A stroke can have consequences that impair one’s ability to drive which must be taken into consideration:

• 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.
• Limited visual field due to losing half of the visual field (hemianopsia).
• Brain ignoring half of the visual field (hemispatial neglect).
• Impulsive reactions and impaired judgment.
• Fatigue and becoming tired more quickly.

For this reason, there are special centers for evaluating and rehabilitating driving abilities after a stroke (link to the Driving After a Stroke page)

Conditions for renewing a driver’s license after a stroke:

Conditions for ischemic stroke patients

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

Note that age is not a metric for performing the tests and that each additional stroke will be considered on its own.

Conditions for hemorrhagic stroke patients

• Anyone who has not been treated is not fit to drive.
• A patient is considered fit to drive only after surgery or endovascular treatment, and only after three months without the appearance of symptoms and after being evaluated.

Conditions for TIA patients

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

Obligation to report stroke

• One of the most common questions following a stroke is whether the patient can return to driving. You should talk to your doctor to receive a specific answer regarding your case.
• By law, any doctor treating a patient over the age of 16 with a health condition that may make driving a danger to themselves or others is obligated to report the condition to the Licensing Division. In practice, this directive is left to the doctor’s discretion. Moreover, every citizen has a duty to report any change in their medical condition to the Licensing Division. Therefore, as a stroke patient, you also have a duty to report.
• 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 should ask their doctor for a referral.

What Is MARVAD?

The Medical Institute for Road Safety (MARVAD) is the “licensed physician” that determines a patient’s fitness to drive after an illness. It has branches in Haifa and Tel Aviv — see the MARVAD website. The MARVAD’s role includes making recommendations to the Licensing Division (which is the deciding body) about people’s medical fitness for driving; improving the independence of people with disabilities with adaptive driving equipment; and advising employment bodies.

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

The MARVAD recommends permanently suspending a driver’s license only in rare cases.

The most common recommendations of the MARVAD are:

• Permission to return to driving.

• Temporary suspension from driving/temporary permission to drive, to be reevaluated in a year or two.

• Negative answer and recommendation to suspend the driver’s license.

Appealing the MARVAD’s decision

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

The Licensing Division is the deciding body for driver’s licenses. The division is entitled to accept or reject the MARVAD’s recommendation.

If you are found unfit to return to driving by the Licensing Division, you are eligible for a mobility allowance from the National Insurance Institute. 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. Find more information about the mobility allowance here.

Common adaptive driving equipment for stroke patients

• Hand controls that allow the driver to operate the pedals with one hand (one hand for the steering knob and one for the pedal controls).
• Steering knob: a knob installed on the steering wheel that allows the driver to steer with one hand.
• The knob can be upgraded with additional functions such as turn signals and horn.
• Turn signal handle on the right side for those with limited mobility on the left side.
• Gas pedal on the left side.

Important information:

• A report from a doctor who considers a medical examination by the MARVAD to be necessary does not mean the license is suspended.

• Usually, following examination, the MARVAD recommends continued driving under supervision or with adaptive driving equipment.

• 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, on 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 parking badges and disabled parking spaces can be found on the Disabled Parking Badge page.