Licence Appeal Tribunal
FILE: 9969/MED
CASE NAME: 9969 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: 9969
-and-
Respondent: Registrar of Motor Vehicles
REASONS FOR DECISION AND ORDER
ADJUDICATOR: Katherine Whitehead, M.D., Member
APPEARANCES:
For the Appellant: Self-represented
For the Respondent: Mr. Kyle Biel, Agent
Heard by teleconference: January 20, 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 47(1) of the Highway Traffic Act, R.S.O. 1990, c. H.8 (the "Act").
EVIDENCE
The Appellant's Class G Driver's License was suspended on February 4, 2015 for the stated reasons of alcohol dependence, seizure, and psychiatric condition. This was in response to a Medical Condition Report sent to the Registrar by an emergency physician on February 1, 2015. On the report, the ER physician checked the boxes for the three conditions: Alcohol Dependence, Seizure(s) - Cerebral, and Mental or Emotional Illness - Unstable. No further comments were provided by the physician. The medical record from the emergency department was not available for consideration at the hearing.
The Appellant said that he had been involved in what he felt was a minor traffic accident. He stated that alcohol was not a factor in the accident. He said that the reason he went to ER was that somebody called an ambulance and they convinced him to go to the hospital. He admitted that he may have been "acting funny" but said he had been taking some prescription pills. He did not recall what they were and stated that he had thrown them away when he got home. He said that the ER physician spoke with him "for three minutes". The Appellant felt that was too short a time to make a proper assessment.
The Appellant said he has never had a seizure. He said he has no history of mental illness.
The Appellant said "I don't drink and drive" many times during the hearing. When the Registrar asked him to comment on his prior conviction for driving over the legal limit for alcohol in July 2013, the Appellant stated "I learned my lesson".
The Appellant said that he is a good driver and told the Tribunal that he used to work delivering phone books but had to quit his job as a result of losing his driver's licence.
The Ministry's suspension letter dated February 4, 2015, required the Appellant to provide three completed medical forms, about alcohol, seizures and mental health. The Appellant's family doctor, Dr. B, filled a Substance Use Assessment form dated April 13, 2105. On it, the physician checked off two of the boxes in the "diagnosis" section: alcohol abuse and alcohol misuse. She did not check off the boxes marked "alcohol dependence," and she also did not check off the box marked "alcohol use within low risk drinking guidelines (see Appendix for definition)." After the Ministry responded in a letter date June 3, 2015, that the second page of this form needed to be filled out, and the other two forms also needed to be completed, the Appellant then sent in these three forms, all completed by Dr. G in the Appellant's Family Health Team, on September 27, 2015.
This second Substance Use Assessment form now had "alcohol dependence" checked off as a diagnosis. It further indicated on the second page, which seemed to have been missing in the April 13, 2015 form, that the Appellant had not abstained from alcohol. In addition, Dr. G checked off "unknown" for a number of other questions, such as whether the patient had ever experienced a seizure, had abstained from drugs, had completed formal addiction treatment, etc. The form also indicated that the Appellant had been treated for alcoholic hepatitis in January and February 2015, and that he had elevated MCV biochemical markers due to "alcohol use" and "B12 and/or folate deficiency."
The family doctor also filled a Mental Health Assessment form. On it, Dr. G checked off boxes to indicate that the Appellant's primary mental illnesses were "depression/ dysthymia" and "substance abuse," with the onset of most recent illness episode being less than three months. The current condition was checked off as being improving with ongoing moderate depressive symptoms. While Dr. G indicated no impairment in the Appellant's cognition, attention or memory, he checked off "Yes" for "difficulties with judgement", and also checked off his opinion that his patient lacked "appropriate insight/understanding of his/her medical condition and the impacts on their functional ability to drive."
The family doctor also filled an Epilepsy and Seizures form. On that form he said that he was not aware if the Appellant had previously suffered a seizure and that he had reviewed the notes from the recent ER visit but could not see any mention of seizure.
On November 10, 2015, the Registrar sent the Appellant a letter stating that they required a period of abstinence from alcohol for one year (or six months with the completion of an alcohol treatment program and the physician's support for reinstatement of the licence), the results of recent blood tests for biochemical markers, and confirmation of a three month-period of psychiatric stability and improved judgment and symptoms successfully treated or resolved. There was no mention of seizures, and the Respondent's representative confirmed that the Respondent was no longer considering resolution of the seizure issue in the decision to re-instate the licence.
ISSUES
Should the decision of the Registrar to suspend the Appellant's licence be confirmed, modified or set aside?
In particular:
Is the Appellant addicted to the use of alcohol or a drug to an extent likely to significantly interfere with his ability to drive a motor vehicle safely?
and
Does the Appellant 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?
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:
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
On the Mental Health Assessment form, the Appellant's family doctor assessed him to have limitations in judgment, insight, and understanding. These qualities are essential for driving, and if they are diminished, this will impair the Appellant's ability to drive safely.
The Appellant has a conviction for driving over the legal limit of alcohol in July 2013. This demonstrates at least one instance of previous poor judgment concerning drinking and driving.
Although the first Substance Use Assessment form marked off only alcohol abuse and misuse, two other physicians have diagnosed the Appellant with alcohol dependence – in the ER form and the second Substance Use Assessment form.
The Appellant felt that the ER assessment was not sufficient to demonstrate a medical or addiction issue. The details provided by the Appellant about the ER visit were vague and did not cast sufficient doubt on the ER physician's ultimate assessment so as to disregard it. It is difficult to objectively evaluate the checked off boxes in the ER assessment without the medical record of that visit, but even if the Tribunal were only to consider the input from the family physician, it would be sufficient to demonstrate a significant driving risk.
The notes from Dr. G, the family doctor, illustrate that the Appellant is dependent on alcohol, has moderate symptoms of depression, and is lacking in insight and judgment. This information is sufficient to demonstrate impaired ability to drive safely.
The combination of the Appellant's July 2013 alcohol-related driving offence, the February 2015 report from the ER physician and the September 2015 reports from the Appellant's family doctor all support a finding against the Appellant's appeal.
Given the evidence, the Registrar's position to follow the guidelines of the Canadian Council of Motor Transport Administrators (CCMTA) for these situations would appear to be reasonable, in terms of asking the Appellant to show a period of abstinence from alcohol. The medical evidence also shows that the Appellant has moderate symptoms of depression, but this in itself is not enough to show that it will interfere with his driving. The indicators of a lack of judgment or insight – which appear to be related at least in part to his alcohol dependence – are more relevant to the ability to drive safely. On the facts of this case, the Registrar has proven that the Appellant is addicted to the use alcohol to an extent that is likely to significantly interfere with his ability to drive a motor vehicle safely.
DECISION
Upon the application by the Appellant to appeal the decision dated August 14, 2015, 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 27, 2016