a medical certificate certifying health reasons for which a safety belt cannot be fastened on the seat of a motor vehicle (Ordinance on medical fitness to drive motor vehicles), as amended
According to Section 137 (3) of Act No. 361 / 2000 Coll., on road traffic and on amendments to certain laws (Road Traffic Act), as amended by Act No. 411 / 2005 Coll. and Act No. 101 / 2013 Coll., for implementation of § 84 (7), § 85 (7), § 87 (7) and § 88 (6) of the Road Traffic Act:
Decree No. 277 / 2004 Coll., on the determination of the medical fitness to drive motor vehicles, medical fitness to drive motor vehicles with the condition and requirements of a medical certificate certifying the health reasons for which the safety belt (medical fitness certificate for driving motor vehicles), as amended by Decree No. 253 / 2007 Coll., Decree No. 72 / 2011 Coll., Decree No. 271 / 2015 Coll. and Decree No. 37 / 2018 Coll., are amended as follows:
1. In footnote 1, the words "Council Directive 91 / 439 / EEC of 29 July 1991 on driving licences, as amended by Commission Directive 2000 / 56 / EC of 14 September 2000 amending Council Directive 91 / 439 / EEC on driving licences' and the words" Commission Directive 2009 / 112 / EC of 25 August 2009 amending Council Directive 91 / 439 / EEC on driving licences. Commission Directive 2009 / 113 / EC amending Directive 2006 / 126 / EC of the European Parliament and of the Council on driving licences. '
2. In Article 4 (4), the words "and the year of the transportpsychological examination (5) ', including footnote 5, are deleted.
3. In Article 6 (1) (c), the words "the physician of the relevant specialised competence 'are deleted and after the words" (hereinafter referred to as "the expert examination') 'are inserted the words" the physician of the relevant specialised competence, clinical psychologist or transport psychologist under § 87a to 87c of the Act'.
4. In Article 6, at the end of paragraph 1, the dot is replaced by a comma and the following point (f) is added:
"(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."
5. In Article 7 (1), the words "A physician or a clinical psychologist carrying out, at the request of a medical assessor, a professional examination of the person under assessment pursuant to Article 6 (1) (c) to (e) 'are replaced by the words" A specialist examination of the person under examination which is carried out at the request of the assessor under Article 6 (1) (c) to (f)';
6. Paragraph 7 (3) reads as follows:
"(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 the findings or observations, in the full extent of the facts found in the medical file."
7. In Annex No 2, the sentence "Transport Psychological Examination under Section 87a of the Act was carried out: (a) ano2), in year................................................ (b) ne2)," is deleted and in the section "Lessons" the fourth sentence "Rights to review a medical opinion may be waived in writing or orally at the end of the text."
8. In Annex 3, Chapter II, Group 2 (b), the number "30 'is replaced by" 40' and the words "to understand speech within a distance of at least 5 m, including by means of a medical device 'are replaced by the words" 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 with a hearing or communication aid'.
9. Chapter IV of Annex 3 reads as follows:
"IV. Diseases, defects or state 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 and subsequently an event which suddenly makes a person unfit;
(b) heart valve disease with aortic regurgitation, aortic stenosis, mitral regurgitation or mitral stenosis, if functional capability is estimated to be NYHA IV or if syncope cases have occurred;
c) Brugado syndrome with syncope or discontinuation of sudden cardiac arrest,
(d) Heart failure with classification as New York Heart Association (NYHA) IV.
