Driving Evaluations

           Duke Driving Program

A very important part of an individual’s return to independence following an injury, illness or accident is the ability to return to driving with safety.


The Duke Driving Program evaluates both new and mature person’s medical fitness to drive. The clinical driving evaluation assesses various skilled components of the driving process. All testing is performed within the clinic, and takes approximately two hours to complete. Following the successful completion of the clinical evaluation, you will be referred to a DMV licensed driving instructor for an on-the-road evaluation.


The Duke Driving Program serves in an advisory capacity to assist in safeguarding the individuals and the public’s well-being. Reports will be shared with the person being evaluated and their referring physician.  If a person was referred by NC DMV Medical Review Unit, the full report will be faxed to them for review.  The Duke Driving Program does not have the authority to issue or revoke a driver’s license.


Who should have a driving evaluation?

Anyone whose driving ability may be affected by an injury or illness::

  • Rehabilitation Patients who have experienced a stroke, traumatic brain injury, multiple sclerosis or spinal cord injury.
  • Older Adults who have vision-related changes, a chronic disease such as arthritis or diabetic neuropathy, a diagnosis with early stages of dementia, or age-related changes and are unsure of their safety.
  • Students or Other New Drivers with a learning disability, attention deficit disorder or a new driver with a physical disability such as cerebral palsy or spina bifida.


What is evaluated?

  • Visual acuity and depth perception
  • Visual perceptual skills
  • Night vision
  • Memory/cognitive skills
  • Safety/judgment skills
  • Understanding of road rules and regulations
  • Physical strength, coordination and sensation
  • Eye-foot and eye-hand reaction time speed

The clinical driving evaluation is performed by an occupational therapist with specialty training in driver rehabilitation services including staff with national certification in driver rehabilitation services.



An evaluation summary specifying performance and recommendations based on the test measures will be presented to the client at the end of the clinical driving evaluation. The following recommendations may be

  • Driving with suggested safety limitations (daylight only driving, local, familiar roads, no highways, limited radius from home)
  • A ‘behind the wheel’ evaluation by a certified DMV driving instructor through various types of driving conditions and vehicle maneuvers.
  • Instruction on use of adaptive driving devices and techniques (specialized mirrors, cushions, loading of adaptive equipment.
  • Annual or semi annual re-evaluation to ensure ongoing safe driving patterns.
  • Exploration of alternative means of transportation when unsafe driving patterns are demonstrated.
  • Referral to a specialist for evaluation and treatment when significant cognitive, motor, or sensory deficits that may affect driving and other activities of daily living are identified.


The occupational therapist provides professional recommendations but, by law cannot make the final decision on medical fitness to drive. Physicians can report directly to NC DMV if they feel that a client’s driving abilities pose a public health risk.


All reports and recommendations will be faxed to the clients referring physician. If a client is referred by the NC DMV Medical Review Unit, the report will also be faxed directly to them within 3 business days.  Clients may access a copy of the clinical driving evaluation and behind the wheel evaluation via the DukeMychart web portal at www.dukemychart.org



A physician referral is recommended to participate in the Duke Driving Program. The clinical driving evaluation is NOT billable to insurance as driving is not a medical necessity. The cost of the clinical driving evaluation is $200.


If you must complete the behind the wheel evaluation with a licensed driving instructor, the costs are approximately $150 for a one hour session. This fee will vary based on how far the vehicle testing location is from the Triangle area.

Receipts will be available to claim the above fees as a medical expense for tax purposes.


If you have a family member or friend who answers yes to any of the following questions, they should consider discussing medical fitness to drive and a clinical driving evaluation with their physician

  • Are there conditions in which you have difficulty driving, or do not drive at all?
  • Do other drivers honk at you, do family members/friends refuse to ride with you?
  • Do you have pain, decreased range of motion, decreased strength or other issues that make driving difficult?
  • Have you recently gotten lost or confused while driving?


Duke Driving Brochure duke-drv-brochure

The Association for Driver Rehabilitation Specialists www.aded.net

American Occupational Therapy Association www.aota.org

NC DMV Request for Driver Re-examination https://www.ncdot.gov/download/dmv/MedicalRequest.pdf



Duke University Health Center at Lenox Baker
Division of Physical and Occupational Therapy
3000 Erwin Road
Durham, NC 27707
Fax # 919 681-5555

Duke Specialty Rehab Services
5920 Sandy Forks Road, Suite 200
Raleigh, NC 27609
Fax # 919 954-3177

To Schedule an appointment call: 919 684-2445