One of the most common vehicle modifications is the installation of hand controls that allow persons who are unable to operate the brake and accelerator pedals with their feet due to physical impairment to drive. Considered the specifics of hand controls (higher workload during driving and lower passive safety), it is very important to analyze the safety of the category of drivers with disabilities who use them. This paper aims to determine which factors influence the participation in road traffic crashes of drivers with disabilities who use hand controls. Based on the identified factors, measures and activities are defined to improve the road safety of drivers with disabilities who use hand controls, to improve the mobility of persons with disabilities, and to encourage potential drivers with disabilities, especially in less developed countries. The research was conducted in Serbia, which belongs to the group of less developed countries in the world. Considering the estimated number of drivers with disabilities who use hand controls, every fourth driver in Serbia participated in the survey (65 respondents). The statistical analysis was performed by the decision tree CART algorithm. Driving experience with hand controls is the most important variable of the participation of drivers with disabilities in a road traffic crash while driving vehicles with hand controls. Improving the system of maintaining hand controls, harmonize the performance of hand controls with the medical status of the drivers with disabilities, improving awareness of drivers with disabilities about risky behaviors in traffic are recognized as the most important measures and activities.