Group 2
(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 and subsequently an event which suddenly makes a person unfit;
(b) heart valve disease with NYHA classification III or IV or ejection fraction below 35%, mitral stenosis and severe pulmonary hypertension or echocardiographically diagnosed severe aortic stenosis or syncope stenosis; except for fully asymptomatic severe aortic stenosis if the stress test requirements are met,
(c) structural and electrical cardiomyopathy, which means 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 less than 3 cm;
2. persistent ventricular tachycardia,
3. sudden death of a relative at first instance,
4. No increase in blood pressure during exercise,
d) Long QT syndrome with syncope or documented torsade des pointes or QTc less than 500 ms;
(e) Brugado syndrome with syncope or discontinuation of sudden cardiac 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 means impairment of sinus node function and conditioning disturbances, and tachyarrhythmias, which means supraventricular and ventricular arrhythmias, with a case or cases of syncope in the past due to cardiac rhythm disorders;
(b) symptoms of angina,
(c) implantation or replacement of a defibrillator or an adequate or disproportionate discharge of a defibrillator;
(d) reflective syncope;
(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) malignant 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 without syncope,
q) Long QT syndrome with syncope, torsade des pointes or QTc less than 500 ms;
(r) bradyarrhythmia, which means symptomatic impairment of the sinus node function and impairment of conditioning with Möbitz atrioventricular block type II, third degree atrioventricular block or alternation of the shoulder block,
(s) tachyarrhythmia, which means supraventricular and ventricular arrhythmias, associated with structural heart disease and sustained ventricular tachycardia, or polymorphic non-sustained ventricular tachycardia, sustained ventricular tachycardia or an indication for defibrillator,
(t) significant carotid stenosis.
Group 2
(a) bradyarrhythmias, which means impairment of sinus node function and conditioning disturbances, and tachyarrhythmias, which means supraventricular and ventricular arrhythmias, with a case or cases of syncope in the past due to cardiac rhythm disorders;
(b) bradyarrhythmia, which means impairment of sinus node function and impairment of conditioning with Möbitz atrioventricular block type II, third degree atrioventricular block or alternation of the shoulder block,
(c) tachyarrhythmia, which means supraventricular and ventricular arrhythmias, associated with structural heart disease and sustained ventricular tachycardia, or polymorphic non-persistent ventricular tachycardia, sustained ventricular tachycardia or defibrillator indication;
(d) symptoms of angina,
(e) implantation of a pacemaker;
(f) reflective syncope;
(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, provided that the left ventricular ejection fraction is at least 35%;
o) heart transplant,
(p) heart valve surgery,
(q) hypertrophic cardiomyopathy if without syncope,
(r) malignant 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,
(s) Grade III 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;
t) congenital heart defect.
3. Other cardiomyopathy
In the case of applicants or drivers with cardiomyopathy already described, such as arrhythmogenic cardiomyopathy of the right ventricle, non-compact cardiomyopathy, catecholinergic polymorphic tachycardia and short QT syndrome, or new cardiomyopathy that may be detected, the risk of events causing sudden inability to drive shall be assessed. ';
10. Chapter VII of Annex 3 reads as follows:
"VII. Diseases, defects or conditions causing mental illness excluding or contingent upon medical fitness to drive motor vehicles
1. Mental diseases that exclude medical fitness to drive motor vehicles are diseases or conditions that cause health complications or derogations that are dangerous for road traffic, in particular:
Group 1
(a) neurocognitive disorders of any aetiology whose grade is severe, consistent with dementia syndrome at moderate and severe,
(b) neurocognitive disorders with neuropsychiatric symptoms the degree of which is severe and resulting from the disease,
(c) schizophrenia, schizophrenia, acute and transient psychotic disorders, schizophrenic disorders, persistent mental disorders with delusions, induced delusions, other non-organic psychotic disorders in the acute phase of the disease, or persistent severe symptoms that impair the ability to drive or maintain severe cognitive impairment;
(d) mental retardation;
(e) pervasive developmental disorders with intellectual disorder.
Group 2
(a) the diseases, defects or conditions laid down for Group 1;
(b) neurocognitive disorders of any aetiology even at the stage of mild cognitive disorder and mild dementia;
(c) clinically serious forms of specific personality disorders resulting in serious impairment of judgement, behaviour or adaptability.
