Licence Tribunal
Appeal d'appel en Tribunal matière de permis
2013-11-14
FILE:
8373/MED
CASE NAME:
8373 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
Applicant
Applicant
-and-
Registrar of Motor Vehicles
Respondent
REASONS FOR DECISION AND ORDER
ADJUDICATOR:
David W. Hurst, M.D., Member
APPEARANCES:
For the Applicant:
Her father, as Agent
For the Respondent:
Kyle Biel, Agent
Heard in Toronto, Ontario
October 31, 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
Mr. Biel’s presentation disclosed that on May 29th, 2013 a Medical Condition Report signed by Dr. M.M,. regarding the Applicant, was sent to the Ministry of Transportation (the “M.T.O.”) with a list of common conditions and a written comment about “periods of confusion.”
On June 27th, 2013 the M.T.O. wrote to the Applicant about this report indicating that she has a condition that affects her ability to drive safely, specifically, her periods of confusion.
The Ministry required that she take the letter to her treating physician, specialist or nurse practitioner and obtain the following information to be sent to the Medical Review Section:
- The results of all investigations conducted, a diagnosis, treatment, current status, confirmation that the condition is controlled
On August 15th, 2013, the Deputy Registrar of Motor Vehicles received a letter from Dr. I.B., the Applicant’s family physician. The doctor explained the Applicant had brought an M.T.O. letter to his office requesting medical information. The doctor said he was attaching psychiatric consultation reports pertaining to the Applicant’s hospitalizations mentioning the Applicant’s admissions to two hospitals in her region in May and June 2013. These reports gave information regarding mental status, diagnosis and treatment.
The Applicant said on August 8th, 2013 she had been assessed earlier that day by a psychiatrist (Dr.W. at the HOPE Team) and also said she was currently receiving medication by injection.
Plans were made to obtain reports from Dr. W. with information regarding mental status, assessment, diagnosis and treatment and send them to the M.T.O.
Mr Biel then presented a discharge summary from a neighbouring hospital regarding the Applicant with an admission date of June 5th, 2013 and a discharge on June 18th, 2013. The admitting diagnoses were:
1Paranoid schizophrenia
2Cannabis abuse
3Personality disorder (avoidant dependant traits)
This summary described the Applicant as a 21 year old who was admitted in a floridly psychotic state, being noncompliant with her medications since her last discharge from the same hospital on May 30th, 2013. She had been admitted on May 23rd, when she was quite upset, breaking objects in the house. She had fled the house and was eventually found by police, and brought into hospital under the care of Dr. M.
The Applicant was not forthcoming with her answers claiming that there was nothing wrong with her. She had only had an argument with her mother regarding a proposed trip to the City.
Her parents described her aberrant behaviour, such as leaving the house in the evening, returning, and hiding in the basement. In her part time job, it was noted that she was quite disorganized in her thinking and was acting strangely. She was described as being quite indecisive and repetitive.
Her parents described her difficulties starting in grade 8 and on through high school. She had been unable to focus, concentrate or complete work. She had struggled to pass high school.
After the high school period, she tried college and university. She was described by her mother as quite impulsive, confused and distractible. She had had three admissions to this same hospital in December 2011 for about a month. At that time she exhibited bizarre behaviour with knives and threatening her brother. She had been discharged and readmitted two days later for a short period of time. Compliance with all medication was poor.
In the summary, there is a note that the father was very distressed and was having difficulties setting boundaries with her. It was also noted that she had been placed on a Form 3 and transferred to a neighbouring hospital.
A Community Treatment Order was put in place and she was started on Risperdal Consta, and a drug called Abilify which was discontinued on discharge due to poor compliance with oral medication.
The patient was made aware of the Community Treatment Plan and the conditions under which she was returning home.
She was described as remaining vague, detached, not being truthful with her symptomatology, tending to asks questions in a repetitive manner and not understanding the regulations of the Form 3 admission. Privileges were allowed.
This summary was signed by Dr. R. P., a specialist in psychiatry.
A consultation report signed by Dr. R.P. was entered regarding the patient on June 8th, 2013. This letter described the Applicant’s admission on transfer from another local hospital. An incident had happened when she attempted to get out of her mother’s moving vehicle and trying to seize the steering wheel while her mother was driving.
