Licence Appeal Tribunal
Appeal d'appel en Tribunal matière de permis
FILE: 8090/MED
CASE NAME: 8090 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 Suspend a Licence
8090 Applicant
-and-
Registrar of Motor Vehicles Respondent
REASONS FOR DECISION AND ORDER
ADJUDICATOR: Dr. David Borenstein, Member
APPEARANCES:
For the Applicant: Self-represented
For the Respondent: Sonia De Santis, Agent
Heard by teleconference: June 12, 2013
DECISION AND REASONS
This is an appeal to the Licence Appeal 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 Applicant attended a rural Emergency Department (“ED”) on March 31, 2013. Police brought him to hospital after he had cut another car off, then jumped on the other car and attempted to injure the car’s occupants. He suffered from ’road rage’. The Applicant has bipolar disorder and had missed 3 doses of his medications due to situational circumstances, He had consumed a fair amount of alcohol earlier in the week of the incident. He was also under stress due to a break up with his girlfriend. In the ED, he was assessed by Dr. B.B, who sent a medical condition report to the Ministry of Transportation, stating – “mental or emotional illness – unstable”. A description of the above event was included on the form.
On April 3, 2013, the Applicant received a letter from the Ministry of Transportation (“MTO”) stating his driving license was under suspension. The Ministry requested completion of their Mental Health Assessment Forms. The Applicant’s psychiatrist, Dr. B.G., completed this form on April 12, 2013. The Applicant’s diagnosis is bipolar disorder. He hadn’t had an illness episode in more than 12 months. His condition was defined as ‘improving with on-going symptoms that were mild’, with condition stability of > 12 months. His symptoms were ‘impulsive or reckless behaviour’ and ‘emotional control issues’. No cognitive or substance abuse problems were identified. Illness insight was not a problem, nor was judgement. No other medical issues were under treatment. A note dated April 26th by the psychiatrist stated the Applicant “is currently stable on his medications. I am in support of him receiving his driver’s license”. Upon review of these documents, the MTO sent the Applicant another letter dated May 1, 2013 in which they requested a copy of the hospital notes and discharge summary, as well as confirmation of an established minimum of three months of emotional and mental stability.
The psychiatrist completed another Mental Health Assessment on May 16, 2013. In this version, the Applicant’s condition was listed as “stable – symptoms resolved” On this form, it is stated that the Applicant is on medications. This was not the same as the previous form. A copy of the hospital ED record and crisis assessment were sent to the Registrar. The ED record confirmed the above history of events. The crisis team assessment was detailed. It documented the history of events, the history of the Applicant’s bipolar disorder since 21 years of age, the fact that he carries a knife with him from work, and the use of alcohol. The discharge summary dictated by Dr. B.G., reiterated the history of illness and events. The Applicant’s discharge medications were Epival 250mg TID, and Seroquel 300mg in the morning, and 600mg at bedtime. The doctor stated, “The patient is medically and psychiatrically stable”. Upon review of this information, the MTO sent a letter dated May 22, 2013 to the Applicant denying licence reinstatement until a period of three months of illness stability from the initial hospitalization.
The Registrar also submitted the Applicant’s driving record as evidence. It shows five speeding convictions since 2010 and the suspension of licence dated April 13, 2013.
The Registrar’s case:
The above facts were presented without objective from the Applicant. The MTO believes that based on CCMTA Guidelines, a period of 3 months of illness stability is warranted and reasonable. In the hearing, the representative did allude to some of the documentation regarding the Applicant’s substance use, however none of the letters sent to the Applicant list substance use as a reason for licence suspension. The Registrar’s representative also questioned some of the discrepancies between the answers the psychiatrist gave on the two mental health assessment forms. Upon questioning by the Tribunal, it was confirmed that the three-month date for stability proof would be July 1, 2013; nineteen days post hearing.
The Applicant’s case:
The Applicant maintained that forgetting his medications, life stresses and alcohol consumption brought on his illness episode. He was quite apologetic about the incident. He offered no excuses. He has been seeing his psychiatrist regularly and has started seeing a therapist for cognitive therapy since the incident that caused the submission of the Medical Condition Report. He is now avoiding alcohol during times when his illness traditionally flares. He is also carrying his pills with him, to ensure he no longer misses his medication doses. He has been bipolar since 2003, but this is his first driving suspension. Not having his driver’s licence is making it hard to work, although he is managing.
ISSUES
Should the decision of the Registrar to suspend the Applicant’s licence be confirmed, modified or set aside?
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:
50 (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
The fact that the incident that lead to the suspension of the Applicant’s driver’s licence occurred while being aggressive in a motor vehicle is concerning. However, the purpose of this Tribunal is to determine if the Applicant has proven medical fitness to drive. It is not the role of the Tribunal to be punitive for any actions taken by the Applicant.
Both parties agree that the Applicant suffers from bipolar disorder. The issue at hand is whether or not the Applicant suffers from a disability that is currently unstable and will likely interfere with his ability to safely operate a motor vehicle. The MTO would like to see proof of the full three month of illness stability. This would require 19 more days of stability from the date of the hearing. The Registrar admits that this time frame was longer when the MTO last rejected the Applicant’s submission.
The discrepancies noted between the two mental health assessments by the psychiatrist are quite benign and show an overall trend of the Applicant improving. The question about current medications could have been interpreted to mean medicines not pertaining to the bipolar disease, but no matter the interpretation, the answer to that question does not reflect on illness stability in this particular case. Both reports support a return to driving and illness stability.
The CCMTA guidelines require the following standards for licensure in psychiatric illness;
- A stable condition
- Sufficient driver insight to stop driving if the condition becomes acute
- Proper function ability to operate a motor vehicle
- Support from the treating physician
- Conditions for maintaining a licence are met.
The CCMTA guidelines do not define the first criteria as being an absolute three months duration. Thus this time period of observation is case dependent. In this case, the Applicant has shown insight to his illness, a plan to deal with his illness, and support from his physician. The Registrar has not questioned other criteria for licensure. That leaves the question – will the Applicant’s condition likely show instability between now and the three-month mark defined by the Registrar, such that his ability to drive a motor vehicle safely will be affected.. The balance of probability suggests it will not, based on the Applicant’s physician opinions.
DECISION
Upon the application by the Applicant to appeal the decision dated April 13, 2013 of the Registrar 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;
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 set aside
LICENCE APPEAL TRIBUNAL
Dr. David Borenstein, Presiding Member
Released: June 20, 2013