2. Mental diseases 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) neurocognitive disorders of any aetiology consistent with mild dementia; the condition is a professional examination by a transport psychologist,
(b) neurocognitive disorders with neuropsychiatric symptoms, the degree of which is mild and resulting from diseases, brain damage or dysfunction or somatic disease, including behavioural, impulse control and perception disorders such as frontal temporal dementia, organic delusion disorder, organic hallucinosis, structural lesions of the brain - post-traumatic, post-inflammatory, post-inflammatory,
(c) pervasive developmental disorders without intellectual disorder;
(d) clinically serious forms of specific personality disorders resulting in serious impairment of judgement, behaviour or adaptability;
(e) other mental illness or personality disorder which cannot be subdivided into mental illness as defined in heading 1, in particular:
1. healing, remission or clinically sufficient form of remission in schizophrenia, schizophrenia, acute and transient psychotic disorders, schizophreactive disorders, persistent mental disorders with delusions, induced delusions or other non-organic psychotic disorders,
2. a history of other mental illness resulting from disease, brain impairment or dysfunction or somatic illness;
3. a history of delirium other than alcohol and other drugs, severe neurotic disorders, behavioural syndromes associated with physiological disorders and somatic factors, personality and behaviour disorders in adults, severe psychological development disorders.
During the expert examinations for all listed states in items 2 of Group 1 (a) to (e), consideration shall be given to the possibility of compensation using harmonised codes for driving restrictions.
Regular medical health check is a medical condition.
Group 2
Diseases, defects or conditions laid down for Group 1 except for the diagnoses referred to in points (a) and (d). ';
11. Chapter VIII of Annex 3 reads as follows:
"VIII. Diseases, defects or conditions caused by the harmful use of psychoactive substances, including alcohol and psychoactive medicinal products, excluding or contingent upon medical fitness to drive motor vehicles
Group 1 and 2
1. The medical fitness to drive motor vehicles shall be excluded for the applicant or the driver who:
(a) is dependent on the consumption of psychoactive substances, including alcohol, psychoactive medicinal products or combinations thereof;
(b) regularly abuse psychoactive substances, psychoactive medicinal products or combinations thereof;
(c) is unable to give up alcohol consumption in such a way that the ability to drive a motor vehicle is not affected (Section 84 (3) of the Act); or
(d) regularly use psychoactive substances or psychoactive medicinal products the effect of which, or combinations thereof, may reduce the ability to drive safely in a quantity that has a negative effect on driving.
2. Medical fitness to drive the applicant's or the driver's motor vehicles,
(a) which has been found unfit to drive motor vehicles because of its dependence on the consumption of psychoactive substances, including alcohol, psychoactive medicinal products or their combinations, or because of its inability to give up the influence of psychoactive substances, including alcohol, psychoactive medicinal products or their combinations during driving, shall be subject to a safe withdrawal period; a safe withdrawal period shall be deemed to be an undisputed consistent and sustained abstinence, the demonstration of which results from the conclusions made by the competent expert and of a minimum duration of 6 months and its continued duration assessed by the treating physician; or
(b) for which a history of repeated acute intoxication has been detected, only on the basis of the conclusions of the expert examination may be accepted.
Regular medical examination is a condition of medical fitness at all times. '
12. Chapter IX of Annex 3 is deleted.
Chapter Chapters IX to XI are renumbered X to XII.
Efficacy
This Decree shall take effect on 1 January 2025.
Minister for Health:
Prof. MUDr. Válek, CSc., MBA, EBIR, v. r.
Sign in for notes, favorites and notifications
Regulation Information
| Citation | Decree No. 445 / 2024 Coll., amending 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 safety belts cannot be fastened to the seat of the motor vehicle (Ordinance on fitness to drive motor vehicles), as amended |
|---|---|
| Regulation Type | Order |
| Author | - |
| Collection | Code of Laws |
| Date of Promulgation | 20.12.2024 |
|---|---|
| Effective from | 01.01.2025 |
| Effective until | - |
| Status | Valid |
The regulation text is for informational purposes only.
Comments 0