North Carolina’s Medical Review Branch


  • Part of the Division of Motor Vehicles (DMV) under the Department of Transportation.
  • Mission:  Promote highway safety by evaluating drivers who may have disabilities that could compromise their ability to safely operate a motor vehicle.
  • Provides guidance regarding unrestricted licensing, restricted licensing, or cancelation of driving privileges.

Referral process

  • Medical Review Branch receives a referral from:
  • Driver license examiners, family members, concerned friends, physicians,  hospitals, crash reports, law enforcement, court system.
  • Referral data is reviewed by Medical Review Branch personnel
  • 3 registered nurses,  4 contract physicians, and administrative staff.
  • Referred individual is mailed medical review paperwork to be completed by a physician.
  • Must be returned within 30 days, with up to 3 extensions by requests
  • Medical paperwork reviewed by Medical Review Branch personnel with an action to:
    • Request additional information (optometrist, neuropsychological evaluation, occupational therapy driving evaluation)
    • Decision made regarding licensure status.
  • Based on additional information, a decision is made regarding licensure status.
    • Requested information must be submitted or the license is canceled.
    • Decisions include:  unrestricted driving, driving restrictions, cancellation.
    • Typical restrictions:  daylight driving, no interstate, 45 mph, hand controls, etc.
    • Periodic reviews are requested for progressive conditions.
  • Upon the decision, individuals can request a hearing.
    • Request must be in writing within 10 days of received decision letter.
    • Restrictions are not applied until decision of the appeal is rendered.
  • Hearings will be scheduled and individual notified by certified mail. 
    • Hearings conducted once a month with two physicians and a registered nurse.
    • Legal counsel can participate.
    • Decision of hearing is sent by certified mail
    • Changes to this decision only occur by an improvement in the individual’s health or an appeal to the superior court by a judge.

Contact Information for Physicians
To refer a patient:

The North Carolina Physician’s Guide to Driver Medical Evaluation
The NC Physician’s Guide was developed by the Medical Review Branch of the Division of Motor Vehicles under the direction of the Department of Transportation.  It was written to provide physicians the criteria for evaluating people who have medical conditions that could affect driving performance.  The Guide provides:

  • Guidelines for physicians on specific conditions.
  • History of the Medical Evaluation Program
  • Identification of Impaired Drivers
  • How to refer a patient
  • Evaluation procedure
  • Appeals and Hearing officer program

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