Missouri Permit With Disabilities: Medical Review and Restriction Codes (2026)

Yes, you can get an instruction permit in Missouri if you have a disability. The Missouri Department of Revenue (DOR) does not deny driving privileges based on a diagnosis. Eligibility is based on your functional ability to safely operate a vehicle, potentially with adaptive equipment or specific restrictions.

Medical review, test accommodations, and optional credential notations are separate processes. A disability does not automatically place every applicant into medical review.

When Can Missouri Require Medical Review for a Permit Applicant?

If DOR needs medical information to determine whether a condition affects safe driving, it may require a physician's examination. The current physician form for that process is Physician's Statement (Form 1528). Form 4319 is a Driver Condition Report used to report a potentially unsafe driver; it is not the applicant's standard physician-review form.

• For conditions like epilepsy, Missouri typically requires being seizure-free for 6 months, verified by a neurologist.
• You must still meet Missouri's vision requirements. Detailed acuity and field-of-vision rules are covered in the dedicated vision guide.

ADHD, Anxiety, and Learning Disabilities

For conditions like ADHD or anxiety, a doctor's letter is not automatically required for the knowledge test. However, if your condition could affect your driving ability, DOR may request medical information, including Form 1528, as part of a medical review. Extended time for the knowledge test due to a learning disability is available, request an oral test or headphones for the audio version.

What Knowledge Test Accommodations Does Missouri MSHP Offer?

The MSHP administers the 25-question permit test and offers several accommodations. You generally do not need to prove a severe disability for basic tools.

• Audio Assist (Headphones): Automated kiosks at all MSHP locations have headphones that read questions aloud.
• ASL Video Interpreter: The testing system includes a built-in American Sign Language video for deaf or hard-of-hearing applicants.
• Human Reader/Oral Exam: You can request an examiner to read the test to you, which usually requires advance scheduling with Troop headquarters.
• Accommodations for extended time and reduced distractions are available upon request.
• The Class F written test is available in 20 language options, including an ASL video option. Kiosks have adjustable font, and paper tests with enlarged text can be requested.

For standard accommodations like headphones, request them when you check in. For a human reader or other specialized request, contact your local MSHP Troop Headquarters in advance, ideally at least 3 weeks before your planned test date, and complete the MSHP Reasonable Accommodation Request (Form SHP-885) if needed so the station can arrange the appropriate support.

Can I take the Missouri permit test orally instead of reading it?

Yes. MSHP provides oral testing options, including computer audio assistance and examiner-read testing when appropriate. Ask the examination station about the available format before you begin.

Is the Missouri permit test available in ASL?

Yes. The current Class F written-test language options include an American Sign Language video version.

What Adaptive Equipment and Driving Restrictions Apply in Missouri

If you need vehicle modifications, use the adaptive equipment required for you to drive safely. Common examples include hand controls, spinner knobs, or left-foot gas pedals. Consulting a Certified Driver Rehabilitation Specialist (CDRS) may be useful.

DOR may place restriction codes on a credential when a driving limitation requires them. A deaf/hard-of-hearing indicator is different from a driving restriction.

For road-test vehicle requirements involving adaptive equipment, use the dedicated road-test vehicle guidance rather than assuming a separate statewide equipment-certification rule.

Is the DHH notation the same as a driving restriction?

No. DHH is an optional deaf/hard-of-hearing notation. It is not itself one of Missouri's standard driving-restriction codes.

What is the difference between a medical review, a medical-alert notation, and a disability indicator?

Medical review is the DOR process used to decide whether a condition affects safe driving and whether medical information or driving restrictions are needed. A notation or disability indicator communicates information on the credential or record; it does not by itself create a driving restriction unless DOR separately assigns one.

What Are the Final Steps and Costs for Missouri Permits With Disabilities?

The current total fee for a Class F instruction permit is $10. The permit is valid for 12 months.

• Study the Missouri Driver Guide and complete the required MSHP examinations.
• Complete any medical review documents DOR specifically requires for your case.
• Bring the normal identity, lawful-status/SSN, and Missouri residency documents. A standard first-time non-REAL-ID credential generally uses one Missouri residency document; an initial REAL ID requires two from different sources.
• If under 18, a qualified person must accompany the applicant to the license office and sign the required permission statement.
• Practice with adaptive equipment, if needed, and use a supervisor who meets Missouri's age-based GDL rules: under-16 learners have the more specific supervisor categories, while learners age 16+ may be supervised by a licensed driver age 21+.