The Applicant minimized the whole episode claiming that she was frustrated. She denied any auditory hallucinations or paranoid delusional beliefs. She denied being depressed or suicidal.
Review of the chart noted that there were episodes when she was seen to be laughing and talking to herself, being quite disorganized, inappropriate in her behaviour, tending to wander at night as well as wanting to go to the city in an impulsive manner.
This consultation described the family history of schizophrenia. Her brother was stated to be suffering from it.
It was noted that her part time work was being carried out poorly and she had been disruptive. A description of her mental status notes that she is pleasant, not clinically depressed, not suicidal, denying any psychosis or thought disorder. Her attention and concentration span appear adequate. Her insight and judgment appeared to be markedly impaired.
The last line of this note described a young woman suffering from a paranoid schizophrenic illness, and will remain in the hospital until treatment strategies are finalized.
The Agent’s next entry was a very lengthy discharge summary by Dr. I.Q.L. which covered her period in a second hospital following transfer from the first hospital on a Form 1 status dated June 2nd, 2013, discharge date June 5th, 2013. Diagnosis on discharge was query psychotic disorder, query anxiety disorder, query psychotic disorder secondary to generalized medical condition.
This is a lengthy document and is summarized herein. The patient is described as a 21 year old, single, never married young lady living with her biological parents. She had been unable to complete her college courses after a few attempts. The events about the episode on the highway were noted when she tried to open the passenger’s door and tried to take over the steering wheel.
She had been medically cleared by the ER physician and was placed on a Form 1 for further psychiatric evaluation. This assessment showed that the Applicant consistently denied any type of psychiatric symptoms, including depression, anxiety or any psychotic symptomatology. She specifically denied the events on the highway. She was critical of her parents. The Applicant admitted the history of admission to a previous hospital on two occasions in 2011 and stated that there had been no psychiatric follow up. Apparently she had been given a prescription for Seroquel but she never took it. In this note, the father described deterioration in her functionality as well as what seemed to be some personality and behavioural changes since 2008. He described her as being withdrawn with some level of decrease in her memory, concentration and focus in 2008. In 2010, she became “more secretive”. Regarding schooling, she had dropped out of a lot of classes and seemed unable to participate. She played sports with considerable ability but eventually dropped out again. She tried an interval at university but dropped out.
In the previous month, the family observed her rather strange behaviour around town in the middle of the night. On one occasion, she ended up in a stranger’s home. As well, recently she had trashed her own home with $8,000.00 damage, with hospitalization for one week. There was no suicidal or homicidal ideation. She was noted by her father to have no depressive symptomatology but he did witness recent “crying and laughing spells voluntarily when she was alone”.
She was not using alcohol or any illicit drugs and does not smoke.
There is reference to family psychiatric illness with her maternal grandmother described as a “hoarder”. This discharge note also states that the Applicant’s biological brother had been admitted in the past to CMAH in a psychiatric state and improved on Seroquel. Her father recorded that three of the Applicant’s mother’s siblings were diagnosed with schizophrenia.
In the section on social and developmental history, the Applicant was very secretive but there are chronic difficulties dealing with stress and she admitted to poor academic performance. She was unable to “survive college”. Her own information disclosed that she was very talented in certain segments of competitive horsemanship, requiring extreme concentration as well as precision ability. The Applicant in this note went on to describe the conflict with her father and described her parents as “over protective”. She is anxious to move out of her parents’ house. Her part time employer had suggested she receive some medical care.
The Applicant was described as certainly not cooperative during her entire stay in the hospital. She refused to provide detailed information. She consistently denied any of the information that had been gathered from collateral sources. She was told that she was not able to go home immediately and she quickly became agitated and verbally and physically aggressive requiring security present. She denied any active suicidal or homicidal ideation.
On her request, a bed for her was arranged at another hospital. She was transferred on a Form 3 status.
