Navigating Virginia Medical Review Services

Understand why DMV opened a review

Virginia's Medical Review Services overview describes a process for conditions that may impair driving even temporarily. Concerns can involve consciousness, vision, judgment, or motor function. The review is about driving ability rather than a diagnosis label alone. Information may reach DMV through a crash, a license application, direct disclosure, or a report from another person. Identifying the event under review helps the treating professional address the actual question.

Read every letter before arranging the examination. DMV distinguishes system-generated notices from an evaluator's customized explanation in its correspondence guidance. The customized letter may specify the condition, medication, or event that needs documentation. Give the provider the complete correspondence packet so that a routine office note is not submitted in place of the requested findings. If letters appear inconsistent, obtain clarification from Medical Review Services rather than choosing the more favorable deadline.

Under the medical review procedure, DMV may require a medical statement, vision statement, rehabilitation evaluation, knowledge examination, or road examination. Its clinically trained evaluators apply the state's policies and review the information submitted. The treating professional supplies medical evidence; DMV makes the licensing determination. A general statement that the patient feels well may leave unanswered questions about recurrence, medication effects, or functional ability.

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Prepare and submit the correct reports

The Customer Medical Report, MED 2, and vision report, MED 4, contain different sections and purposes. Complete the customer portions and have the appropriate professional complete the requested clinical portions. Bring all relevant DMV letters to the appointment. If a specialist manages the condition, coordinate that provider's information with the primary care report. Missing signatures, unanswered relevant sections, or an outdated examination can delay a review even when the driver has already attended several medical appointments.

Virginia now provides the Medical Review Services online portal for secure submission by drivers and health care providers. Mail and fax remain available according to the forms and correspondence. The portal does not accept the disabled parking application MED 10, sun-shading application MED 20, or commercial Medical Examiner's Certificate. Send each transaction through its own channel rather than placing unrelated medical paperwork into the same upload and assuming every program will receive it.

As reviewed October 21, 2026, DMV's deadline guidance says an initial review deadline generally allows 60 days from notification to MRS of the need for review. The individual notice controls the driver's case. DMV asks for completed information at least 5-7 days before the suspension date to allow processing. If a provider delay threatens that date, contact MRS immediately to ask whether an extension is available; do not assume that one has been granted.

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Apply the policy for the actual event

Virginia's seizure and blackout policy ordinarily calls for a six-month suspension from the last seizure when DMV is notified of an episode in a licensed driver. An unexplained blackout or loss of consciousness can also trigger six months. Reinstatement requires the specified medical report and review. Simply reaching a date on the calendar does not establish that DMV has approved a return to driving.

The seizure policy contains narrower provisions for breakthrough seizures and qualifying isolated episodes that may allow consideration after three months. Those provisions depend on medical circumstances and documentation; they are not options the driver selects for convenience. An isolated event associated with alcohol or substance withdrawal remains subject to the stated six-month rule and additional requirements. Ask the treating neurologist to address the specific policy criteria rather than shortening the suspension based on a personal interpretation of the event.

DMV's diabetes policy addresses blackouts, seizures, loss of consciousness, or altered awareness associated with insulin reaction or hypoglycemia. Required evidence includes the relevant medical report and physician-certified, glucometer-verified blood sugar logs for 15-30 days. The policy specifies values above 70 and below 400 mg/dl for its licensing assessment. These are DMV reporting criteria, not an individualized treatment plan; clinical targets and medication decisions belong with the treating professional.

After qualifying diabetes-related reinstatement, Virginia describes three-month review followed by six-month and annual review cycles. Possible release from periodic reporting depends on the subsequent history and adequate control. Commercial drivers can face more stringent evaluation. A person driving a truck for work should therefore disclose that role to both the provider and DMV instead of assuming an ordinary-license medical outcome resolves all commercial medical obligations.

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Address cognition, vision, and equipment

The cognitive impairment policy requires knowledge and skills testing for covered impairment or dementia. If the knowledge examination is unsuccessful after three attempts, a successful rehabilitation evaluation is required before an additional attempt under that policy. DMV may also require an evaluation before testing when there is evidence that the condition has affected driving. Follow the ordered sequence so examinations are supported by the necessary medical clearance.

Vision concerns are evaluated under the state's vision requirements, which distinguish unrestricted, daylight-only, and commercial credentials. A vision restriction can remain on the license after treatment until DMV formally removes it. Drivers who need specialized controls should also consult the adaptive equipment policy. New hand controls or a left-foot accelerator can require a certified rehabilitation evaluation, while minor fitting aids are treated differently.

Medication effects can matter even without a permanent diagnosis. DMV's prescription driving guidance recommends discussing side effects and combinations with a physician or pharmacist. Include nonprescription drugs in that discussion and share the complete medication list among prescribers. Avoid driving when the effect is uncertain or when the person feels ill, tired, or disoriented. A medication change may warrant a transportation plan while its effects are assessed.

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Read the outcome and maintain compliance

Possible review decisions range from continued unrestricted licensing to limitations, further testing, periodic reports, or suspension. Keep the outcome letter with the driver's record and identify each required action. A restriction to particular conditions is different from permission to drive generally, and a request for another evaluation is different from final clearance. Verify current status before driving after a suspension or an unresolved reporting deadline.

Drivers placed on periodic review must provide updated medical evidence on the assigned cycle. DMV generates a reminder 60 days before the next review date and recommends arranging the appointment about two months ahead. A final reminder can identify the approaching suspension deadline without a later separate suspension notice. Calendar the reporting date independently from license expiration because the physical card can remain unexpired while the driving privilege is suspended.

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Reporting concerns and disputing a decision

DMV accepts written safety concerns through its impaired driver reporting process, including MED 3. Virginia protects the source and reason of a report supplied by a relative or treating medical professional; information about other reporters may be released. Provide specific observations and accurate identification. The purpose of the report is to enable evaluation, so avoid presenting speculation as a confirmed diagnosis or describing someone else's account as a personally observed event.

A driver disagreeing with a medical action can follow the MRS appeals process by requesting an administrative fact-finding proceeding in writing. DMV normally conducts medical hearings by teleconference, with an in-person option at headquarters. Its page says results can take up to six weeks, and further review can proceed through circuit court. A hearing request should not be assumed to restore driving authority; confirm the current status and any stay separately.

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Frequently Asked Questions

Does a medical review automatically mean permanent license loss?
Virginia can allow continued licensing, impose conditions, request additional evaluation, or suspend privileges according to the evidence and applicable policy.

Can I submit a commercial medical certificate through the MRS portal?
The portal excludes commercial Medical Examiner's Certificates, which follow Virginia's separate electronic examiner reporting system.

Is the general seizure waiting period always three months?
Virginia generally uses six months, with narrower three-month provisions for qualifying breakthrough or isolated seizures supported by the required medical evidence.

What should my clinician receive before completing the DMV report?
The clinician should receive the DMV forms and correspondence, especially any customized evaluator letter identifying the condition or event requiring an answer.

Will DMV issue a separate suspension notice after every final reminder?
Virginia's periodic review guidance warns that a missed final deadline can produce suspension without another suspension notice.

How does a driver challenge a medical licensing decision?
The published MRS procedure allows a written request for an administrative fact-finding proceeding, followed by the applicable circuit court review route if necessary.

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More Virginia DMV guides

The other Virginia DMV guides, 52 of them: