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Medically at-risk drivers who are referred to State licensing agencies are screened for fitness to drive by a variety of mechanisms (see Countermeasure “License Screening and Testing” for more information). If a State licensing agency determines that a driver poses excessive risks only in certain situations, the driver can be issued a restricted license. License restrictions preserve the driver’s mobility while protecting the driver, passengers, and others on the road.

Most States offer licensing restrictions for medically at-risk drivers who are deemed to be safe under certain circumstances. Restrictions include daytime driving, road types and speed, trip purpose, specific geographical area, and more. The AAAFTS publishes the Driver Licensing and Policies database, which includes a section on the types of restrictions each State may impose (Dunlap and Associates, Inc., 2019). One of the more common restrictions is daytime driving only.


The number of States currently issuing restricted licenses specifically for older drivers is not known, but the AAAFTS Driver Licensing Policies and Practices database shows 49 States and the District of Columbia can place at least some types of conditions or restrictions on the licenses of older or medically at-risk drivers (Dunlap and Associates, Inc., 2019). Restrictions are generally determined using medical records or in consultation with physicians.


Several studies show driver license restrictions lower the crash risk for older drivers, though their crash risk is still higher than similar-aged drivers with unrestricted licenses (Potts et al., 2004; Vernon et al., 2001). Research conducted by Braitman et al. (2010) found license restrictions may be an effective alternative to complete driving cessation, providing drivers with some degree of continued mobility and independence. However, they also concluded that while the overall safety benefits of license restrictions may be unknown, license restrictions tend to reduce driving exposure, especially in higher risk situations.

Langford and Koppel (2011) found imposing a license restriction was usually associated with a reduction in absolute crash rates and identified three restrictions producing lower crash rates for consideration. The three restrictions (driving within a specified distance of home, not driving at night, and driving only in specified areas) can be thought of as major components of a graduated driving reduction program.

Iowa offers tailored drive tests that allow drivers to be tested in their own community on roads they would typically drive and, if successful, these drivers are allowed to drive where they have demonstrated proficiency. An evaluation of the “local drive test” (LDT) option, offered to older Iowa drivers who might not otherwise be able to renew their licenses, found the overall crash rate of LDT drivers was higher than the general population of licensed drivers 65 and older, but was lower than the overall driver crash rate for Iowa drivers (Stutts & Wilkins, 2012).

NHTSA published a report on older drivers’ compliance with license restrictions (Joyce et al., 2018). The study used a combination of approaches, including a literature review, a driving evaluator panel consisting of license administrators and law enforcement officers from Florida, Iowa, and Virginia, an analysis of driver license and crash data from the 3 States and Maryland, and a field study of driving exposure of adults 70 and older. Restrictions included daytime driving only, maximum limit on travel speeds, and limits on geographic locations or distances traveled from home. In Maryland, the restrictions on locations and distances traveled included limits on trip purpose. Results demonstrated that drivers generally complied with restrictions imposed by licensing agencies. Crash rate analysis from the 4 States showed mixed outcomes. Drivers with restrictions had lower crash rates than when they drove without restrictions in Iowa and Maryland. In Virginia, the crash rates slightly increased post-restriction. Restrictions for speed and location (geographic limits) were associated with about 25% reduction in crash rates in Iowa. Conversely, the daytime-driving only restriction was not associated with a crash rate reduction. This result is not unexpected given that self-restriction of nighttime driving is common among older drivers and therefore licensing restrictions of this nature are unlikely to result in observable change.


Once drivers have been screened and assessed, the costs of issuing a restricted license are minimal.

Time to implement:

Restricted licenses can be implemented as soon as any needed policy or legislation changes are enacted.