Iowa driver: Why did DOT give me a mental test for using a cane?

Not much makes Judy Simmons angry anymore, but the 74-year-old fumed this month after trying to renew her driver’s license in Des Moines.

A driver's license clerk asked the Windsor Heights woman why she walks with two canes. She needed them for arthritis in her knees, she replied.

Then she was asked to schedule a driver’s test.

“I asked why and was told that since I walked slowly it was necessary to ensure I could work the pedals of the car,” she wrote to Reader's Watchdog. “I said that seemed a bit much, but I would take the test.

"Then came the most ridiculous questioning I have been exposed to."

What Simmons was asked focused not on her physical capabilities, but rather on her mental acuity:  "What is your date of birth? What is your full home address? What state are we in now?"

The nine questions posed to Simmons — a screening given to thousands of drivers in Iowa since 2014 to determine their mental clarity — made her question whether Iowans with physical disabilities are being discriminated against because of a misperception that they are mentally impaired as well.

“It would be interesting to know if people with many tickets and bad driving records are subjected to these procedures,” said Simmons, who has a good driving record. “I doubt it.”

An Iowa Department of Transportation official said the agency uses the screening tool to try to assess as quickly and objectively as possible whether someone should be driving.

“We use it broadly for any drivers who are asked to take a driving test or asked to submit a medical or vision report,” said Debra Carney, driver fitness officer for the agency.

But that screening troubles those who advocate for people with disabilities in Iowa.

“It’s not objective at all,” said Jane Hudson, executive director of Disability Rights Iowa.

Hudson said the screening reminded her of extra hoops some disabled voters have been put through with voter ID laws that make them prove they are eligible to vote.

“Election workers get the power to check signatures,” she said. “And some people get provisional ballots when (the workers) perceive them to not have the cognitive ability to vote.”

North Carolina's overhaul

Discrimination against disabled drivers has proven costly in another state.

Last year in North Carolina, the state’s Division of Motor Vehicles was forced to overhaul its licensing program after it was sued by six plaintiffs who said disabled drivers were being forced to spend extra time and money to prove they weren't a driving risk.

The 2016 consent judgment resolving the 2014 lawsuit filed by Disability Rights North Carolina found that disabled drivers were being subjected to unnecessary tests and medical reviews under the division’s previous medical evaluation program.

The plaintiffs accused North Carolina’s system of violating the federal Americans with Disabilities Act and the Rehabilitation Act.

Insulting but discriminatory?

The nine screening questions Simmons was asked were identical to those given all drivers believed to need further examination, whether they are perceived to have a physical or a mental impairment.

Simmons said she found them insulting.

“I have no idea what qualified the driver's license clerk to decide I was too impaired to drive or that I might have a cognitive impairment,” she said.

Simmons was told she would have to come back Aug. 11 to take the driving test. Nevermind, she said, that she never was subject to any such questioning when she replaced her license last fall after her purse was stolen.

When she got home, she called the Iowa Department of Transportation and asked to speak with a supervisor.

The supervisor, she said, explained the questioning happens all the time to keep the roads safe.

“She asked if I was taken to a private area for the questioning. I said no. She said I should have been, and she would look into this,” she said. “She could see nothing wrong with the subjective determination that a slow walk indicated a cognitive problem.”

Only some are screened

Under Iowa law, anyone can ask the Department of Transportation to re-examine a person’s fitness to drive.

That re-exam can include both written and road testing and require medical information from a doctor at the driver’s expense, if needed.

Sometimes, people with physical, mental or visual impairments are issued licenses that restrict driving to local areas they are familiar with or allow driving only during daytime hours.

Carney said the DOT worker involved in Simmons’ renewal appeared to have handled the situation as instructed.

If a person renewing a license has a temporary disability — say, a broken ankle — the driver will not be required to take a driver’s test.

But if the impairment could be more lasting, the driving test can be required.

And when the test is required, all drivers are subject to the mental screening questions designed at the University of California, San Diego, College of Public Health.

In Iowa, Carney said, some drivers are taken in a private room, and some are questioned out in the open if there aren’t people nearby.

None of the questions involve medical history.

The DOT chooses to use the 30-second to one-minute screening tool before drivers are re-tested on the road.

“If the person is unable to answer adequately, we would refer them to a physician for a medical report,” she said.

The only other option, she said, would be to screen all drivers at renewal time, which would take more time.

“We don’t screen on a duplicate license,” Carney said.

Few drivers referred

The screening tool developed is widely used by law enforcement to determine if someone might be cognitively impaired, she said.

The first year it was used, workers conducted 5,000 screenings and received fewer than 10 complaints.

“Only 3 percent of the screenings resulted in a medical referral,” she said.

How and when other states use the tool varies, but the questions are the same, Carney said.

Hudson, however, said she would be reviewing the division’s screening questions and procedures.

And she requested Simmons contact Iowa Disability Rights if she was interested. The office's work is funded by the federal government and its work on behalf of clients is free. 

Even though the Department of Transportation can consider whether an individual with an obvious disability can safely operate a motor vehicle, cognitive test questions are irrelevant to testing whether someone can drive, she said.

"The employee seems to have made a giant leap when she decided that a renewal applicant needed a cognitive test," Hudson said.

If someone has an obvious disability raising driving safety concerns, the case should be referred to an Americans With Disabilities Act coordinator, she said. 

The coordinator should follow specific written policies for determining whether an individual can safely drive and whether the individual can be accommodated, according to guidance from the U.S. Department of Justice on licensing.

Lee Rood's Reader's Watchdog column helps Iowans get answers and accountability from public officials, the justice system, businesses and nonprofits. Contact her at lrood@dmreg.com, 515-284-8549 on Twitter @leerood or at Facebook.com /readerswatchdog.

The mental fitness test

Subtract one point for each incorrect response. 

 1. What is your date of birth? (-1 point)

Month, day, and year required; must match documents.

2. What is your full home address? (-1 point)

Address must match document; if not, prompt
for address listed on documents.

3. What state are we in now? (-1 point)

4. What city/town are we in now? (-1 point)

5. Without looking at your watch, can you estimate what time it is now? (-1 point)

Answer provided must be plus or minus one hour or correct time.

6. What day of the week is it? (-1 point)

7-9. What is today’s date?

Prompt formonth, day and year if needed.

• Month: (-1 point)
• Day: (-1 point)
• Year: (-1 point)

Scoring

Subtract one point for each incorrect response.

• 5 or more incorrect: Re-exam needed. Unsafe to drive
• 3-4 incorrect: Re-exam needed. Potentially unsafe to drive; consider totality of circumstances
• 0-2 incorrect: No referral or re-exam based on totality
  of circumstances