Appeal under subsection 50(1) of the Highway Traffic Act, R.S.O. 1990, c. H. 8, from a decision of the Registrar of Motor Vehicles to suspend a driver’s licence under subsection 47(1) of the Act.
Between:
T.R.
Appellant
and
Registrar of Motor Vehicles
Respondent
DECISION
Panel: Dr. Katie Awad, MD, Member Cezary Paluch, Member
Appearances:
For the Appellant: T.R., Self-Represented
For the Respondent: Kyle Biel, Agent
Observer: Declan, Student
Place and Date of Hearing: By Teleconference October 24, 2018
REASONS FOR DECISION
A. Overview:
1On November 2, 2017, the appellant was taken to a hospital by police after drinking the day before. The appellant’s wife was concerned for his well-being and contacted the police. He was kept as an inpatient at the hospital for 23 days, and upon discharge on November 22, 2017, continued to receive support as an outpatient at a wellness and addiction treatment centre. The Registrar of Motor Vehicles (the “Registrar”) suspended the appellant’s driver’s licence effective November 7, 2017, due to the appellant’s medical condition, after receiving a Medical Condition Report from a psychiatric resident at the hospital diagnosing the appellant with alcohol dependence and a mental or emotional illness.
2Pursuant to s. 203(1) of the Highway Traffic Act, R.S.O. 1990, c. H.8 (the “HTA”), all medical practitioners are required to report any person 16 years of age or older who is suffering from a condition that may make it dangerous for the person to drive.
3The appellant appealed the suspension by filing a Notice of Appeal received by the Tribunal on September 21, 2018, on the grounds that he is alcohol free and has recovered.
4For the reasons that follow, we find that the Registrar has proven on a balance of probabilities that the appellant suffers from alcohol dependency and a mental illness, and has proven that this medical condition is likely to significantly interfere with his ability to drive safely. Accordingly, we confirm the Registrar’s decision to suspend the appellant’s driver’s licence.
B. ISSUES:
5The issue for the appeal is whether the appellant suffers from alcohol dependence and/or a psychiatric condition(s) which is likely to significantly interfere with his ability to drive a motor vehicle safely. In order to answer that question, we will address the following issues:
Does the appellant suffer from alcohol dependence and/or a psychiatric condition?
Is the appellant’s medical condition, if any, likely to significantly interfere with his ability to drive safely?
C. THE LAW:
6The Registrar has the burden of establishing the ground for suspending the licence on a balance of probabilities.
7The Registrar has the power under s. 47(1)(g) of the HTA to suspend a driver’s licence for a sufficient reason.
8Subsection 14(1)(a) of O. Reg. 340/94 (the “Regulation”) under the HTA requires that a holder of a driver’s licence must not suffer from any physical condition or disability likely to significantly interfere with his or her ability to safely drive a motor vehicle of the applicable class.
9Section 14(2)(a) of the Regulation allows the Minister of Transportation to consider the CCMTA Standards when determining whether the requirements of s. 14(1) are met. Similarly, the Tribunal may take the CCMTA Standards into consideration. The CCMTA standards are not binding on the Minister of Transportation or on this Tribunal, though we may consider them.
10Pursuant to section 50(2) of the HTA, the Tribunal may confirm, modify or set aside the decision or order of the Registrar after a hearing.
D. ANALYSIS:
11The test the Tribunal must consider in this appeal is whether the appellant suffers from a mental, emotional, nervous or physical condition or disability likely to significantly interfere with his ability to drive. In order to address that question, we will address the following issues:
- Does the appellant suffer from alcohol dependence and/or a mental illness?
12There is agreement by both parties that the condition of alcohol abuse was present on November 2, 2017 when T.R. was admitted to hospital and spent 23 days as an inpatient receiving treatment for his addiction.
13We also accept the evidence in the report of Dr. F.H. dated November 2, 2017 indicating that the appellant has alcohol use disorder and a psychiatric condition. In the "Optional" portion of the report the specialist medical practitioner wrote "patient has alcohol use disorder with poor insight."
14In addition, we also accept the evidence of Dr. J.W., the appellant’s treating family doctor, who completed a Mental Health Assessment and a Substance Use Assessment, both dated November 20, 2017, indicating a Major Depressive Disorder and Substance Use as the appellant’s primary mental illness with the symptoms being described as “mild”. The results of the biochemical markers in the Substance Use Assessment were marked as elevated (three of the four). A good response to treatment was noted.
