A CAM license lets you drive a car with hand controls if you cannot use your feet to operate the pedals

A CAM license (Conditional Automatic Transmission) is a restricted driver's license that permits you to operate a vehicle equipped with automatic transmission and hand controls. The hand controls replace the foot pedals for acceleration and braking, allowing people with lower-body disabilities or injuries to drive safely. The restriction appears on your license to show law enforcement and insurance companies that you may only drive vehicles with these modifications.

You do not need a CAM license to own or drive a hand-control vehicle — you need it if your state's DMV has determined that you cannot safely operate standard foot pedals. The license itself is proof that you have passed a behind-the-wheel test in a vehicle with hand controls and that a medical professional has documented your need for them.

Key Takeaways

  • A CAM license restricts you to driving only vehicles with automatic transmission and hand controls, and this restriction is printed on your license card.
  • You must obtain a medical certification from a doctor stating that you cannot safely use foot pedals before you can request a CAM evaluation.
  • The road test for a CAM license takes place in a vehicle equipped with hand controls, and you must demonstrate safe operation of those controls.
  • Hand-control vehicles are expensive to modify, typically costing $5,000 to $15,000 depending on the vehicle and the type of controls installed.
  • Some states offer grants or rebates to help pay for vehicle modifications, though availability and amounts vary by location.

How to get a CAM license: the basic steps

The process begins with a medical evaluation. You will need a letter from a licensed physician, occupational therapist, or other medical professional stating that you have a permanent or long-term condition that prevents you from safely operating standard foot pedals. This letter must be specific — it should name your condition and explain why foot pedals are unsafe for you, not just that you prefer hand controls.

Once you have the medical certification, take it to your state's DMV or driver licensing office. You will fill out a form requesting a CAM license evaluation. Some states call this a "restricted license process" or "medical evaluation for driving." The DMV will review your medical documentation and may ask follow-up questions about your condition.

If the DMV approves your request, you will be scheduled for a behind-the-wheel road test in a vehicle with hand controls. You cannot use your own car for this test — the DMV or a contracted testing facility will provide a vehicle equipped with hand controls. During the test, an examiner will watch you operate the hand controls, merge, brake, park, and handle other standard driving tasks. You must pass this test to receive your CAM license.

What hand controls are and how they work

Hand controls are mechanical or electronic devices mounted near the steering wheel that let you accelerate and brake using your hands instead of your feet. The most common type is a push-pull lever: you push the lever away from you to brake and pull it toward you to accelerate. Some vehicles use a push-button system where you press buttons on the steering wheel or a mounted pad. Others use a joystick-style control that moves in different directions for different functions.

Hand controls work only with automatic transmission vehicles because the driver no longer needs to operate a clutch pedal. The controls connect to the vehicle's throttle and brake systems through cables, hydraulics, or electronic signals, depending on the system type and the vehicle's age. Newer vehicles often have electronic hand controls that integrate with the car's computer, while older vehicles may use mechanical systems.

Installing hand controls is not a straightforward add-on — it requires professional modification by a shop that specializes in adaptive driving equipment. The installer will remove or disable the foot pedals, mount the hand controls at a comfortable height and angle for you, and test the system thoroughly before you drive it. The entire installation typically takes several days to a week.

The cost of hand-control vehicles and where to find funding

Hand-control modifications are expensive. A basic push-pull lever system costs between $5,000 and $8,000 installed. More advanced electronic systems can run $10,000 to $15,000 or higher. These costs are on top of the price of the vehicle itself, so a hand-control car is a significant investment.

Some states and nonprofit organizations offer grants, rebates, or low-interest loans to help pay for vehicle modifications. The availability and amount of funding varies widely by state. Your state's vocational rehabilitation agency (often called "VR" or "Voc Rehab") may fund modifications if you are working or planning to work and need the vehicle to get to your job. The Veterans Administration offers grants to may be able to access veterans with service-connected disabilities. Some disability organizations and foundations also provide one-time grants for adaptive equipment.

