Licence Appeal Tribunal
Appeal d'appel en Tribunal matière de permis
FILE: 9249/MED
CASE NAME: 9249 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
-and-
Registrar of Motor Vehicles
Respondent
REASONS FOR DECISION AND ORDER
ADJUDICATOR: Katherine Whitehead, M.D., Member
APPEARANCES:
For the Appellant: Self-represented
For the Respondent: Kyle Biel, Agent
Heard in Toronto: December 19, 2014
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”).
FACTS
The Appellant, holding a Class G driver’s licence, applied for a commercial driver’s licence and submitted a medical report to the Registrar in support of this application.
This medical report was dated March 26, 2012 and was filled out by the Appellant’s family physician of 4-5 years, Dr. H.J.
In this report, Dr. H.J. indicated “h/o schizophrenia, stable, no medication” and “Pt has a history of Schizophrenia, was on medications, he has been off medications since 2006 (at the request of his psychiatrist)”.
Dr. H.J recommended a report from the Appellant’s psychiatrist to “clear” him.
The Registrar then requested that the Appellant provide a letter to the Medical Review Section outlining specifics of his psychiatric history.
On April 19, 2012, Dr. H.J. sent a Medical Condition Report to the Registrar.
In this report, Dr. H.J. checked the box for “Mental or Emotional Illness – unstable”.
Dr. H.J. commented, “He recently had a MTO form filled out. He was stable physically but today, April 19th 2012, he comes in with psych issues. He has been referred to psychiatry. Recommend no driving till his psychological issue is dealt with.”
On June 4, 2012, the Registrar sent the Appellant notice that his Class G licence was suspended and requested that the Appellant provide a letter to the Medical Review Section outlining specifics of his psychiatric history.
On October 8, 2012, the Appellant wrote a letter to the Registrar outlining his understanding of the suspension, but did not provide further medical information.
The Registrar responded to this letter on December 10, 2012 and provided the Appellant with a Mental Health Assessment Form to be filled out by his physician.
On July 17, 2013, a Mental Health Assessment Form was filled out by Dr. L.S.
In this form, Dr. L.S. indicated that he had no knowledge of the Appellant before the visit to fill out the form and could only report what the Appellant told him during that one visit. Dr. L.S. did not comment on the current status of the Appellant’s condition and stated that he was seeing the Appellant for the first time that day. Dr. L.S. did note that there was no impairment in cognition, attention, or memory. He noted that there had been one hospitalization within the past year for a psychiatric condition and that the Appellant was on no medication.
The Registrar reviewed the case and on August 1, 2014, requested an up to date report detailing the specifics of his psychiatric condition by a physician familiar with his medical history.
The Registrar sent four letters requesting the above information and did not receive it.
The Registrar received faxed copies of the previous assessment from Dr. L.S. and also what appeared to be a copy of the original April 19, 2012 Medical Condition Report from Dr. H.J. which had been altered from the original. This later faxed report had the comment section removed.
The only document submitted to the Tribunal by the Appellant was his Notice of Appeal form.
On that form, he made mention of not having received paperwork, issues surrounding his insurance, comments about his driving record, and other issues that seem not to be related directly to his appeal.
During the appeal hearing, the Appellant was pleasant and cooperative. He appeared to have a real desire to provide clarity in the case.
Similar to his comments on the appeal form, his comments during the hearing often seemed tangentially related or not related to the facts of the case. He appeared to have difficulty organizing and focusing his answers to questions asked of him. For this reason, it was difficult to further clarify points of the medical or psychiatric history.
The Appellant had an opportunity to ask questions and ask points of clarification of both the Ministry representative and the Tribunal Member. At the end of the hearing, he confirmed that he was satisfied that all of the facts he wanted to make clear had been stated.
The Appellant did not enter any new medical evidence at the hearing.
ISSUES
Should the decision of the Registrar to suspend the Appellant’s licence be confirmed, modified or set aside?
In particular:
Does the Appellant suffer from a mental, emotional, nervous or physical condition or 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.
Section 47(1) of the Act gives the Registrar the power to suspend or cancel a driver’s licence on the ground(s) set out in section 14(1) of the Regulation set out above.
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
Weighing the evidence on a balance of probabilities, the Tribunal finds that the Appellant is suffering from a condition which is likely to significantly interfere with his ability to drive a motor vehicle safely.
The simple fact that the Appellant suffers from schizophrenia does not, in itself, significantly interfere with his ability to operate a motor vehicle safely.
The point of consideration is whether his psychiatric condition is unstable and therefore unduly interferes with his ability to drive safely.
Persons suffering from unstable schizophrenia may have impairments in insight, judgment, attention and executive function (that is, neurologically-based skills involving mental control and self-regulation) that would diminish their ability to drive safely.
Considering the medical evidence available there is sufficient evidence to find that the Appellant’s psychiatric condition is unstable.
The only reports from a physician familiar with the Appellant’s medical history come from Dr. H.J., his family physician of 4-5 years. In his most recent correspondence (April 19, 2012), Dr. H.J. stated that the Appellant’s psychiatric condition was unstable and recommended no driving. The Tribunal does not accept the altered April 19, 2012 Medical Condition Report (received later with the comments deleted) as evidence that Dr. H.J. meant to reconsider those comments. The Tribunal accepts that the form, as it was originally submitted, conveys the intended message from the physician.
The assessment of Dr. L.S. is less significant with regards to the Appellant’s function given that he was not familiar with the Appellant’s medical and psychiatric history.
There is report of a recent hospitalization for psychiatric reasons, which supports a finding of an unstable condition.
The written and in person communication from the Appellant is in keeping with a person with schizophrenia who may struggle with executive function and attention.
The Tribunal is not in a position to make a formal psychiatric assessment of the Appellant. The Tribunal can only rely on the medical evidence it has received and its direct observations at the hearing. More detailed psychiatric information from the Appellant’s health care team would have assisted the Tribunal. As it was presented, the evidence was limited and only that which was presented can be considered.
As there was no evidence submitted from health care professionals familiar with the Appellant to indicate his condition has stabilized since the report of April 19, 2012, the Tribunal agrees with the Registrar’s submissions that the Appellant’s condition remains unstable.
A person with a “mental condition”, such as the Appellant’s, which results in impaired insight, judgment, attention and executive function would have difficulty with risk perception, decision making, anticipation, and integration of feedback to change plans. These are all skills essential to safe driving, especially in times of unexpected road situations.
In view of the serious nature of his unstable psychiatric condition, the Tribunal finds that the Appellant is impaired sufficiently to interfere with his ability to drive a motor vehicle safely.
DECISION
Upon the application by the Appellant to appeal the decision effective June 4, 2014 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 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 Registrar be confirmed.
LICENCE APPEAL TRIBUNAL
Katherine Whitehead, M.D., Member
Released: January 7, 2015