The summary of this note presented her as quite agitated with impulsive behaviour, a background history of gradual deterioration of her mental status as well as functionality, since 2008. At this time, there had been no definitive psychiatric diagnosis. Having said that, considering the significant family history of psychotic illness, as well as her gradual rapid deterioration of function and a gradual escalation of her agitation, the doctor thought that she deserved a thorough psychiatric evaluation and treatment if necessary. It was concluded that “one should certainly entertain the idea of possible psychotic illness secondary to generalized medical condition, in particular possible head injury”. (She had struck her head once when she fell from a horse and a CT examination was negative). Due to this short stay in hospital, no further imaging studies could be carried out. This review was signed by Dr. I.Q.L. a consultant in psychiatry.
The Agent’s next entry was a discharge summary signed by Dr. M.M. regarding the patient’s record in one of these two neighbouring hospitals with an admission date of May 24th, 2013 and discharge of May 29th, 2013. There were pertinent comments from this document describing the Applicant’s “explosive discharge at her home” when she became quite destructive. She had become quite angry with the fact that she did not have access to her car. During this stay in hospital she denied experiencing any hypomanic or manic symptoms. She denied experiencing any persecutory delusions. She denied responding to unseen stimuli. She denied any depressive symptoms or any anxiety symptoms.
Collateral information at this time depicted a different picture. Her mood would fluctuate between euphoria and irritability with euthymia (normal mental status). These episodes could last up to a day. The only symptom that she actually acknowledged was periods of confusion at times.
She was noted in the unit at times to respond to unseen stimuli. The Applicant denied this and said that she would laugh at times just because she would remember things, but again denied experiencing any auditory or visual hallucinations. She denied engaging in self-harm behaviour at any point of time. She denied having relationships which are characterized by extreme ups and downs.
Past psychiatric history is significant for a diagnosis of major depression with psychotic features that occurred the prior year. She denied any suicidal attempts. Her medical history discloses one concussion.Family history is significant for a couple of family members with schizophrenia. These doctors understood that her brother might have schizoaffective disorder. There were no suicidal attempts noted in the family.
On meeting with the Applicant’s mother, this doctor described his clinical impression that the Applicant might actually suffer from a bipolar mood disorder versus a schizoaffective disorder and would provide follow up care, but the Applicant said she did not need it. She refused to be followed up by the HOPE Team. The doctor also offered her a CT scan of her head and she refused. She was adamant in stating she does not need any follow up or medication.
While assessing the Applicant’s mental status at the time of discharge, the doctor explained he was going to remove her driving licence because of her periods of confusion and also two car accidents over the past six months.
The doctor’s impression was that the Applicant suffered from either bipolar mood disorder or schizoaffective disorder. He was unhappy that she could not be diagnosed with either of them as she herself denies any symptomatology. He felt that careful follow up was needed. The doctor estimated that driving licence suspension would cover an interval of between three and six months, with stability, and also no presence of confusion. He said that she was no longer certifiable in the sense that he could actually hold her in a psychiatric facility. She again stated that she did not want follow up treatment.
The Applicant was discharged with a prescription of Seroquel 50mg at bedtime and also 25mg twice a day as needed.
The Agent then introduced a letter from Dr. A.W. a HOPE psychiatrist of August 19th, 2013. It said the Applicant had recently joined the HOPE for an early psychosis program under a doctor’s care. Her periods of confusion were related to a diagnosis of schizophrenia. The condition is now largely stable and is being treated with an injectable antipsychotic medication. Provided she continues to take the medication, the condition should remain under good control. She had adapted to the medication at this point so it should not affect her ability to drive. This doctor attached a copy of his initial assessment with further details.
In this document dated August 8th, 2013, the Tribunal learned that in summary, the diagnosis is most consistent with schizophrenia with prominent disorganized behaviour and indirect evidence of hallucinations. Noncompliance has been a significant issue playing a part in having been hospitalized multiple times, first in December 2011 then in late May 2013, secondary due to unruly conduct at home, breaking objects and then fleeing and being picked up by police and then .trying to open a car door while her mother was driving on the highway and grabbing the steering wheel. A long slow decline in functioning may date back to as far as middle school, with more difficulty noted after graduating from high school at which point she was unable to stick to a plan of schooling or activity and began bizarre behaviour. There was a comment in this note regarding a strong family history of schizophrenia and having an older brother with schizophrenia as well as an aunt and uncle on opposite sides of the family. When reviewed at her home, she was found to be behaving in a much more organized fashion according to her mother. She has a new part time job and is much more goal directed. Her mother noted that there were still some inappropriate activities considering her age. This was described as a substantial improvement. Signs such as laughing inappropriately or talking to herself have completely disappeared according to her mother.
