Licence Appeal Tribunal
Appeal d'appel en Tribunal matière de permis
FILE: 7273/MED
CASE NAME: 7273 v. Registrar of Motor Vehicles
Appeal under section 50(1) of the Highway Traffic Act, R.S.O. 1990, c. H.8, from a Decision of the Registrar of Motor Vehicles pursuant to section 47(1) of that Act - to Appeal a Suspended Licence
Applicant Applicant
-and-
Registrar of Motor Vehicles Respondent
REASONS FOR DECISION AND ORDER
ADJUDICATOR: Hakam Abu-Zahra, M.D., Member
APPEARANCES:
For the Applicant: Self-represented
For the Respondent: Russell McKnight, Agent
Heard in Chatham: April 10, 2012
DECISION AND REASONS
This is an appeal to the Licence Appeal Tribunal (the "Tribunal") by the Applicant respecting a decision of the Registrar of Motor Vehicles (the "Registrar") pursuant to section 47(1) of the Highway Traffic Act, R.S.O. 1990, c. H.8 (the "Act").
FACTS
The Registrar's Agent presented the Ministry's ("MTO") submissions as the sole evidence. By agreement it was entered as Exhibit #1.
The Applicant, who is 42 years old, was diagnosed in 2006 with schizophrenia. He was admitted to the hospital on August 19, 2009, with delusional and somatic pain with delusional interpretation in keeping with paranoid type.
Dr. J.W., family physician, notified the Registrar of the Applicant's mental illness and psychosis under section 203 of the Act, and accordingly, the Applicant's driver's licence was suspended, for medical reasons under section 47(1) of the Act, on August 31, 2009. MTO advised the Applicant that: "...your case will be reconsidered upon receipt of medical information, satisfactory to the Registrar, including an up-to-date psychiatrist's assessment, diagnosis, treatment, hospitalization and discharge summary."
On March 22, 2010, Dr. R.C., Consultant Psychiatrist, sent a medical report to MTO on behalf of the Applicant, in which he stated:
The patient has a diagnosis of Schizophrenia, has been compliant with treatment and at present is symptom-free from his illness and free from side effects of his medications. He has been adherent to the medications.
There has been no evidence of decompensation and his illness has run a predictable course.
At present, there is no evidence of any impaired judgement, impaired concentration, behavioural difficulties nor any sedation or psychomotor retardation due to medications. He is on a slow-release medication of Seroquel XR. He is mentally and emotionally stable and is motivated to return to work for which he requires his driver's license (sic).
On April 12, 2010, the Medical Advisory Committee ("MAC") of MTO approved a waiver to a Class "A" licence that meets medical standards with a requirement that an assessment from the driver's treating psychiatrist be filed annually.
The Applicant's driver's licence was reinstated on May 28, 2010, with the provision that:
Under the terms of the waiver of the medical standards, you will be required to file both an annual Waiver Certificate and a follow-up assessment, which is based on a recent examination...The next reports will be required on March 22, 2011.
The Applicant was later notified of the amendment made to Ontario Regulation 340/94 under the Act, removing the requirement for filing a signed waiver, but confirming the requirement to still file an up-to-date assessment from the treating physician or psychiatrist. That assessment was due at the time of the letter.
On March 21, 2011, Dr. R.C. wrote:
For the last year, when he [the Applicant] was last seen here has not been on any antipsychotic medications. His mental status continues to demonstrate ongoing hallucinatory experience of people talking about him while he is driving the truck, but there is no evidence of suicidality of violence. He believes that they do not distract him, he is able to carry out his driving and he has not had any motor vehicle accidents.
...He does not believe he has any psychiatric pathology, does not believe that he requires medication and is unclear as to why he was referred back to us.
At present, his delusional disorder of schizophrenia is chronic but stable and he is unwilling to comply with any treatment although we have recommended to him for relapse prevention that it should be carried out. There appears to be no concern based on his description regarding his driving ability and his illness but this would need to be monitored as it had become an issue in the past...
