In short
You need a medical MPU if an illness, long-term medication or your eyesight raise doubts about your fitness to drive. The legal basis is § 11 FeV. Many illnesses are easily treatable, so you often keep your licence – sometimes with conditions or a time limit instead of losing it completely.
Not every MPU (medical-psychological assessment, Medizinisch-Psychologische Untersuchung) has to do with alcohol, drugs or traffic offences. Health reasons can also lead the driving licence authority (Fahrerlaubnisbehörde) to demand proof of your fitness to drive. The page What is an MPU? explains how an MPU works in principle.
What is a medical MPU?
A medical MPU is an assessment of fitness to drive that focuses mainly on health issues. It clarifies whether you can take part in road traffic safely despite an illness, medication or impaired vision.
The legal basis is § 11 FeV (Driving Licence Regulation, Fahrerlaubnis-Verordnung). This section governs the general requirements for fitness and sets out when the authority may require medical reports or an MPU. The professional standard is set by the Guidelines for Assessing Fitness to Drive (Begutachtungsleitlinien zur Kraftfahreignung) of the Federal Highway Research Institute (Bundesanstalt für Straßenwesen, BASt).
Initially, the evidence is often a specialist medical report (fachärztlicher Bericht) containing a statement on fitness to drive. Depending on the question, the authority additionally orders a medical MPU – the specific order is always what counts.
Which illnesses can affect fitness to drive?
Fitness to drive can be affected above all by illnesses that lead to a sudden loss of control, disturbances of consciousness or impaired perception. The authority then examines whether and under what conditions you can continue to drive safely.
Typical areas are:
- Epilepsy – risk of seizures at the wheel
- Diabetes – risk of hypoglycaemia up to loss of consciousness
- Eyesight – visual acuity and field of vision
- Dementia and cognitive decline
- Cardiovascular diseases
- Mental disorders
- Long-term medication, for example with opioids or sedatives
The trigger is often age-related doubts or reports from doctors. An accident or something noticed during a traffic check can also raise questions about your fitness in terms of health.
Am I allowed to drive a car with epilepsy?
According to the BASt assessment guidelines, with epilepsy you are usually allowed to drive a car or motorcycle again if you have been seizure-free for at least 1 year. In certain situations this is possible earlier, from about 3 to 6 months.
For Group 2 – i.e. lorries, buses and passenger transport – much stricter standards apply. Here, fitness to drive usually only exists without anti-epileptic drugs and after a long seizure-free period. The specialist assesses which situation applies to you on the basis of your medical history.
Am I allowed to drive a car with diabetes?
With diabetes, you are usually fit to drive, as long as you do not have severe or repeated hypoglycaemic episodes in which you depend on help from others. The requirements are good treatment control, training and reliable self-monitoring.
It only becomes critical if severe or repeated hypoglycaemia occurs. Even then, the outcome depends on severity and treatment control – a driving licence with conditions or a time limit is possible.
What are the requirements for eyesight?
The requirements for eyesight are set out in Annex 6 FeV (Anlage 6 FeV) and depend on the licence group. Much stricter values apply to lorry and bus drivers than to car and motorcycle drivers.
| Criterion | Group 1 (A/B, car/motorcycle) | Group 2 (C/D, lorry/bus) |
|---|---|---|
| Eye test passed from | 0.7/0.7 | – |
| Visual acuity (ophthalmologist) | at least 0.5 (better eye or both eyes) | better eye 0.8, worse eye 0.8, both eyes 1.0 |
| Exceptional case | – | worse eye down to 0.5 (0.1) after examination by an ophthalmologist |
| Field of vision | at least 120° (central up to 20° normal) | at least 140° |
Anyone who does not pass the simple eye test needs an ophthalmologist's report (augenärztliches Gutachten). You should bring your glasses or contact lenses to the examination itself.
Am I allowed to drive while taking medication, substitution therapy or ADHD medication?
With medication, substitution therapy or ADHD medication, fitness to drive is possible if your dosage is stable and you are under medical supervision. Also important: no additional use of other substances (Beikonsum) and no signs of impairment.
This applies, for example, to a stable opioid or substitution therapy, for instance with methadone, or to ADHD treatment with methylphenidate. On the other hand, a new prescription where the effect has not yet stabilised and mixed use, for example with alcohol or benzodiazepines, speak against fitness.
Prescribed medicines fall under the medication privilege under § 24a (4) StVG (Medikamentenprivileg nach § 24a Abs. 4 StVG, Road Traffic Act). However, this only protects you if you take them as intended according to the prescription. It offers no protection if there are signs of impairment or an accident. Separate rules apply to medical cannabis, which are explained under MPU because of cannabis. If non-prescribed substances are involved, the page MPU because of drugs is the right place to go.
What evidence do I need for a medical MPU?
The most important evidence is a specialist medical report, which usually must not be older than 3 months. It must contain an explicit statement on fitness to drive – a general diagnosis or a doctor's letter without this statement is usually not enough.
It makes sense to give the specialist a copy of the authority's order. That way, they can address the specific question asked. For the examination itself, bring:
- Identity card or passport
- Current specialist medical findings (usually less than 3 months old)
- Documents on your medication and treatment
- Glasses or contact lenses for the eye test
The page How the MPU works describes the components of the examination.
Will I lose my driving licence immediately because of an illness?
You do not automatically lose your driving licence because of an illness. Many illnesses are easily treatable, and fitness to drive then remains – often with conditions or a time limit instead of losing it completely.
Possible conditions include regular medical check-ups or a time-limited driving licence with a follow-up examination. The outcome depends on the severity of the illness and how well it is controlled.
The deadlines are also important: as long as you still have your driving licence, you usually have to provide proof of fitness within a deadline set by the authority. If you miss it, your licence may be revoked. A lawyer specialising in traffic law (Fachanwalt für Verkehrsrecht) can check whether an order is lawful.
What happens next?
Read the order carefully and, if anything is unclear, request file inspection (Akteneinsicht) so that you know the specific question. Make an appointment with the specialist early and keep an eye on the authority's deadline. If behavioural or substance-use issues also play a role alongside the medical question, you can find suitable counselling through MPU Plus.
Frequently asked questions
Do I have to report my illness to the driving licence authority?
A medical review is often triggered by reports from doctors or age-related doubts on the part of the authority. Regardless of this, you should check for yourself whether you can drive safely despite your illness. If you are unsure, talking to your specialist about your fitness to drive will help.
How old may the medical certificate for the MPU be?
A specialist medical report should usually not be older than 3 months. It must contain an explicit statement on your fitness to drive. A simple doctor's letter without this statement is usually not enough.
Can I keep my driving licence while on methadone?
Yes, a stable substitution therapy does not automatically rule out fitness to drive. The requirements are medical supervision, no additional substance use and no signs of impairment. Mixed use with alcohol or benzodiazepines speaks against it.
What visual acuity do I need for a lorry driving licence?
For Group 2 (C/D), at least 0.8 in the better eye and 0.8 in the worse eye apply, and 1.0 with both eyes. The field of vision must be at least 140°. In exceptional cases justified by an ophthalmologist, the worse eye may be below this.
How long do I have to wait before driving after an epileptic seizure?
For cars and motorcycles, the assessment guidelines usually require at least 1 year without seizures. In certain situations, fitness to drive is possible earlier, from 3 to 6 months. Much stricter rules apply to lorries and buses.