The doctor noted that the Applicant’s focus on switching to oral medications, lowering the dose of medication and finding out when her obligations to persist with treatment, should cease. She was described as showing fluctuating reasons for wishing to switch off injectable medications. The doctor suspected she had no intention of continuing with medications given the option, and likely does not appreciate the reasons being recommended for her. She had already been found incapable to consent to treatment.
At this point, an entry from HOPE (early psychosis intervention program, intake and comprehensive assessment) was provided by Mr. Biel. This entry was signed by Ms K.F. described as intake staff. This standard form survey document was reviewed in detail, as follows.
REASON FOR REFERRAL INTAKE
SYMPTOMS OF PSYCHOSIS YES NO COMMENTS
Hallucination (auditory, visual, tactile, old factory, gustatory) X Denied- but was seen responding to internal stimuli
MOOD
Low mood, poor sleep and appetite, X client denied this enjoyment of activities
Elevated mood, risk taking behaviour, racing thoughts, poor sleep, excessive spending X client denied this however it also states in the collateral info that there are periods when the client has elevated mood for approximately a day at a time.
FUNCTIONING
Decline in functioning at school, work and/or socially X was in a local college for a year but dropped out – no explanation provided
Social withdrawal/isolation X has been isolating at home
Uncharacteristic personality change X has been destructive at home and destroying property
Has disorganized thinking X very disorganized thinking over the last year – please see presenting problems of this document for further information
RISK NO
Aggression or violent/homicidal ideation, self harm/suicide and substance use X
An extract of the final three pages of this survey notes that the Applicant is dishevelled, with inappropriate speech and cognition problems with memory, attention, and concentration. Intelligence is marked as average or above. It is noted that there is no insight, and poor judgment.
On September 17th, 2013, the M.T.O. wrote to the Applicant saying that she has a condition that affects her ability to drive safely, i.e. psychiatric condition. Under section 47(1) of the Highway Traffic Act the Ministry suspended her driving privilege.
This form letter from the Ministry went on to state that for reinstatement of the driving privilege there must be confirmation of a six month period of stability.
Mr. Biel then entered a copy of the Applicant’s driving record in which one finds several events regarding speeding, then on the 27th of September 2013 a suspension for medical reasons. There were three demerit points.
The Applicant’s father provided the Tribunal with a copy of a letter from Dr. A. W. (HOPE psychiatrist) dated October 30th, 2013 (Exhibit 3). This states:
The Applicant is a patient of mine, followed through the HOPE early psychosis program. She has a diagnosis of schizophrenia and has been clinically stable since midsummer. She takes Invega Sustenna 150mg intramuscular once a month currently to manage her condition. He went on to say “I do not anticipate either the illness or treatment would interfere significantly with her ability to drive. Provided she continues with the current treatment, her prognosis is good in terms of remaining well.”
Mr. Biel referred the Tribunal to a copy of the CCMTA documents in which he drew special attention to page 215 (guidelines for assessment 14.6.1 psychiatric disorder – all drivers). He noted that the driver, to be eligible for a licence,must satisfy the following:
The condition is stable
The driver has sufficient insight to stop driving if his condition becomes acute
The functional abilities necessary for driving are not impaired
A treating physician supports a return to driving, for drivers who have stopped driving due to a psychiatric disorder, and
The conditions for maintaining a licence are met.
The Agent referred to Dr. M.M.’s comments that a period of three to six months of psychiatric treatment must be completed to be certain of the Applicant’s stability.
EVIDENCE FOR THE APPLICANT
The Applicant’s father (Mr. J) began by questioning qualifications of the lady K.F. whose name appears in the document presented by Mr. Biel. Mr. Biel objected stating that the Applicant’s father could have subpoenaed K.F. to appear at the hearing. At this juncture there was a possibility of an adjournment to wait for an update letter regarding the Applicant’s stability. Mr. J declined. He then addressed the letter of August 8th, 2013 from Dr. A. W. a psychiatrist, with the Canadian Mental Health Association noting Dr. A.W.’s obligation to tell the M.T.O. if he believed that the patient was at a risk to drive. Again Mr. Biel objected on the basis that the Applicant’s Agent was attempting to speak for Dr. A.W., CMHA. The Tribunal agreed.
