A.D. v. Registrar of Motor Vehicles, 2019 CanLII 32255

Date: 2019-03-07

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:

A.D.

Appellant

and

Registrar of Motor Vehicles

Respondent

REASONS FOR DECISION AND ORDER

Panel: Dr. Erica Weinberg, Member

Appearances:

For the Appellant: A.D., self-represented

For the Respondent: Kyle Biel, Agent

Heard by Teleconference on: March 4, 2019

OVERVIEW

1The appellant is a 58-year-old woman who appeals the suspension of her driver’s licence under s. 47(1) of the Highway Traffic Act, R.S.O. 1990, c. H.8 (the “Act”).

2On August 25, 2016 the appellant attended the emergency room (“ER”) at a local hospital. The ER physician filed a Medical Condition Report (“MCR”) with the Registrar of Motor Vehicles (the “Registrar”).

3On September 5, 2016, the Registrar suspended the appellant’s driver’s licence under s. 47(1) of the Act.

4The appellant now appeals the Registrar’s decision to suspend her driver’s licence on the basis that she has a good driving record, does not suffer from a mental health (“MH”) disorder, is not delusional and is not on any MH medication.

5For the reasons set out below, I find that the appellant suffers from a MH disorder that is likely to significantly interfere with her ability to drive safely.

6For these reasons, I confirm the Registrar’s decision to suspend the appellant’s driver’s licence.

ISSUES

7The issue in this appeal is whether the appellant suffers from a medical condition that is likely to significantly interfere with her ability to drive safely.

8To answer that question, I will address the following issues:

a. Does the appellant suffer from a medical condition?

b. Is the appellant’s medical condition, if any, likely to significantly interfere with her ability to drive safely?

LAW

9The Registrar has the power under s. 47(1) of the Act to suspend or cancel a driver’s licence. In this case, s. 47(1)(g) is the relevant ground for suspension. It states that a licence may be suspended for “any other sufficient reason not referred to in clause (d), (e) or (f).”

10Subsection 14(1) of O. Reg. 340/94 (the “Regulation”) under the Act 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;

11According to s. 14(2)(a) of the Regulation, if the Minister of Transportation is determining whether the requirements of s. 14(1) are met, the Minister may take into consideration the Canadian Council of Motor Transport Administrators Medical Standards for Drivers (the “CCMTA Standards”). The Tribunal may also take the CCMTA Standards into consideration, although they are not binding requirements.

12The Registrar has the burden of establishing the grounds for suspending the licence on a balance of probabilities. Following a hearing, the Tribunal may, under s. 50(2) of the Act, confirm, modify or set aside the Registrar’s decision or order.

EVIDENCE AND ANALYSIS

a. Does the appellant suffer from a medical condition?

13I find that the evidence presented establishes that the appellant suffers from a MH disorder.

14According to the appellant, after seeing her family doctor on August 25, 2016, she attended the ER department of a local hospital in an attempt to get speedier access to see an out-patient psychiatrist. The ER notes reflect that the appellant’s ‘reason for visit’ was ‘direct to psychiatry’. While at the hospital, the appellant was placed on a Form 1. She was seen by an ER doctor, a social worker and a psychiatry resident, and also underwent a number of investigations to be ‘cleared medically’ (all tests normal). Eventually the Form 1 was cancelled, as the appellant was thought not to be a threat to herself and previously was managing on her own at home. The appellant was discharged home the same day with her daughter, who lives locally, able to assist if needed. The final diagnosis made by the ER doctor was ‘psycho affective disorder’ (a MH disorder). At the hearing the appellant stated that the ER notes from this hospital were lies, that the health care professionals (“HCPs”) were unprofessional and should be charged for misconduct and that she called a lawyer during or after this visit.

15The appellant is a professional engineer by training, having worked for over 20 years in the construction industry. Several years ago, the appellant described that she resigned from a number of companies in a relatively short period of time, and eventually stopped working. The appellant stated that she is on disability for MH reasons.

16At the hearing, the appellant stated that for several years prior to 2016, she suffered from both professional and personal stress and pressure, including abuse from her former husband.

17The appellant testified that she does not suffer from any MH disorder. When questioned about how she could be on disability for her MH, without suffering from a MH disorder, the appellant described that she signed a form and did not know what she signed. Furthermore, the appellant adamantly denied ever suffering from major depression, delusions and/or hallucinations. She did however, describe symptoms that she has had on and off since her teenage years, including: itchy skin, burning eyes, bodily pain, headache, drowsiness, fatigue, and falling asleep. These symptoms would worsen during episodes of increased stress or pressure. The appellant stated that she was not sure if these symptoms were MH-related or not, but her ‘brain was fine’ because her ‘MRI and CT scan were normal’.