Before you buy a vehicle and have it modified, research what funding might be available in your state. Contact your state's DMV, vocational rehabilitation office, or a local disability services organization to ask about programs. Some adaptive driving equipment shops also know which funding sources are currently active and can help you explore.

Restrictions that come with a CAM license

When you receive a CAM license, your license card will show a restriction code — usually something like "Hand Controls Required" or "Automatic Transmission Only." This restriction means you may only drive vehicles that have both automatic transmission and hand controls installed. Driving a standard vehicle or a manual transmission vehicle with a CAM license is a violation and can result in a ticket.

Some states add additional restrictions, such as limiting you to daytime driving only or requiring you to drive only within a certain distance of your home. These extra restrictions depend on the examiner's assessment during your road test and your medical condition. If you believe a restriction is too limiting, you can request a re-evaluation after a set period (usually one to two years), but you will need to pass another road test.

Your insurance company must know about your CAM license and the hand controls on your vehicle. Tell them when you get the license and when you have the vehicle modified. Some insurers charge slightly higher premiums for hand-control vehicles because of the cost to repair them, but others do not. It is worth asking your insurer directly.

Renewing a CAM license and what happens if your condition changes

A CAM license renews on the same schedule as a standard driver's license in your state — usually every four to eight years, depending on your age and state rules. When you renew, you will need to provide updated medical certification showing that your condition still prevents you from using foot pedals. If your condition has improved and you can now safely operate standard pedals, you can request that the restriction be removed.

If your condition worsens or changes, contact your DMV to report it. You may need a new medical evaluation or a new road test. If you can no longer safely operate hand controls at all, you may need to surrender your license. Conversely, if your condition improves enough that you no longer need hand controls, you can take a standard road test to get an unrestricted license.

Differences between CAM and other restricted licenses

A CAM license is one type of restricted license, but it is not the only one. Other restricted licenses include those for corrective lenses (you must wear glasses or contacts), hearing aids (you must wear a hearing aid), or automatic transmission only (no hand controls required). Some states also issue restricted licenses for drivers with seizure disorders or other conditions that require monitoring.

The key difference is that a CAM license requires both a medical evaluation and a specialized road test in a hand-control vehicle. A corrective lens restriction, by contrast, requires only an eye exam. A CAM license is also one of the few restrictions that requires you to own or have access to a specially modified vehicle — you cannot straightforward meet the restriction by wearing something or changing your behavior.

Frequently Asked Questions

Can I get a CAM license if I have a temporary injury, like a broken leg?

No. A CAM license requires a permanent or long-term medical condition. If your injury is temporary, your state may issue a temporary restricted license that allows you to drive an automatic transmission vehicle without hand controls for a set period. Once you recover, the restriction expires. Talk to your DMV about temporary options while you heal.

Do I need to pass a written test to get a CAM license?

Most states require you to pass the standard written knowledge test (the same test all new drivers take) before you take the CAM road test. Some states waive the written test if you already hold a valid driver's license. Check with your state's DMV to confirm what tests you need.

Can I drive someone else's hand-control vehicle with my CAM license?

Yes, as long as the vehicle has both automatic transmission and hand controls installed. Your CAM license allows you to drive any vehicle that meets those requirements, not just your own. However, you should practice in any new hand-control vehicle before driving it on busy roads, since different systems feel different.

What if I fail the CAM road test?

You can retake the test, usually after waiting a set period (often 7 to 14 days). Some states allow unlimited retakes; others limit you to a certain number within a year. If you fail multiple times, the DMV may require you to take additional training or provide a new medical evaluation before you can test again.

Will my insurance cost more with a CAM license?

It depends on your insurer. Some charge slightly more because hand-control vehicles cost more to repair. Others do not adjust your rate. Call your insurance company and ask directly — do not assume your premium will increase without checking first.