Licence Tribunal
Appeal d'appel en
Tribunal matière de permis
FILE: 10211/MED
CASE NAME: 10211 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 32(5)(b)(i) – to Change the Class of Classes of Motor Vehicles in respect of which the Licence was issued.
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: Sonia De Santis, Agent
Heard by teleconference : June 13, 2016
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 32(5)(b)(i) of the Highway Traffic Act, R.S.O. 1990, c. H.8 (the “Act”).
FACTS
Evidence for the Respondent
A Medical Condition Report was completed on September 8, 2015 by Dr. N., a specialist, in compliance with section 203 of the Act.
The report stated:
Stroke/TIA
Multi-territorial CVA with right arm weakness, confusion and apraxia.
A second Medical Condition Report was completed on September 18, 2015 by Dr. G., a family physician.
This report stated:
Seizure(s)-Cerebral
Patient sustained a solitary grand mal seizure on September 7, 2015 secondary to a mild stroke which has completely resolved. He is currently being maintained on dilantin and it is anticipated that he will be eligible for licence restoration at a future date.
The Registrar informed the Appellant on October 8, 2015 that his driving privilege was suspended under section 47(1) of the Act.
He was requested to take the letter of suspension to his physician and to have an Epilepsy and Seizure Assessment, and a Cerebrovascular Diseases Traumatic Brain Injury/Tumour Assessment completed and forwarded to the Ministry’s Medical Review Section.
The latter assessment was completed on March 16, 2016 by an internal medicine specialist, Dr. B.
In summary this assessment stated:
Primary diagnosis: stroke, with his first seizure more than 6 months ago and now stable
The underlying cause has been addressed with treatment
No significant impairments
He does not have epilepsy or seizure disorder
Functional driving assessment is not required
He is on medication with no effects on driving safety and is adherent to treatment
The final diagnosis is Small CVA with complete recovery.
The Epilepsy and Seizure Assessment by the same physician contains similar findings:
- Had small seizure associated with a small stroke and both have completely resolved with no further seizures.
Following review of the medical reports, the Registrar informed the Appellant on April 8, 2016 that his Class ’G’ licence was reinstated.
However, he was informed that he no longer met the National Medical Standards for a commercial licence. In order to be considered for reinstatement of his commercial licence, he must submit a medical report that confirms that he remained seizure free for a period of five years on anti-convulsant medication or that he remained seizure free off medication.
Evidence for the Appellant
In his reasons for appeal, the Appellant stated that his seizure was found to be due to a stroke and it has completely resolved with no neurological impairment.
The Appellant informed the Tribunal that on the day in question, he had been feeling unwell after a long weekend and awoke with one arm weak and impaired speech. He was taken to the Emergency Room where he had a witnessed seizure a day following his admission. The seizure lasted five or six minutes. A CT scan of his brain was reported to be normal and he was started on Dilantin 300 mg daily.
He was also taking Aspirin and medication for cholesterol management.
Since then, he has been attending a gym regularly. He drinks alcohol only on special social occasions and does not smoke. He is a private contractor and drives a dump truck on occasion.
He has been seen by his specialist, Dr. B., three or four times since September and has been advised by him that he will wean him off Dilantin twelve months after the stroke.
ISSUES
Should the decision of the Respondent to change the class of motor vehicles in respect of which the licence is issued in accordance with the result of the examination be varied, modified or set aside?
In particular:
Does the Appellant suffer from a mental, emotional, nervous or physical disability to an extent that he should no longer be entitled to exercise the privilege of a Class ‘DZ’ licence?
LAW
The relevant statutory provisions state as follows:
Section 32(5)(b)(i):
- No person shall drive a motor vehicle on a highway unless the motor vehicle is within a class of motor vehicles in respect of which the person holds a driver’s licence issued to him or her under this Act.
(5) The Minister may require an applicant for driver’s licence or an endorsement or a person who holds a driver’s licence to submit to the examinations that are authorized by the regulations at the times and places required by the Minister who may,
(b) in the case of a person who holds a driver’s licence,
(i) impose the conditions authorized by the regulations, remove any conditions or endorsements or change the class or classes of driver’s licence held by the person, in accordance with the results of the examinations and other prescribed requirements…
Further, 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.
SUBMISSIONS
The Respondent’s Agent relies on the Canadian Council of Motor Transport Administrators, (CCMTA) Guideline 17.6.1 which applies to drivers who have experienced one provoked seizure caused by a stroke.
The Guideline states:
All drivers are eligible for a licence if:
they have undergone a neurological assessment to determine the cause of the seizure, and epilepsy is not diagnosed;
it has been 6 months since the provoking factor stabilized, resolved, or was corrected, and they have not had a seizure during that time;
the treating neurologist or neurosurgeon indicates that no further seizures are likely.
Suggested Reassessment in one year if a seizure occurred within the past twelve months.
Ms. De Santis stated that the Ministry’s position is that if the Appellant continues to require anti-convulsant medication, he will remain under suspension with respect to his commercial licence for five years. However, if his specialist discontinues the medication twelve months following the seizure and he confirms that the Appellant remains seizure-free, the commercial licence would be considered for reinstatement.
The Appellant stated that it is his intention to see his specialist in September, with a view to discontinuing Dilantin and to arrange for the necessary medical reports to be forwarded to the Ministry.
APPLICATION OF THE LAW TO FACTS
The Tribunal finds that the Ministry was justified in suspending the Appellant’s commercial driving licence upon receipt of medical reports of seizure due to stroke, in compliance with section 203 of the Act, in September 2015. The Tribunal finds that the CCMTA is silent regarding commercial drivers who have sustained a single seizure provoked by stroke that has been successfully treated without impairment but who remain on anti-seizure medication for a period of twelve months following the seizure.
The medical assessments submitted did not find a diagnosis of epilepsy and therefore, the Tribunal finds that CCMTA Guideline 17.6.1 may be applied.
The Ministry has the Appellant’s undertaking to seek the advice of his specialist in September 2016, with a view to discontinuing the anti-convulsant therapy and will arrange for the specialist to inform the Medical Review Section that the Appellant has remained seizure-free for a period of twelve months and that he is not required to continue this medication.
The Tribunal notes that the Appellant’s Class ‘G’ licence has been reinstated. The issue is whether the Appellant suffers from a physical condition to an extent that he should not, at this time, be entitled to exercise the privilege of a commercial licence in light of safety concerns as set out in the Act. As stated above, the Tribunal finds, on these particular facts that the CCMTA guideline is helpful in assessing the issue of whether the commercial licence should be reinstated at this time. The Tribunal is not satisfied that there is enough evidence to support reinstatement given that the Appellant has not been 12 months seizure free. The Tribunal notes, however, that it is the Appellant’s stated intention to see his specialist in September, at which time he anticipates receiving a favourable report which will satisfy the Ministry’s concerns. Without binding the Ministry to a certain outcome, Ms De Santis has stated that such a report would allow the Appellant’s commercial licence to be considered for reinstatement.
The Tribunal finds that pending the receipt of a medical report that confirms the Appellant is seizure-free for a period of twelve months and does not require anti-convulsant medication; his commercial licence should remain suspended.
DECISION
Upon the application by the Appellant to appeal the decision, dated April 6, 2016, of the Respondent to change the class or classes of motor vehicles in respect of which the licence was issued pursuant to Section 32(5)(b)(i) of the Act, and having considered the evidence filed with the Tribunal, and the submissions of the Registrar and of the Appellant, and in particular, the likely re-assessment of the Registrar’s decision upon receipt of a further report from the Appellant in September, 2016;
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
Kevin Flynn M.D., Member
Released: June 27, 2016