The Applicant was asked to provide confirmation that his psychiatric condition was controlled and appropriately treated with prescribed medications as recommended by his physician and was advised that if the information was not received by December 27, 2011, that his commercial class license would be changed to a Class "G".
Dr. J.B., family physician, wrote on November 28, 2011:
This man's psychiatric condition and (sic) is in excellent control. He is currently taking no medication.
MAC recommended a driver's licence suspension on February 21, 2012, and added:
Reconsider with a detailed assessment from the treating psychiatrist confirming driver has achieved at least two years of freedom from hallucinations and symptom stabilization if he remains off recommended medication. Further, will require an up to date mental status exam, including an MMSE or MOCA or frontal battery to examine for negative/cognitive symptoms of schizophrenia. If approved, suggest MTO retest to class.
The reason given was as follows:
Treating psychiatrist's report of March 2011 confirms driver's diagnosis of psychiatric pathology/chronic Schizophrenia with ongoing hallucinations of people talking to him while driving his truck. Individual's denial of diagnosis, in spite of history and hospitalization has resulted in refusal to comply with treatment putting him at high risk for illness relapse. Family physician's very short letter provides no explanation/definition of "in excellent control". In the absence of treatment, above period of driving-compatible symptoms level, at a minimum, would seem prudent for any licence. Above noted period of symptom stabilization should be expected for driving if he is not undergoing treatment.
The Applicant was duly notified of his licence suspension under section 47(1) of the Act. He was asked to give the letter to the treating physician and when his condition improved he was to provide the following information to the Medical Review Section:
Confirmation that you have achieved at least two years of freedom from hallucinations and symptom stabilization if off recommended medications.
Up-to-date mental status exam, including an MMSE [Minimal Mental Status Examination] or MOCA [Montreal Cognitive Assessment] or frontal battery to examine for negative/ cognitive symptoms of schizophrenia.
Dr. T.M., family physician, on March 20, 2012, wrote:
Patient has h/o delusional disorder of schizophrenia, stable as per last note from psychiatrist.. He denies any delusions, hallucinations at present. I don't have any reservation against him to drive.
Dr. L.W.P, practicing in a walk-in clinic also sent a medical report noting "No" in the "Psychiatric Disorders" box, with no mention of any other schizophrenic related symptoms.
Since none of the requirements requested by MTO were supplied, the Applicant's driver's licence was suspended effective March 8, 2012.
On March 13, 2012, the Tribunal received the Applicant's Notice of Appeal along with a letter from his employer, a three year driver record search and a medical report by his treating psychiatrist dated March 21, 2011, on which there is a hand-written note "Updated information will be signed shortly".
The Applicant declined to give evidence. A certain language barrier was noted. He merely said "I feel healthy; I need a licence; I need to work". Upon inquiry regarding the hand-written note, the Tribunal was informed that an appointment with the psychiatrist was scheduled in two days. Having had no medications for an elapsed period of two years, with no evidence of relapse, the Applicant is hoping for a favourable medical report.
ISSUES
Should the decision of the Registrar to suspend the Applicant's licence be confirmed, modified or set aside?
Does the Applicant no longer suffer from a mental, emotional, nervous or physical disability likely to significantly interfere with his ability to drive a motor vehicle safely?
LAW
O. Reg. 340/94, section 14 states:
(1) An applicant for or a holder of a driver's licence must not,
(a) suffer from any mental, emotional, nervous or physical condition or disability likely to significantly interfere with his or her ability to drive a motor vehicle of the applicable class safely; or
(b) be addicted to the use of alcohol or a drug to an extent likely to significantly interfere with his or her ability to drive a motor vehicle safely.
(2) In determining whether an applicant for or a holder of a driver's licence of any class meets the qualifications described in subsection (1), the Minister,
(a) may take into consideration the relevant medical standards for applicants or holders of that class of driver's licence set out in the CCMTA Medical Standards for Drivers; and
(b) may require the applicant or holder to provide evidence satisfactory to the Minister that he or she is able to drive a motor vehicle of the applicable class safely, including,
(i) any reports of examinations under section 15, and
(ii) any additional medical information.
