The DVLA assesses Group 2 drivers against its Assessing fitness to drive guidance. Having a condition does not automatically mean you cannot hold a bus or lorry licence. What matters is whether it is controlled and whether it could affect safe driving. At a D4 medical with PCV Medicals, the doctor's role is to record your health accurately so the DVLA has the information it needs to decide.
This is a general overview, not medical advice. Your doctor, your specialist and the DVLA will consider your individual circumstances.
How the DVLA assesses medical conditions for Group 2
The medical standards for lorry and bus drivers are higher than for car drivers, because of the size of the vehicles and the time spent driving them. The D4 asks a series of questions about conditions that can affect driving, and the doctor completes these with you during the appointment. If your answers or the examination raise something the DVLA needs to look at more closely, it may write to you, ask your specialist for a report or request further tests. Some conditions must be reported to the DVLA as soon as they are diagnosed, whatever your renewal date, so do not wait for your next medical to declare them.
Common conditions that affect a bus or lorry licence
Diabetes
Diabetes managed by diet, or by tablets that do not carry a risk of hypoglycaemia, is usually compatible with Group 2 driving. Insulin-treated diabetes, and other medication that can cause hypos, comes with strict requirements, including regular glucose monitoring and full awareness of hypoglycaemia. The DVLA assesses these drivers individually.
High blood pressure
Group 2 drivers must not drive if their resting blood pressure is consistently 180 systolic or more, or 100 diastolic or more. Blood pressure that is treated and controlled is generally acceptable, provided the medication does not cause side effects that affect driving.
Heart conditions
Angina, heart attacks, heart failure, arrhythmias and some valve conditions need to be declared. After a cardiac event, Group 2 drivers may need to stop driving for a period and have further investigations before returning to work.
Epilepsy and seizures
The Group 2 rules on epilepsy and seizures are strict. Your specialist is the best person to explain how they apply to you, alongside the DVLA guidance.
Sleep apnoea and excessive sleepiness
Obstructive sleep apnoea that causes excessive sleepiness must be declared. Once it is effectively treated and the symptoms are controlled, many drivers can continue driving, with regular review to confirm the treatment is working.
Stroke and TIA
After a stroke or transient ischaemic attack, Group 2 drivers must stop driving for a period and may need further assessment before returning.
Mental health
Many mental health conditions are compatible with professional driving when they are stable. More severe conditions, or medication that causes drowsiness, may need assessment.
Alcohol and drug misuse
Alcohol misuse or dependence and drug misuse are taken seriously for Group 2 licences, and drivers usually need to show a period of control or abstinence before being licensed.
Having a D4 medical with a condition at PCV Medicals
When you request a quote, a short note about any condition helps the doctor prepare for your appointment. Keep the detail for the medical itself. On the day, the doctor goes through the relevant D4 questions with you, measures your blood pressure and records your answers and findings on the form. The doctor can explain what the DVLA is likely to ask about, but cannot make the licensing decision. Where specialist evidence is relevant, bringing it with you helps the form give a complete picture.
- Recent letters from your specialist or hospital clinic
- A full list of your medication, with doses
- Glucose meter or sensor data if you take insulin
- Results of any recent tests related to your condition
The full checklist is in our guide on what to bring to your D4 medical.
Which medical should you book?
The medical itself is the same D4 examination whether or not you have a condition. New bus and coach drivers book a PCV medical, new lorry drivers an HGV medical, and existing drivers a D4 renewal. Each is a fixed fee, confirmed before you book; see pricing.
This guide is general information for drivers, correct to the best of our knowledge when written. Rules change, so check current guidance on GOV.UK, or ask the doctor at your appointment.