Licence Appeal Tribunal / Tribunal d'appel en matière de permis
FILE: 9528/MED
CASE NAME: 9528 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.
Appellant Appellant
-and-
Registrar of Motor Vehicles Respondent
REASONS FOR DECISION AND ORDER
ADJUDICATOR: Kevin Flynn, M.D., Member
APPEARANCES:
For the Appellant: Self-represented
For the Respondent: Kyle M. Biel, Agent
Heard by teleconference: May 21, 2015
DECISION AND REASONS
This is an appeal to the Licence Appeal Tribunal (the “Tribunal”) by the Appellant 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”).
OVERVIEW
This hearing arises from an appeal by the Appellant of a Notice of Suspension issued by the Registrar of Motor Vehicles.
The Appellant, in his Notice of Appeal denies that he has dementia or other disability that would affect his ability to safely operate a motor vehicle. He claims that he is capable of driving safely and that he is able to carry on the usual activities of daily living. He believes that he was suspended because of a coronary artery bypass and stroke. Psychiatric evidence before the Tribunal confirms the diagnosis of dementia.
For the following reasons, the Tribunal finds that this appeal should not be granted, and the Tribunal confirms the suspension of his licence to drive.
PRELIMINARY MATTERS
The hearing was scheduled to commence by teleconference at 1 p.m. on May 21, 2015.
Because the Appellant does not have access to a touch-tone telephone, the Tribunal was unable to complete telecommunication with the Appellant in spite of several attempts by the case management officer over a period of 35 minutes.
The Appellant successfully contacted the Tribunal at approximately 2:15 p.m on May 21st and the hearing then proceeded.
FACTS
The Respondent’s Evidence
The Registrar received an unsolicited letter from Dr. M., family physician, on July 17, 2014.
The letter, dated July 15, 2014 stated:
This patient has multiple health issues and I would like his licence to be reviewed.
I hope this has been of assistance.
The Registrar wrote to the Appellant on July 22, 2014 stating that a report had been received, indicating that he may have a condition that affects his ability to drive safely.
The Appellant was requested to contact his treating physician and have the following sent to the Medical Review Section:
Results of all investigations conducted, a diagnosis, treatment, current status and confirmation that the condition is controlled.
He was requested to arrange for this information to be received by September 20, 2014.
Failure to do so would result in suspension of his driver’s licence.
On August 8, 2014, the Appellant wrote to the Registrar.
He stated that in 2010 he underwent bypass and valve surgery during which he had a stroke which required him to take Warfarin, an anti-coagulant. He was also taking medication for blood pressure and a thyroid condition.
He had low iron and since taking iron medication, he felt stronger and had no problems driving.
On September 29, 2014, the Registrar requested that the Appellant complete the information requested and the deadline was extended to November 28, 2014.
On November 14, 2014 a Medical Condition Report was completed in compliance with Section 203 of the Act, by Dr. P., a psychiatrist at a Geriatric Centre.
The condition reported was: Dementia or Alzheimer’s
87 year old male seen for geriatric assessment. Patient’s MoCA score is 17/30. He has poor insight into his medical illness and poor judgement and poor balance. He is a serious risk to road safety and has been told he cannot drive. Family has been advised to take away his keys and that he cannot drive.
Dr. P. also completed a medical report that listed:
Cardiovascular disease, significant risk of falls; poor balance; anemia, dementia; decreased cognition; poor gait and balance; impaired judgement and coordination, tremors.
The Appellant’s licence was suspended under section 47(1) of the Act, effective December 28, 2014 due to the report of cognitive impairment.
The Appellant’s Evidence
The Appellant, now age 87, stated that he was referred by his family physician, Dr. M. to the Geriatric Clinic close to the physician’s office.
He was accompanied by his niece and sister. On completion of the tests by Dr. P., he continued to drive until he received the letter of suspension.
He stated that he lives alone, that he “is in good shape”; does his own shopping, cooking, has never got lost, and never forgot where he parked his car. His sister lives next door but does not drive.
He complains of a walking disability and is able to do his shopping only once a week with his niece. He stated that he had difficulty completing the forms requested by the Registrar, i.e. Cognitive Assessment, because his physician did not wish to do so.
He sees his family physician about once a week. He takes an iron pill and has a laboratory test once a month for the anticoagulant therapy.
He believed that his suspension was due to the by-pass surgery and stroke.
He has not asked his family physician about getting his licence reinstated, and has not been back to see the psychiatrist, Dr. P.
LAW
Subject to section 47.1.(g), the Registrar may suspend or cancel a driver’s licence on the grounds of any other sufficient reason not included in clause (d), (e) or (f).
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
(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.
Section 50 sets out the right of appeal:
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.
Submission by the Respondent
Mr. Biel, Agent for the Respondent, cited the Canadian Council of Motor Transport Administrators (CCMTA) guideline 6.1:
Cognitive impairment, also called cognitive dysfunction or neuropsychological impairment refers to any impairment of a cognitive function such as memory, attention, language, problem solving or judgement.
Dementia refers to a disorder characterised by memory impairment in conjunction with one or more other cognitive deficits.
Alzheimer’s disease is one of the most common types of dementia, including impairment of:
recent memory
word finding
confrontation naming
orientation, and
concentration.
CCMTA 6.6.1 Standard states:
Driver is eligible if complete medical assessment indicates cognitive functions necessary for driving are not impaired.
Mr. Biel stated that the Ministry would not issue a temporary licence to drive for the purpose of a functional driving assessment.
The Registrar was correct in issuing a suspension under section 47(1) of the Act upon receiving a medical report of serious cognitive impairment and a recommendation by a physician that the Appellant stop driving.
No medical support for reinstatement has been received.
The Appellant did not make any closing submissions.
APPLICATION OF THE LAW TO FACTS
The Tribunal finds that the Registrar was justified in issuing a suspension under section 47(1) of the Act, upon receipt of a medical report of cognitive impairment, and a recommendation from the reporting psychiatrist that the Appellant should not be permitted to drive.
The Tribunal notes that the MoCA test, (Montreal Cognitive Assessment) administered to the Appellant by the psychiatrist found deficiency of many of the functions that are required for safe driving. The score of 17/30 is well below the passing score of 26/30
The Tribunal finds that the Appellant does suffer from a 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.
DECISION
Upon the application by the Appellant to appeal the decision dated January 28, 2015 of the Respondent to suspend the Appellant’s driving privilege under section 47(1) of the Act, and having considered the evidence filed with the Tribunal, and the submissions of the Respondent and of the Appellant;
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 Respondent be confirmed.
LICENCE APPEAL TRIBUNAL
Kevin Flynn, M.D., Member
Released: June 4, 2015