(3) Despite clause (2) (a) and unless otherwise provided in this Regulation, if there is a difference between a medical standard set out in the CCMTA Medical Standards for Drivers and a medical standard set out in this Regulation, the Minister shall take into consideration the standard set out in this Regulation instead of the standard set out in the CCMTA Medical Standards for Drivers.
(4) In this section, the CCMTA Medical Standards for Drivers means the document entitled CCMTA Medical Standards for Drivers, published by the Canadian Council of Motor Transport Administrators and dated March 2009, as it may be amended from time to time, that is available on the Internet through the website of the Canadian Council of Motor Transport Administrators.
Section 47(1) states:
Subject to section 47.1, the Registrar may suspend or cancel,
(b) a driver's licence; ...
on the grounds of,
(d) misconduct for which the holder is responsible, directly or indirectly, related to the operation or driving of a motor vehicle;
(e) conviction of the holder for an offence referred to in subsection 210(1) or (2);
(f) the Registrar having reason to believe, having regard to the safety record of the holder or of a person related to the holder, and any other information that the Registrar considers relevant, that the holder will not operate a commercial motor vehicle safely or in accordance with this Act, the regulations and other laws relating to highway safety; or
(g) any other sufficient reason not referred to in clause (d), (e) or (f).
Section 50 of the Act states:
- (1) Every person aggrieved by a decision of the Minister made under subsection 32(5) for which there is a right of appeal pursuant to a regulation made under clause 32 (14) (n) or a decision of the Registrar under section 17 or 47 may appeal the decision to the Tribunal.
(2) The Tribunal may confirm, modify or set aside the decision of the Minister or the Registrar.
APPLICATION OF THE LAW TO FACTS
O. Reg. 340/94, section 14 states:
(1) An applicant for or a holder of a driver's licence must not,
(a) suffer from any mental, emotional, nervous or physical condition or disability likely to significantly interfere with his or her ability to drive a motor vehicle of the applicable class safely;
The Canadian Council of Motor Transport Administrators' Medical Standards for Drivers, Standard 11.4, states:
The individual who has suffered an acute psychotic episode should be permitted to drive only after a period of satisfactory mental and emotional stability has been demonstrated and the individual's request to resume driving is supported by the attending psychiatrist.
The regulatory standard focuses on ensuring that those operating on Ontario's highways may do so safely. In the Applicant's case, the Tribunal has taken notice of the following:
There has been no evidence of relapse of the Applicant's condition since his hospitalization in 2009, yet he has been on no medications for an elapsed period of two years.
The Applicant's driving record shows no evidence of vehicle accidents.
The employer's letter attests to the Applicant's driving skills by stating that:
...in the employ of...for over six years. He has carried out his duties well as a local driver. We have had many comments from customers on how well
is able to handle and manoeuvre his truck.
Taking these observations into consideration, one may be inclined to assume that the Applicant's hallucinatory experience, while driving, has no impact on his ability to drive safely. However, the Tribunal finds on the evidence before it, on the balance of probabilities, that the Applicant unfortunately, does suffer from a mental disability likely to significantly interfere with his ability to drive a vehicle safely.
The Tribunal, therefore, accepts MTO's demand for a psychiatrist's assessment and the need for treatment compliant by the Applicant, if deemed necessary.
DECISION
Upon the application by the Applicant to appeal the Registrar's decision, effective March 8, 2012, to suspend his driver's licence pursuant to section 47(1) of the Act, and having considered the evidence filed with the Tribunal and the submissions of the Registrar and of the Applicant, and in the absence of an updated report from the psychiatrist;
IT IS THE DECISION OF THE TRIBUNAL pursuant to the authority vested in it under section 50(2) of the Act that the decision of the Registrar be confirmed. The Tribunal is of the opinion on receipt of a satisfactory report from the psychiatrist, that MTO give serious consideration to re-instating the Applicant's licence in an expeditious manner.
LICENCE APPEAL TRIBUNAL
Hakam Abu-Zahra, M.B., B.Ch. FRCPC Presiding Member
RELEASED: May 2, 2012