UK law requires most drivers and passengers to wear a seatbelt, but there are some specific circumstances where people can be legally exempt from doing so. The most significant exemption is on medical grounds — if a doctor determines that wearing a seatbelt is not suitable for you due to a medical condition, they may issue a .

This document may be granted by a doctor to individuals who, due to a medical condition, are unable to wear a seat belt safely, which applies to both drivers and passengers. Essentially, it covers any that would make it unsafe for the individual to wear a seat belt.

that make it difficult to access or use seat belts, or that could be aggravated by seat belt pressure, may qualify for an exemption. Simple solutions like drop links — hardware that lowers the position of the shoulder belt, preventing it from rubbing against their neck — might be considered first, but if they don't resolve the issue, an exemption could be necessary.

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that affect a person's body shape or posture, making it physically impossible or unsafe to wear a standard seat belt, could be eligible for exemption. Other conditions that could necessitate a Certificate of Exemption from Compulsory Wearing include severe chest or abdominal injuries, fractured ribs, recent surgery to the chest or abdomen, or the presence of medical devices including colostomy bags or catheters that could be aggravated by seat belt use.

Chronic respiratory conditions, such as severe asthma or (COPD), where seat belt pressure could further restrict breathing, may also be considered. , while not an automatic exemption, may also be deemed as a pertinent reason for a car user to be granted a certificate — but only if their doctor determines it is medically advisable.

Each case must be assessed individually by a medical practitioner, who will consider whether the risks of not wearing a seat belt outweigh the proven safety benefits, taking into account the overwhelming evidence that seatbelts save lives and reduce injuries in road accidents.

Each case is judged on its own merits and there are no conditions that automatically qualify for exemption. The certificate must specify a period of validity, which can be as long or as short as the doctor considers medically necessary.

If your condition changes, the exemption can be reviewed or revoked. It is also necessary to inform your car insurer if you are exempt from wearing a seatbelt, as this may affect your policy.

Apart from medical exemptions, the law also recognises several practical exemptions where wearing a seatbelt is not required. These include drivers who are reversing or supervising a learner driver who is reversing, drivers of goods vehicles on deliveries where the vehicle travels no more than 50 metres between stops, licensed taxi drivers looking for customers, either by being hailed in the street or waiting at a taxi rank, and also disabled persons who are wearing a specially designed seatbelt.

Other exemptions apply to vehicles used for , , and some paramedics. While ambulance drivers must wear seatbelts, healthcare professionals riding in the rear of an ambulance providing urgent medical attention, or treatment that cannot be delayed or effectively administered while wearing a seatbelt, do not.

This certificate must be carried at all times when you are driving or riding as a passenger without a seatbelt for medical reasons. If you are stopped by the police, you are required by law to produce this certificate as proof of your exemption. A letter from your doctor is not sufficient; only the official certificate is valid and recognised under the law.

If you claim a medical exemption but do not have the official certificate with you, you can be fined for not wearing a seatbelt. The certificate must be shown to the police on request. Without it, you are not legally exempt, regardless of your medical condition. The certificate is your legal proof and must be presented to authorities if requested. Failing to do so means you are not exempt and could face penalties.

The Road Traffic Act 1988 states that anyone who fails to wear a seatbelt and is not in possession of a Certificate of Exemption from Compulsory Seat Belt Wearing is breaking the law. "A person who drives or rides in a motor vehicle in contravention of regulations under this section is guilty of an offence; but, notwithstanding any enactment or rule of law, no person other than the person actually committing the contravention is guilty of an offence by reason of the contravention," the act reads.

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