15The Substance Use Assessment indicates a diagnosis of “alcohol misuse”, however, on November 27, 2017, Dr. J.W. wrote an unsolicited letter to the Ministry of Transportation explaining that since he completed his assessment he received additional information from another treating physician that indicated to him that T.R. was not truthful in answering questions related to his use of alcohol when he was questioned on November 20, 2017 and the new information leads him to conclude that T.R.’s use of alcohol is much more than he initially thought and he is more likely to have an “alcohol dependence disorder” rather than an “alcohol misuse disorder.”
16The appellant gave written and oral testimony. He admitted to abusing alcohol in the past during a difficult time in his life but testified that everything is fine now and he has abstained from alcohol from November 2017 to May 2018. However, when he had blood work done in May 2018, his GGT (liver marker that is specific for alcohol use) was still elevated.
17Clearly, the appellant has minimized and downplayed the November 2017 incident by explaining in his testimony that this was a one-time out of character incident. However, the facts reveal that he was taken to the hospital by police and spent a very significant period of time, being 3 weeks, as a patient at a hospital being treated for substance abuse.
18As part of his evidence, the appellant also provided part of Dr. J.W.’s Substance Use Assessment form (page 2) that appeared to have had some of the responses altered. For example, under paragraph 10, in regards of biochemical markers, the answers were changed from “elevated” to “within normal laboratory range.” As well, under paragraph 8, the answer to the question whether the patient has completed a formal addiction treatment program, the answer was changed from “no” to “yes.” The appellant was asked questions about these alterations to the medical form and admitted at the hearing that he changed the responses himself without any real explanation other than he did not intend to deceive anyone. At a minimum, this shows poor insight or judgment on the part of the appellant as the correct and unaltered form was submitted to the Tribunal by the Registrar.
19The appellant’s Notice of Appeal signed by the appellant states that “I am attaching recent blood work results that prove that alcohol has not been a factor in my life. I have since been alcohol free…I am very proud of my recovery and I am fit to drive…” Again, the results of the blood tests conducted by LifeLabs on May 14, 2018, indicate “‘high” GGT levels, which are inconsistent with someone who says they do not drink. Moreover, the appellant’s testimony at the hearing confirms that he has been socially drinking at the cottage and is not totally alcohol free. All of these inconsistencies, taken as a whole, led the Tribunal to question the appellant’s credibility and give his testimony that he is not alcohol dependant and has totally recovered less weight.
20Therefore, based on the medical evidence before us, we find that the appellant suffers from alcohol dependence and a mental illness.
- Is the Appellant’s medical condition likely to significantly interfere with his ability to drive safely?
21Having found that the appellant suffers from a medical condition, we now must consider whether this condition is likely to significantly affect his ability to drive safely.
22There is no doubt that the appellant suffers from alcohol dependency and, it appears this is exacerbated by his mental health condition. We have significant objective medical evidence relating to the November 2017 incident and more recent May 2018 blood test results (less than 6 months prior to the hearing) that confirm that liver markers specific for alcohol use were still elevated.
23As well, we find that T.R.’s depressive disorder has made it more difficult for him to control his alcohol addiction, which in turn creates a risk to driving. The appellant’s mental health needs to be actively monitored and managed to ensure stability so that T.R. does not suffer another setback. The Tribunal was made aware that at the time of this hearing, there was still a significant amount of information requested from T.R but unfortunately not yet received by the Registrar.
24We also note that although the appellant saw his family physician 2 weeks prior to the hearing no updated information, including updated bio-markers or confirmation of a three month period of emotional stability, was ever provided. With more complete up-to-date medical information, including the results of recent blood work and a medical report that would corroborate that his mental health would not affect his alcohol addiction and as a result his driving, the Registrar may consider the appellant for restoration of his driving privileges.
25In considering the evidence and applying the law, the Tribunal is mindful of the safety of both the appellant and the motoring public and the dangerous of operating a vehicle was intoxicated. We have concerns that T.R.’s depression and challenging work stressors if not managed, could lead him to drink. We also recognize that T.R’s drinking in the past was connected to his bouts with stress and depression.
E. CONCLUSION:
26After carefully considering the evidence, the submissions of the parties and the law, we find on a balance of probabilities that the appellant’s medical condition, namely, alcohol dependence, as exacerbated by his mental health condition, is likely to significantly interfere with his ability to drive safely.
F. ORDER:
27For the reasons set out above, pursuant to subsection 50(2) of the HTA, the Registrar’s decision to suspend the appellant’s driver’s licence is confirmed.
LICENCE APPEAL TRIBUNAL
____________________________
Dr. Katie Awad, M.D., Member
____________________________
Cezary Paluch, Member
Released: January 9, 2019