Again Mr. J. referred to the letter from Dr. A.W. (August 19th, 2013) with the observation was that Dr. A.W. said that his daughter could drive.
Mr. J. then directed his attention to Dr. M.M.’s discharge summary regarding the Applicant dated May 29th, 2013. Mr. J. said Dr. M.M. set some boundaries with his daughter and especially explained to her that she couldn’t drive unless she complied with the necessity to take her medications.
Mr. J. referred to Dr. I.Q.L.’s final note dated June 5th, 2013 describing her long discussion with his daughter, Dr. I.Q.L. had sent no letter to the M.T.O. and was unaware of his daughter having lost her licence.
Mr. J. denied the statements in Dr. R.P.’s letter that his son (the Applicant’s brother) was schizophrenic. Mr. J. then noted that the M.T.O. wrote to his daughter on June 27th, 2013 and failed to give a diagnosis other than to say that there was confusion and said nothing about driving. The M.T.O. required further information and with that the doctors had complied. He then noted the letter by his daughter’s family physician Dr. I.B. dated August 15th, 2013 and no mention was made of his daughter’s ability to drive. He complained as well about the letter from the M.T.O. to his daughter on June 27th, 2013 and stated only “reports questioning the ability of his daughter to drive safely”. This had been based on a Medical Condition Report signed by Dr. M. M, May 29th, 2013 which simply remarked that his daughter had suffered periods of confusion. Mr. J.’s point was that there was a serious lack of information.
Mr. J. observed in a letter presented at the hearing from Dr. A.W., now Exhibit #3, that his daughter can drive safely.
Mr. J. then presented his daughter as a witness.
In a series of questions she disclosed that she is taking her medication now and since mid June. She admitted to having taken a driver test from an examiner and she passed. Further questions disclosed that when she was ill she did not drive but turned in her keys. She has not driven since her suspension. She states that she is stable, is at school, concentrating well and is on the university soccer team and as well is playing hockey. She confirmed if she fell ill while driving she would pull off the road and stop. She denied any physical limitations regarding her ability to drive.
Finally, on questioning, she observed that her doctor said she can drive if she takes all her medications.
Mr. Biel then questioned the Applicant regarding her compliance with medications. He asked about her noncompliance and the Applicant said that this was because the side effects of the drugs made her worse and she also stated that she had no problem.
Mr. Biel, observing the behavioural problems and signs of mental difficulties dating back to 2011, inquired as to what has changed. The Applicant says she understands she is ill. He asked why she now preferred injectable medications. Her reply was that it was simply easier to handle a monthly injection rather than one pill a day. Her history indeed shows that she forgets to take her pills. When queried as to her unwillingness to inform her doctors of her problem she denied she was withholding information. Mr. Biel observed the doctor’s comments the Applicant was not truthful; this produced a denial from the Applicant. Her parents wouldn’t let her drive (early on) even though she felt able. She went on to state that she now knows that she must not drive if she feels ill. Mr. Biel also observed that while Dr. W. now states in his latest letter that the Applicant can drive, there is the important proviso that if she takes her medications. Mr. Biel again noted the suspension is partly based on the fact that the Applicant had no intention of taking her medications. The Applicant denied this totally. Mr. Biel noted that Dr. W. is very cautious in his comments, because he is uncertain about the Applicant’s compliance.
MR. J.’S SUMMARY
He observed that his daughter had passed her driver’s exam when she was most seriously ill. He admitted she had trouble accepting the diagnosis of a mental health problem. He said that it took two to three months of parental pressure to persuade their daughter to seek medical help. He observed that his daughter has been taking medication regularly since July and is feeling better every day, participating in her sports, (horse riding, hockey) and at college has recently achieved a mark of 71%. The doctors have no issues with his daughter now driving as noted in the previous reports. Mr. J. acknowledged the fact that all drivers must be stable and sometimes require letters stating that they are stable and on their medications. His daughter now has insight and will stop driving if she felt ill. He observed that her doctors say she can drive and their letters have been presented.
