What hand controls are and who uses them

Hand controls let you operate the gas and brake pedals using your hands instead of your feet. They attach to your existing pedals and connect to a lever or knob mounted on the steering column or dashboard. You push the lever forward to brake and pull it back to accelerate — or use a hand-operated throttle and separate brake lever, depending on the system.

Hand controls are used by people with lower-limb disabilities, spinal cord injuries, amputations, paralysis, or conditions that affect leg strength or coordination. Some drivers use them temporarily after surgery or injury. Others rely on them permanently. The controls let you keep both hands near the steering wheel, which many drivers find safer than foot pedals.

Hand controls are not the same as adaptive steering wheels or other modifications. They specifically replace the pedal function. You may use hand controls alongside other adaptations — like a steering wheel spinner knob or seat lift — depending on your needs.

Key Takeaways

  • Hand controls attach to your gas and brake pedals and let you operate them with a lever or knob on the steering column or dashboard.
  • The two main types are push-pull systems (one lever for both functions) and separate hand throttle and brake systems (two controls).
  • Installation costs range widely depending on the system and your vehicle, and some insurance plans or vocational rehabilitation programs may cover part of the cost.
  • You will need a medical evaluation and a behind-the-wheel assessment from a certified driving rehabilitation specialist before installation.
  • Hand controls require practice and retraining, and you may need a special license notation or restriction depending on your state.

The two main types of hand control systems

Push-pull systems use a single lever mounted on the steering column. You push the lever away from you to brake and pull it toward you to accelerate. This design is simpler, takes up less space, and costs less than other options. However, it requires you to move your hand between two functions, which takes a fraction of a second longer. Push-pull systems work well for drivers who have good hand strength and coordination.

Separate hand throttle and brake systems use two independent controls — usually a hand throttle on one side of the steering column and a hand brake lever on the other. This setup lets you keep one hand on each control and switch between them without moving your hand. It is faster and may feel more natural if you are used to driving with foot pedals. The trade-off is higher cost and more complex installation.

Some systems also include a left-foot accelerator option, which lets you use your left foot for gas while your hand operates the brake. This is less common but may suit drivers with partial lower-limb function. A driving rehabilitation specialist will help you choose the system that fits your abilities and your vehicle.

What the installation process looks like

Before you install hand controls, you need a medical evaluation from your doctor or a specialist who understands your condition. They will confirm that you have the strength, range of motion, and coordination to operate the controls safely. This step is not optional — it protects you and other drivers on the road.

Next, you will work with a certified driving rehabilitation specialist (CDRS). This person will assess your driving ability in your own vehicle and recommend which hand control system suits you best. They will also identify any other adaptations you might need, such as a steering wheel spinner, seat cushion, or transfer equipment. You can find a CDRS through the Association of Driving Rehabilitation Specialists (ADEERS) website or by asking your doctor for a referral.

Once you have chosen a system, a certified installer will fit it to your vehicle. Installation typically takes one to three days, depending on the complexity. The installer will test the controls and make sure they work smoothly before you leave. After installation, you will need behind-the-wheel training with your CDRS to practice using the new controls in real traffic. Most people need several sessions to feel confident.

Cost and what may help pay for it

Hand control systems range from about $1,500 to $4,000 or more, depending on the type and your vehicle. Push-pull systems are usually on the lower end; separate throttle and brake systems cost more. Installation labor adds another $500 to $1,500. Some vehicles are more expensive to modify than others because of how their pedal systems are designed.

Several funding sources may cover part or all of the cost. Vocational rehabilitation programs (run by your state) often pay for hand controls if you need them to work. You will need to contact your state's vocational rehabilitation agency and show that the controls are necessary for employment. Veterans Affairs covers hand controls for may be able to access veterans through their automobile adaptive equipment program. Some private insurance plans cover adaptive driving equipment, though coverage varies widely — check your policy or call your insurer to ask.

If you do not have coverage, some nonprofit organizations and disability service agencies offer grants or low-interest loans for vehicle modifications. Ask your CDRS or local disability services office whether programs exist in your state. A few manufacturers also offer payment plans or discounts for bulk orders through rehabilitation centers.

License requirements and driving restrictions

Once you have hand controls installed and have completed your behind-the-wheel training, you will need to notify your state's Department of Motor Vehicles (DMV). Most states require a new driving test or an evaluation by a certified examiner to confirm you can operate the hand controls safely. Some states allow your CDRS to conduct this evaluation; others require a DMV examiner.

If you pass, your license will be issued with a restriction or notation stating that you must use hand controls. The exact wording varies by state — some say "hand controls required," others say "adaptive equipment required." This notation is important because it tells police officers and insurance companies that you are legally permitted to drive with this equipment. Driving without the notation when your license requires it can result in a ticket.

A few states also require a medical certification form signed by your doctor, renewed every few years. Ask your DMV what your state requires before you schedule your test. Your CDRS can usually guide you through the process and help you gather the paperwork.

Maintenance and what to expect long-term

Hand controls are mechanical systems, so they need occasional maintenance. The lever or knob should move smoothly without sticking or grinding. If you notice resistance or hear unusual sounds, have the system inspected by your installer or a certified mechanic familiar with adaptive equipment. Most problems are minor — a loose bolt, a need for lubrication, or a worn cable — and cost less than $200 to fix.

If you sell your vehicle, the hand controls usually stay with the car unless you arrange otherwise with the buyer. If you buy a new vehicle, you will need to have hand controls installed in the new car. The cost and installation time are the same as the first time. Some people keep their old vehicle longer specifically to avoid the expense of re-installing controls in a new one.

Hand controls are durable and typically last as long as your vehicle if they are maintained. However, if your physical abilities change — for example, if your hand strength decreases or your range of motion shrinks — you may need to switch to a different system or add other adaptations. Stay in touch with your CDRS or rehabilitation provider if your needs shift.

Frequently Asked Questions

Can I install hand controls in any vehicle?

Most vehicles can be fitted with hand controls, but some are easier and cheaper than others. Newer vehicles with electronic throttle systems are often simpler to adapt. Very old vehicles or those with unusual pedal layouts may cost more. Your installer will tell you whether your specific vehicle can be modified and what the cost will be.

Do I need to practice a lot before I can drive with hand controls?

Yes. Most people need several training sessions with a certified driving rehabilitation specialist before they feel confident. The exact number depends on your experience and how quickly you adapt. Plan for at least three to five sessions, though some people benefit from more. Practice in quiet areas first, then gradually move to busier roads.

Will hand controls work if I have limited hand strength?

It depends on how limited your strength is. Push-pull systems require less force than separate brake and throttle systems. If your strength is very limited, you may need power-assisted hand controls, which use a motor to help you operate the pedals. These cost more and are less common, but they exist. A medical evaluation and CDRS assessment will determine what is possible for you.

What happens if my hand controls break while I am driving?

Hand control systems are designed with safety in mind. If the lever fails, you will lose the ability to accelerate or brake, but the vehicle will not suddenly accelerate or veer. You should pull over safely and call for help. This is why regular maintenance is important — catching wear before failure prevents emergencies.

Can I remove hand controls and drive with foot pedals again?

Yes, but you will need to notify your DMV and may need to take another driving test. Your license restriction will be removed once you show that you can drive safely with foot pedals again. If your condition is temporary, discuss this plan with your doctor and CDRS before installation so you understand the process.