What a driving evaluation involves: a guide for older drivers and families
What happens at a professional driving evaluation, what it costs and how to prepare
When a family worries about an older driver, arguments often go in circles. One person says the driving is fine. Another says it is not. A comprehensive driving evaluation settles the question with facts.
It is not a DMV road test. It is a medical style assessment by a trained specialist. The goal is to find out what is getting in the way of safe driving and whether it can be fixed. This guide walks through what happens, what it costs and how to get ready.
Who does the evaluation
The person who does the test is called a driver rehabilitation specialist. Most are occupational therapists, health workers trained to help people do daily tasks safely. Many hold one of two credentials [1]:
- CDRS, Certified Driver Rehabilitation Specialist, from the Association for Driver Rehabilitation Specialists
- SCDCM, Specialty Certification in Driving and Community Mobility, from the American Occupational Therapy Association
These specialists work in hospital rehab programs, private clinics and some Veterans Affairs medical centers. Many programs need a referral or order from a doctor.
Part 1: the office exam
The first part takes place in a clinic. It often lasts about one and a half to two hours [2]. The specialist will:
Review history. Expect questions about health, medicines, past crashes and tickets, and where and when the person drives.
Test vision. This goes beyond reading an eye chart. Tests may check side vision, depth perception, contrast and glare recovery.
Test thinking skills. Short tasks check attention, memory, visual scanning, judgment and how fast the brain processes what the eyes see. These skills matter at busy intersections.
Test the body. The specialist checks strength, how far the neck and arms can turn, coordination and how fast the foot moves from gas to brake.
Part 2: the drive
If the office results allow it, the specialist goes out for a drive with the person. Most programs use a car with a brake on the passenger side, so the specialist can stop the car if needed [3].
The route usually starts easy and gets harder. It may include quiet streets, turns at busy intersections, lane changes, merges and parking. The specialist watches how the person handles real traffic, not just whether they follow rules.
Comparison compiled by Safety Behind the Wheel Foundation
How a driving evaluation differs from other checks
| Type of check | Who does it | What it tells you |
|---|---|---|
| Comprehensive driving evaluation | Driver rehabilitation specialist | Whether health changes affect driving, and what can help |
| DMV road test | State examiner | Whether the person meets the minimum standard for a license |
| Driving school lesson | Driving instructor | Skill coaching; not a medical assessment |
| CarFit check | Trained volunteers | Whether the car is set up to fit the driver |
| Refresher course | Course provider | Updates on rules and safe habits |
Source: Based on guidance from The Hartford, MIT AgeLab and the American Occupational Therapy Association [1].
What the results can be
Many people fear the evaluation will end in “You must stop driving.” That is only one possible result. Common recommendations include [1]:
- Keep driving with no changes
- Keep driving with limits, such as daytime only or within a set area
- Take driving lessons to sharpen certain skills
- Add equipment, such as a spinner knob, a left foot gas pedal or wider mirrors
- Treat a health problem first, then retest
- Retest after a set time, especially if a condition is changing
- Stop driving and plan other ways to get around
Knowing that most outcomes keep people on the road can make it easier for an older adult to agree to go.
What it costs and who pays
Prices vary by program and region. Published prices from a few programs give a sense of the range:
- MossRehab in Pennsylvania lists $320 for an evaluation [2].
- Madonna Rehabilitation Hospitals list $385 total for the clinic and road parts [4].
- PAM Health lists $450 for its specialty driving evaluation [5].
Coverage is mixed. Some hospital programs bill the clinic part as occupational therapy, which many health plans cover with a doctor’s order [6]. Others say insurance and Medicare do not pay for their driving services at all [2]. The road portion is often paid out of pocket. Call the program and the insurer before you book.
Veterans may be able to get a driving evaluation through the VA. Ask the local VA medical center about its driver rehabilitation program.
Who sees the results
Ask this question before the test. In some programs, the report goes to the referring doctor. In some states, results that show unsafe driving may be shared with the driver licensing agency. Knowing the rules up front avoids surprises and builds trust with the person being tested.
How to prepare
A little planning helps the person do their best:
Checklist from Safety Behind the Wheel Foundation
- Get a good night’s sleep before the test
- Take medicines as usual, unless a doctor says otherwise
- Bring glasses, hearing aids and any driving aids
- Bring a valid driver’s license or permit
- Bring a list of all medicines and health conditions
- Eat a normal meal beforehand
- Wear comfortable shoes
- Arrange a ride home, in case the specialist advises against driving
How to find a specialist
Start with the person’s doctor, who may know local programs. Federal safety officials also point families toward driver rehabilitation specialists when there are concerns [7]. You can also search the directories from the Association for Driver Rehabilitation Specialists and the American Occupational Therapy Association. Hospital rehab departments often run programs. Wait lists can be weeks long, so call early.
Frequently asked questions
Is a driving evaluation the same as losing a license?
No. The specialist does not take away a license. Only the state can do that. But the specialist may give advice to the doctor, and in some states a report may reach the licensing agency.
How long does the whole process take?
Plan for about two to three hours for both parts. Results are often discussed the same day, with a written report later.
Can a person fail and try again?
Yes. Many programs offer lessons and a retest. Some people improve after treatment for a health problem, such as cataract surgery.
Related articles
Sources and further reading
- 1The Hartford Center for Mature Market Excellence, MIT AgeLab and American Occupational Therapy Association. “Your Road Ahead: A Guide to Comprehensive Driving Evaluations.” core.ecu.edu/…/Your_Road_Ahead.pdf
- 2MossRehab Driving Program. “Frequently Asked Questions.” mossrehab.com/…/FAQs%20(002).pdf
- 3Washington University Occupational Therapy. “Driving Evaluation.” otservices.wustl.edu/driving-evaluation
- 4Madonna Rehabilitation Hospitals. “Driver Rehabilitation Program.” madonna.org
- 5PAM Health. “Specialty Driving Program.” pamhealth.com/download_file/view/1183/782
- 6Ascension Alexian Brothers Rehabilitation Hospital. “Driver rehabilitation and evaluation program.” healthcare.ascension.org/…/driver-rehabilitation
- 7National Highway Traffic Safety Administration. “Older Drivers.” nhtsa.gov/road-safety/older-drivers
This article reflects the safety priorities of driver rehabilitation and older driver safety. It is general education, not medical advice. Prices and coverage change, so check with programs and insurers. Reviewed November 2026.
Special thanks to our contributors
We appreciate the professionals, experts, and community members who share their knowledge and perspectives to help make this resource better. Your insights are always welcome and appreciated.
Have professional expertise, firsthand experience, or a perspective that could make this resource better?
We welcome your input. Your knowledge and experience can help us make this resource more useful, accurate, and meaningful to the people who rely on it.
Thank you. Your contribution is on its way.
We’re grateful you took the time to share your knowledge with us. Our team reviews every contribution with care. If it helps improve this resource, we’ll update the page and recognize you the way you chose.
Keep learning
Safe Driving Resource Center
Guides, self-checks and articles for drivers, parents of new drivers, and families recovering after a crash.
