License renewal: regulatory chaos and costs, a nightmare for patients

By Laura D'Ettole

Driver's license renewal: for those who have a subcutaneous defibrillator it is chaos. The Commission for special licenses follows very strict guidelines approved by the association of medical examiners Asl, however never adopted by the Tuscany Region. Result: if previously the license could be renewed every three years, now the expiration becomes annual.

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Valerio Pelini, vice president of Aicarm, former director general of the Tuscany Region, lived this experience firsthand and promises a clarifying intervention by the Association at the Ministry of Health. "In 2016, I made my first visit to the San Salvi special licensing office in Florence, shortly after the subcutaneous defibrillator was installed". Valid for two years, returns in 2018, was the response. This second time, the answer is even more favorable: expiration in three years, come back in 2021. Pelini returns in 2021 and, mind you, under the same clinical conditions, the Commission renews his license for only one year. “At my resentful request for explanations, they told me to abide by certain guidelines of medical examiners Asl, that is, to non-binding prescriptions of a private association! This is not a plausible explanation ”he points out. The first in-depth analysis is with the Tuscany Region: no one knows anything about these requirements and no department has made them their own. "As Aicarm, we want to raise the issue with the Ministry of Health asking them to clarify the guidelines to refer to throughout the national territory".

Driving license regulationsThings are not going too much better in terms of "normal" procedures for those suffering from heart disease and having to renew their driving license. An expense of over 300 euros, an overwhelming network of obligations and a loss of at least a couple of working days if all goes well. It is a real odyssey. Between tickets, bulletins, certificates and medical examinations it is a kind of labyrinth in which you risk getting lost. You pay the ASL, the land transport department, and the specialist, but it doesn't stop there. If you also have the audacity to go to sea and therefore need to renew the nautical license, the "creditors" expand because the Port Authority and even the State Treasury enter the field, which requires a 1,68 bulletin euro to print the new document. We do not think that once the renewal has been obtained, we can throw the experience behind us, on the contrary. If the deadline is only annual, within six months you have to book for the following year and resign yourself: the renewal of the license will become a grim presence that will chase for life.

The attached form lists all the requirements and costs necessary for the renewal of a type B driving license and a yachting license for pleasure craft.


License renewal: instructions for use

 Car license renewal B

1. Proof of payment of € 32,59 (of which € 18,59 for health rights and € 14,00 for secretarial rights) on postal C / C n. 24668501 in the name of Azienda USL 10 Firenze
2. Proof of payment of € 10,20 on postal current account no. 9001 (available at post offices) in the name of the Department of Land Transport - Rights Law 14/67
3. For renewal: Proof of payment of € 16,00 on postal C / C n. 4028 payable to the Department of Land Transport - Stamp duty.
4. Two photo recent passport size 40 × 33 mm, on a white background, bare head and without glasses.
5. Medical exams required:
o cardiological visit,
o anamnestic certificate,
o ICD test certificate for normal functioning.


Nautical license renewal for pleasure craft

1.     Medical test "Reaction times"
2. Proof of payment of € 32,59 (of which € 18,59 for health rights and € 14,00 for secretarial rights) on postal C / C n. 24668501 in the name of Azienda USL 10 Firenze
3. Revenue stamp of € 16,00
4. 3 photo Tessera
5. Proof of payment of € 1,68 (State Treasury) for printed nautical license
With the documentation as elaborated above by the Special Licenses Commission, it is necessary to go to the competent Port Authority to obtain the new license.

 An important tip:

Once the two licenses have been obtained, remember to book the commission for the renewal of the following year within 5-6 months, practically without interruption

Let's try to summarize the costs:

  1. 2 bulletins of € 32,59
  2. 1 bulletin of € 10,20
  3. 1 bulletin of € 16,00
  4. 1 bulletin of € 1,68
  5. 5 passport photos (self-service machines produce compositions of 4 photos) € 10,00
  6. 1 revenue stamp of € 16,00

Reaction time test ticket € 15,62

Anamnestic certificate € 50,00

Cardiology visit € 220,00

It is also estimated a commitment, if all goes well, equal to at least two working days.

Cardiological visit, exams required together with the technical report 

  • Echocardiogram or cardiac doppler ecolor
  • Electrocardiogram

 Technical report from the specialist, content required

Clinico-functional diagnosis of heart disease and NYHA class;
Ejection fraction;
Pharmacological therapy in progress
In case of ICD carrier, the report must also indicate:
Time of implantation of the ICD or PM and motivation (primary or secondary prevention); · Absence / presence of ventricular arrhythmias resolved with shock, even if not syncopal, from the moment of implantation of the ICD; ·
Risk of syncope (low, medium, high);
State of efficiency of the device
In case of bearer of Pace Maker, the report must also indicate:
Time of implantation and motivation; ·
State of efficiency of the device

The service can be carried out by a public health facility (booked through Cup, even as a freelance) or private (with direct contact) by presenting the medical prescription. The examinations and the health report are valid for three months.

The rate of the services is the sole responsibility of the client.