Vehicle Industry Registration Procedures Manual

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Section 22 of 38

Chapter 21: Special Plates

21.075 Disabled Person Certification (VC §§5007, 22511.55, 22511.59)

Certification—A properly completed Application for Disabled Person Placard or Plates (REG 195) form is required for Disabled Person License Plates and/or a Disabled Person placard. The certification of the applicant’s disability must be completed as follows:

If the Applicant Suffers FromThe Certification Required Is
If the Applicant Suffers FromA lung diseaseThe Certification Required IsSections 6 and 6A of the REG 195 must be completed by a:
• Physician (items 2–8 only).
• Surgeon (items 2–8 only).
• Physician’s assistant (items 2–8 only).
• Nurse practitioner (items 2–8 only).
• Certified nurse midwife (items 4–7 only).
• Podiatrist (items 4–7 only).
• Chiropractor (items 6–8 only).
If the Applicant Suffers FromA cardiovascular disease
If the Applicant Suffers FromA diagnosed disease or disorder which substantially impairs or interferes with mobility
If the Applicant Suffers FromA severe disability in which they are unable to move without the aid of an assistant device
If the Applicant Suffers FromA significant limitation in the use of lower extremities
If the Applicant Suffers FromThe loss or loss of use of one or more lower extremities and does not apply in person
If the Applicant Suffers FromThe loss or loss of use of both hands and does not apply in person
If the Applicant Suffers FromCentral visual acuity that does not exceed 20/200 in the better eye, with corrective lensesThe Certification Required IsSections 6 of the REG 195 must be completed by a:
• Doctor who specializes in diseases of the eye.
• Optometrist.
If the Applicant Suffers FromThe loss of one or more lower extremities or both hands and applies in personThe Certification Required IsSection 6A DMV USE ONLY of the REG 195 may be completed by a DMV employee.

The certification must include the medical license number and signature of the authorized medical provider from California or another state.

Note Certification by a medical provider located and licensed in another country is acceptable only if the customer is applying for a DP travel placard.

The medical provider’s medical license number must be keyed in the MISC field on the RO/LO screen.