A stroke can affect the skills required to drive a vehicle, and thus people who have had a stroke must undergo testing and evaluation to determine whether they are fit to drive.

By law, doctors have a duty to report drivers with health conditions that may endanger themselves or others to the Licensing Division. Moreover, every citizen has a duty to report any change in their medical condition to the Licensing Division.

After receiving a report, the Licensing Division will summon the patient to a driver medical fitness test at the Medical Institute for Road Safety (MARVAD). If a patient does not receive such a summons, they ask their doctor for a referral.

What Is the MARVAD?

The Medical Institute for Road Safety (MARVAD) advises the Licensing Division about people’s medical fitness for driving. The MARVAD has branches in Haifa and Tel Aviv – see their website. 

The MARVAD performs various tests in order to reach a recommendation:

The recommendations will be:

1. Permitted to drive.
2. Temporarily permitted/not permitted to drive, to be reevaluated in a year or two.
3. Negative answer and a recommendation to suspend the drivers’ license (in rare cases).

You can appeal the MARVAD’s recommendation with the appeal committee, which is part of the Ministry of Transport and Road Safety. Even if rejected by the appeal committee, you can request an additional referral to the MARVAD a year after receiving the appeal committee’s decision.

The Licensing Division, which is the determining body for driver’s licenses, is entitled to accept or reject the MARVAD’s recommendation.
If you are found unfit to go back to driving by the Licensing Division, you are eligible for mobility benefits from the National Insurance Institute of Israel (NIII). Additionally, you might be able to apply for an Israeli driver’s license for your primary caregiver (including foreign workers) so they can drive you around. For more information, see the Mobility and Driving page in the Rights section.

A stroke may have consequences that impair driving ability and must be taken into consideration during rehabilitation:

• Difficulty operating the steering wheel or gearshift due to paralysis/weakness in the hand.
• Difficulty operating the pedals due to paralysis/weakness in the leg.
• Partial visual field due to losing half of the visual field (hemianopsia).
• Brain ignoring half of the visual field (visual neglect).
• Impulsive reactions and impaired judgment.
• Fatigue and tiring quickly.

For this reason, there are special centers for evaluating and rehabilitating driving abilities after a stroke.

These driving rehabilitation centers employ occupational therapists who specialize in the field, and they can work with patients to regain the skills required for driving a car, such as:

• Practicing on driving simulators (not on the road).
• Familiarity with disabilities related to the visual field, cognitive disabilities, reduced function at night, and reduced abilities on long drives.
• Learning driving strategies.
• Driving a car with the help of driving aids and a driving teacher (if the patient has a valid driver’s license).

At the end of the process, the stroke patient receives a report summarizing their diagnosis, explaining their impairments and detailing any necessary equipment to allow for safe driving. This report is intended to be given to the MARVAD. However, it is important to know that the MARVAD is not obligated to accept the recommendation of the report. Note that if the report recommends suspending the patient’s license, it is transferred directly to the medical authority in the Licensing Division, as per the instructions of the division.

*It is advisable to call these centers and consult with them in advance, in order to understand whether the framework is suitable for your needs. There are driving centers in hospitals and community frameworks. Most are paid for by the individual and cost around NIS 1,000, not including the driving lessons.

*There are many driving rehabilitation centers in private institutes and hospitals. You should consult with your doctor or rehabilitation doctor to find a suitable center.

In general, there are certain conditions for renewing a drivers’ license after a stroke:

Conditions for ischemic stroke patients

1. Driving is forbidden for a period of at least one month.
2. After a month, the patient’s motor, visual and cognitive skills should be evaluated by a neurologist/rehabilitative doctor or family doctor.
3. Patients who refuse treatment will be disqualified from driving.

**Note that age is not a metric for performing the tests, and that each additional stroke will require individual reconsideration.

Conditions for hemorrhagic stroke patients

1. Anyone who has not been treated is not fit to drive.
2. A patient is considered fit to drive only after surgery or endovascular treatment, and only after three months symptom-free and after being evaluated. 

Conditions for TIA patients

1. If the patient was discharged from hospital with the same diagnosis as a stroke — the criteria for reporting and driving are the same as for an ischemic stroke.
2. If not, the patient will be considered unfit to drive for two weeks only, after which time the driver’s license will automatically be renewed.

Important Information:

• A report from a doctor opining that a medical examination by the MARVAD is necessary does not mean the license is disqualified. 
• Usually, after the examination, the MARVAD recommends continued driving under supervision or with use of driving aids. 
• Despite the legal obligation to report, reporting to the authorities varies from one hospital to another, and even among different doctors, so the responsibility to report falls primarily on the patients themselves — that is, you. If you are involved in a car accident during this period, your insurance company may retroactively refuse to insure you, since you were forbidden from driving during this period.
• Information about disabled vehicle certificates and disabled parking badges can be found on the Disabled Parking Badge page.