He noted that she is compliant on the HOPE program. She is in good physical condition, not psychotic and her memory has improved. There have been no previous driving problems and there had been no accidents (there are previous reports of accidents). His final observation is that she has passed her driving test and should not have been suspended and he asks that her privilege be restored.
MR. BIEL’S SUMMARY
The Ministry showed responsibility in complying with section 47(1) of the Highway Traffic Act. He then noted that the initial Medical Condition Report indicated periods of confusion, the suspension noting that with the confusion there could be inadequate concentration on the part of the driver.
Mr. Biel found that the investigations had identified a lengthy period of mental illness with serious noncompliance on the part of the Applicant, hence the suspension. He said that the Ministry requires a minimum of six months of health and stability to achieve re-licencing. Again he referred to the pertinent sections of the CCMTA report. He went on to say that there was evidence here of bizarre behaviour – trying to get out of a moving vehicle, trashing her house with many confirmatory pages of notes from various psychiatrists, and found that there was significant history of denial of her medical condition and that there was serious lack of insight and judgment. Mr. Biel conceded that there is nothing in the CCMTA document requiring a period of six months of stability. The M.T.O.’s position regarding the six month is arbitrary but in the best interest of highway safety.
Mr. Biel found that there may be 3 ½ to 4 months of success achieved by the Applicant and is very pleased about that. Mr. Biel said that the M.T.O. must be very careful in restoring the driving privilege particularly in this case where there has been a history of noncompliance. He observed that Dr. W.’s latest letter stresses the importance of the Applicant’s compliance with her medications, and that it should be regularly reviewed. Mr. Biel also referred to previous comments from the Applicant wanting to find out when she can cease treatment. Dr. W. agreed that this is a concern and expressed his suspicion that she would not continue treatment.
Mr. Biel closed by indicating that the M.T.O. can’t ignore the copious psychiatric reports. He observed that the M.T.O. is hoping for improvement but that a longer period of control is required.
ISSUES
Should the decision of the Registrar to suspend the Applicant’s licence be confirmed, modified or set aside and in particular: does the Applicant suffer from a mental, emotional, nervous or physical disability likely to significantly interfere with her 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:
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 Applicant’s travails began upon the M.T.O.’s receipt of a Medical Condition Report stating that she was suffering from periods of confusion. This was filed on May 29th, 2013. Her father stated that this is totally inadequate information to cause a licence suspension. It is very apparent that in the Tribunal’s receipt of copious reports from well qualified psychiatrists and from discharged summaries of two hospitals and a mental health organization, there have been serious mental health issues..
The psychiatrists have not been able to make a completely accurate diagnosis in a large part due to the Applicant’s lack of insight and failure to admit to a mental illness. The psychiatrists have had to seek collateral sources of history pertaining to her problems. They have observed their difficulties in coming to a precise diagnosis because of lack of time with regular interface with their patient (the Applicant).
The Applicant has had a difficult time with her illness, a condition from which she suffers through no fault of her own. Her lack of compliance both with the history and examination and use of medications may well be due to a form of denial on her part that she has such trouble. This Tribunal is in complete sympathy. The Applicant is showing early signs of satisfactory progress perhaps at least partially due to the fact that the doctors have by trial and error found suitable medication for her. This precise choice of medication hopefully could be more accurate if there was a longer period of intensive treatment; this might happen now that the patient has better insight. While Mr. J is now able to state correctly that she is showing very good progress possibly over a period of three months, the Ministry is asking for at least three more months of satisfactory reports if the Tribunal agrees. It is of benefit not only to the Applicant but also in regard to highway safety.
The Tribunal finds the Applicant is suffering from a condition which is likely to significantly interfere with her ability to operate a motor vehicle safely. The Tribunal is pleased to learn of her current progress and agrees that a longer period of treatment while suspended is prudent, and accords with the specific statutory framework which the Tribunal is required to consider. .
DECISION
Upon the application by the Applicant to appeal the decision dated June 27th, 2013 of the Registrar to suspend her 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 confirmed.
LICENCE APPEAL TRIBUNAL
David W. Hurst, M.D., Presiding Member
RELEASED: November 14, 2013