Driving after a stroke

For some people inability to drive following a stroke may just mean a temporary loss of independence, but for others, such as professional drivers, it can have a serious financial impact. 

Here we answer questions about driving after a stroke, a transient ischaemic attack (TIA, or ‘mini-stroke), or a heart attack and whether you have to tell the DVLA and your motor insurance provider. 

Can you drive after a stroke?

Everyone who has a stroke must stop driving for a least one month afterwards, regardless of the type of stroke or kind of licence they hold. After that, whether you can drive again, and when, depends on the opinion of your doctor. Many people can return to driving, but for some it may be impossible. 

Why can’t I drive immediately after a stroke?

Even if you feel fine there are many reasons why a stroke or TIA may affect your ability to drive, making you a danger to yourself and others. A stroke can have temporary or permanent effects such as:

• Fatigue. This is more than normal tiredness and affects your driving ability.

• Physical effects, such as weakness in arms, legs or both, balance problems, pain and sensation changes.

• Double or blurred vision, loss of central vision, or an area of vision, often on the same side as weakness in your face, arms or legs.

• Cognitive effects. These could include reduced ability to concentrate and multitask – essential when driving – and affect your capacity to understand driving situations and to navigate. You could also experience problems with your memory and perception of space and time.

• Epilepsy, which some people develop after a stroke.

Determinants of driving after a stroke

Whether and when you can drive after a stroke or TIA depends on 

• Your medical condition as assessed by doctors,

• the kind of stroke you have had, and 

• the type of driving licence you hold. 

Some people may not want to start driving again, but if you do, there are standard procedures in place in the UK before you can do so. 

• Your ability to drive safely must be assessed by your doctor or medical team. 

• They should explain the current DVLA guidelines (DVA in Northern Ireland).

• They may contact other professionals or medical advisers at the DVLA for advice.

• In some circumstances you may be able to return to driving only if you have passed an assessment test. 

Ensure you know which type of stroke you have had and what kind of licence you hold because the rules vary according to the kind of licence.

Do I need to inform the DVLA after a stroke?

Sometimes not, but under other circumstances it is essential. It's your responsibility to tell the DVLA about any medical issue that impacts your ability to drive safely, including a stroke. Your doctor is not responsible for this. You can report your stroke to the DVLA online.

Failing to tell the DVLA about a medical condition that affects your driving carries a fine of up to £1,000, and if you have an accident you could be prosecuted.

Driving after a TIA, an ischaemic stroke or lacunar stroke

After a single TIA or ischaemic stroke (including a lacunar stroke), many drivers can resume driving after a month, but your return depends on your medical condition and type of licence. 

• Car or motorcycle licence: you cannot drive for one month after an ischaemic stroke or single transient ischaemic attack. You need not inform the DVLA during this month. 

If after that month, a doctor judges that you have any remaining cognitive or visual issues you will may have to wait longer, but you may be able to restart driving if your remaining problems are limited to limb weakness.

If you have a series of TIAs over a short period, you cannot drive until you have been free of them for three months. 

If you are in the group that does not have to notify the DVLA for a month, you must notify the DVLA after that month if you have any ongoing effects. If your doctor says you cannot drive for more than three months you will need to surrender your licence to the DVLA.

• Heavy goods vehicle (HGV) or public service vehicles (PCV) licence:  you cannot drive these types of vehicles for a year. The DVLA must be informed immediately. 

• Taxi drivers: your local authority (or in London, the Public Carriage Office) must be informed and it will decide on the medical standards you must meet before returning to driving.

Driving after a haemorrhagic stroke

These come in two types: 

a) Subarachnoid haemorrhage

• Car/motorcycle licence: a doctor must certify you as safe before you can go back to driving. However, you do not need to inform the DVLA. If you have surgery for intercranial aneurysm, you cannot drive for at least six months.

• HGV/PSV licence: You will be forbidden to drive for at least six months, but it could be longer, according to where the haemorrhage was and the type of treatment you received. The DVLA must be informed. 

b) Intracranial haemorrhage due to infratentorial arteriovenous malformations (AVMs)

• Car/motorcycle licence: You can continue driving. The DVLA does not need to be told provided you have no symptoms that may affect your driving.

• HGV/PSV licence: Your licence will be revoked for a period, and the DVLA must be notified.   Your licence will be revoked permanently if you receive no treatment, but you may be able to resume driving if treatment successfully removes the AVM and you have no symptoms that could impair your ability to drive.

The DVLA and strokes: checklist

You must notify the DVLA as soon as possible if:

• you have multiple TIAs over a short period 

• your condition worsens at any time 

• you have any form of epileptic seizure following your stroke, other than ones within the first 24 hours after it. Other than during that period, if you have a seizure or develop epilepsy after a stroke you must stop driving and inform the DVLA. 

• your stroke treatment included brain surgery

• you have experienced more than one stroke in the past three months

• your doctor expresses concern about your fitness to drive

• you are a Group 2 driver (lorry and bus).

Do I have to inform my insurance company after a TIA or stroke?

Yes. Even if your doctor has said you can start driving again, you still need to tell your insurance company about a stroke or a TIA. Failing to do so may mean you are not covered in full for future claims.

Tell your insurance company as soon as possible. If after a month you are confirmed as being safe to drive again by your doctor, your insurer may ask for medical confirmation that you are safe to return to driving and may ask you to tell the DVLA/DVA about your stroke or TIA. 

Driving after a stroke – insurance

Your ability to buy motor insurance should not be affected by a stroke or TIA, even if your stroke has left you with a disability that means you start driving an adapted vehicle.

How will having a stroke or TIA affect my motor insurance premiums?

Your premiums may be unaffected unless you need an adapted vehicle. Consult your insurer. It’s illegal to charge extra for motor insurance because of a disability unless the insurer can prove it’s justified, as stated in the Equality Act 2010, and there is no evidence to suggest that disabled drivers pay higher insurance premiums, according to the charity Disabled Motoring UK.

Consider rebroking your cover, particularly if you are expecting to reduce your mileage after your stroke or TIA. You may find that telematics (black box) cover or pay per mile cover suits you better, at least in the short term. 

What if I am declared medically unfit to drive?

It is essential that you inform your insurer and the DVLA, otherwise you are committing a criminal offence.

After this the DVLA will decide that you can either: 

• keep your licence and continue driving

• be granted a temporary licence 

• be given a licence, but only for a car with specific adaptations.

• Decide that you cannot continue to drive, and revoke your licence. 

Fitness to drive assessments and return to driving courses

In some cases you may be offered an assessment at a local mobility centre. About 50% of people who have strokes can consider returning to driving according to the charity Driving Mobility, which offers courses at 20 locations across the UK. 

If referred through the NHS, a GP, other health professional, the DVLA, DVA, or Motability, assessments are free to clients at most centres. You can self-refer, in which case you pay – ask about costs. 

For more information about driving after a stroke or TIA, see The Stroke Association 

Downloadable guide: Driving After a Stroke.

Driving after a heart attack – insurance and DVLA 

Many of the rules about driving after heart attacks are similar to those about strokes. If you have had a heart attack, you don’t need to inform the DVLA, but it recommends stopping driving for four weeks. 

As with strokes, when you can get back behind the wheel is a decision for your doctor. If you are not fit to drive for three months or more, you must surrender your licence. You can reapply for it once medical advice changes. 

Inform your car insurance company of any changes to your medical condition and this will be taken into account before your policy is renewed or a new policy is issued. 

You may be able to reduce your premiums by changing your car. As always it can pay to  shop around for cover.