Historically, job and licensing opportunities for individuals with medical impairments have been restricted because of an assumption that these individuals were less reliable, less productive, or less safe. Recent legislation addressing the employment and social opportunities of individuals with disabilities signals a change in societal attitudes regarding the capabilities of these persons. Affording these individuals greater access to jobs means greater access to potentially dangerous jobs as operators of trucks, buses, and heavy equipment. While the legislation signals that society is no longer willing to assume these persons are unsafe, until proven otherwise, there remain legitimate safety concerns. We explore these issues and suggest that changes may be necessary to appropriately deal with these drivers.