Attention, stroke and spinal injury survivors in Australia. You can still apply for a driver's license or continue driving your vehicle, provided you're still capable.

All states and territories grant driving privileges to persons with disabilities (PWD) so long as applicants present proof that they're fit to drive. The process may vary among the local transport authorities, but it generally follows a standard guideline. Also, the applicant's registered vehicle needs to be modified for PWD use.

This is a blessing for PWDs, namely those who suffered from stroke and any form of spinal injury. The Stroke Foundation last year warned of rising incidences of stroke in the next few decades, potentially reaching 72,000 cases by 2050. (1)

Meanwhile, the National Disability Insurance Scheme (NDIS) recorded an increase in the number of participants suffering from spinal cord injury. Despite only making up 1% of all NDIS participants, spinal cord injury cases as of March 2025 rose by 5% from 2024. This is higher than the 3% increase between 2023 and 2024. (2)

Getting Driving Privileges

Stroke and spinal injury survivors can seek help in getting driving privileges via the NDIS. However, according to Austroads' Assessing Fitness to Drive, a PWD's eligibility will be based on two key considerations. (3)

  • Impairment of functions: Identifies sensory, motor, and cognitive functions that were impaired as a result of their condition.
  • Risk of sudden incapacity: Gauges the driver's risk of suddenly being rendered unable to drive, which risks losing control of their vehicle.

The guidelines call for an initial OT driving assessment (OTDA) conducted by a NDIS-registered service. Working with various conditions including stroke and spinal cord injury, the driver-trained occupational therapist (OT) can create a driver rehabilitation plan and suggest vehicle modifications. Contact one to learn more about what else they can do.

NDIS participation provides a major advantage. Before the program's nationwide rollout in 2016, PWD driving didn't gain as much traction due to the high cost of driving lessons and, more importantly, vehicle modifications.

Today, participants can fund such expenses through their NDIS plan. In this case, driving is part of capacity building (CB) and can be paid for via the CB daily activities budget. Vehicle modifications can be funded through the assistive technology budget.

The OTDA Process

Stroke and spinal cord injury, as well as other debilitating conditions, choose no one. They can affect both experienced drivers and those applying for a driver's license. While they're equally eligible for OTDA, their respective approaches differ.

Those who already had licenses before their stroke or spinal injury can go straight to an OTDA. The assessment applies to standard driver's license (Class C license) holders, though it's relatively similar for other license types.

The OT driving assessment consists of two components: an off-road and on-road section. An off-road evaluation reviews the individual's driving history and their understanding of driving laws in their state. This is also where the OT conducts a series of tests that assess the person's faculties (i.e., the functions mentioned earlier).

An on-road assessment is the practical portion of the assessment. The person operates a modified vehicle with passenger seat controls for the driving instructor. The OT joins them in evaluating the driver's capacity to control the vehicle. Once complete, they'll send their report to the driver's doctor, the NDIS, and the driver licensing authority.

Any mistake during the on-road test that prompts the instructor to intervene automatically results in failure. However, this doesn't mean the individual is considered unfit to drive for good. A stroke or spinal injury can keep them away from the wheel for a long time, leading to a stagnation of crucial driving skills.

In such a scenario, it's possible to get another chance at passing the assessment. The OT and instructor may advise retaking the OTDA or waiting until full recovery before doing so. Multiple failures increase one's risk of being permanently marked unfit to drive.

Process for Learner Drivers

The assessment for learner drivers or those with little to no driving experience is different. The person's lack of practical skills means the evaluation is limited to their understanding of driving principles (e.g., defensive driving) and road rules.

Nevertheless, taking the necessary lessons is essential in securing a provisional license. If the individual hasn't shown any improvement after many lessons, the OT may assess them as unfit to drive. Also, NDIS funding for driver training may be stopped.

Ready to Drive? Take the Next Step

A stroke or spinal injury doesn't have to mark the end of one's ability to operate a vehicle. A favorable outcome in an OTDA can help get any survivor back on the wheel upon making a full recovery from their disease. Take one as soon as possible to continue enjoying driving.

References:

1. Economic Impact of Stroke Report 2024 Executive Summary [Internet]. Available from: https://strokefoundation.org.au/media/q15bh2w3/executive-summary-economic-impact-of-stroke-2024.pdf

2. Ndis.gov.au. 2025 [cited 2025 Jul 1]. Available from: https://dataresearch.ndis.gov.au/media/4333/download?attachment

3. Assessing Fitness to Drive 2022 [Internet]. Austroads.gov.au. Austroads; 2024. Available from: https://austroads.gov.au/publications/assessing-fitness-to-drive/ap-g56/assessing-fitness-to-drive-general-guidance/impact-of-medical-conditions-on-driving