18The Ministry sent the appellant a letter dated November 28, 2018. It requested confirmation: of a three-month period of mental and emotional stability; that her condition does not impede her ability to safely operate a motor vehicle; of compliance with a treatment regimen; of appropriate insight into her condition; that her condition had been successfully treated or resolved; and that symptoms of delusions and emotional control had been successfully treated. In response, the appellant wrote a letter to the Ministry on December 4, 2018 stating: “I did not take any medicine for mental illness, I never was delusional, and I am abused, harassed and assaulted by many organizations and for absolutely no reason after one visit in hospital… I am very sorry to see how a ministry, police, hospital and doctors are played by bunch of abusers who for covering their harassment and unethical behavior plan this game…”

19At the hearing, the appellant testified that a psychiatrist, Dr. E., prescribed a ‘relaxant’ medication for her in 2012. According to Dr. E.’s progress notes, this medication was started late July 2012. The appellant testified that she took this ‘relaxant’ for only a few weeks. This is verified in Dr. E.’s progress note of August 27, 2012 where he states, “[s]he believes that the medication that I had prescribed will cause…and believes in fact that I was part of the larger conspiracy to hurt her”.

20The appellant went on to testify that no one else had ever recommended or prescribed any other medication to her other than her thyroid medication, vitamin B12 tablet and very recently, a blood pressure pill.

21Dr. R., the appellant’s family physician since early 2016, submitted three Mental Health Assessment (“MHA”) forms to the Ministry (October 11, 2016; March 14, 2017; June 26, 2018). In 2016 and 2017, Dr. R. noted that the appellant suffered from the following MH conditions: major depressive disorder and ‘other’ (specified as paranoid subtype of delusional disorder). In 2018, Dr. R. noted that the appellant suffered from the MH condition of paranoid delusions. In all the completed MHA forms, Dr. R. indicated that the appellant had stable but ongoing symptoms of mild-moderate severity, which included, over the time period: anxiety, depression, delusions, agitation and emotional control. In the additional/comment section of the June 26, 2018 MHA form, Dr. R. wrote “[p]atient has been diagnosed with paranoid delusions by multiple different psychiatrists and psychotherapists. Meds are always recommended and prescribed. However patient has no insight in[to] her condition and therefore does not take them”.

22Taking all the evidence into consideration, I prefer the opinion of Dr. R. for the following reasons: he has been the appellant’s physician for approximately three years and his diagnoses are consistent with and are supported by other psychiatrists, psychotherapists, an ER doctor and other HCPs. Thus, I find that the appellant suffers from a MH disorder.

b. Is the appellant’s medical condition of MH disorder, if any, likely to significantly interfere with her ability to drive safely?

23I find from the evidence presented that the appellant’s MH disorder is likely to significantly interfere with her ability to drive safely.

24The Registrar has the burden of establishing that the appellant’s MH disorder will significantly interfere with her ability to drive safely.

25The Registrar’s agent referred to Chapter 14 of the CCMTA Standards, “Psychiatric Disorders”. Section 14.4, refers to the effect psychiatric (MH) disorders may have on one’s functional ability to drive. This section describes that psychiatric disorders can result in either a persistent or episodic impairment of the functions necessary for driving. In particular, section 14.4 states that a driver’s level of insight is a “critical consideration”. Furthermore, this section states that, “drivers with good insight are more likely to be diligent about their treatment regime and to seek medical attention and avoid driving when experiencing acute episodes and have the judgment and willingness to adapt their driving to these limitations”.

26A review of the appellant’s extended driving record shows that she has a clean driving record.

27In an attempt to better determine whether or not the appellant’s MH disorder affects her ability to drive safely, and as requested by the Ministry in its March 23, 2018 letter, Dr. R. referred the appellant back to her last psychiatrist, Dr. S., who saw her between 2016 and 2017, and subsequently to Dr. E., who was her psychiatrist between 2012 and 2014.

28On November 16, 2018, the appellant saw Dr. E. His 2018 letter describes that the appellant was “quite insistent as she leaves [believes] the traffic lights are intended to provide her specifically with directions… On at least one occasion, she was racing with a vehicle that she thought was following her. She said that the vehicle cut her off. She said that she took a picture of the licence plate and presented it to the police but they would not do anything”.

29Dr. E.’s mental status examination of the appellant on November 16, 2018 stated that the appellant “became volatile when talking about ‘abuse’…her affect was labile…she had a wide range of paranoid delusional beliefs with a grandiose flavour…she did not have hallucination[s]…her judgment and insight were poor.” In the report, Dr. E. also states, “again, my impression is that this woman has a chronic paranoid psychosis, consistent with a late onset schizophrenia. Given her poor insight and judgment, her volatility, her behaviour around driving and her unwillingness to accept treatment, I would not support a reinstatement of her driver’s licence”.

30At the hearing, the appellant denied that she and Dr. E. discussed any of the above.

31After considering the evidence and submissions of the parties, I find that the appellant has poor insight and judgment with respect to her MH disorder. Insight and judgment are an important part of safe driving. Although I am not bound by the CCMTA Standards in making my decision, section 14.6 lists many assessment factors for consideration, including whether the driver has sufficient insight to stop driving if the condition becomes acute. The evidence is clear that the appellant does not have the necessary insight into her condition.

32The appellant expressed grandiose delusions with respect to traffic lights and racing vehicles, both which may impede her regard for personal and public safety in making driving choices. Furthermore, the appellant is not compliant with recommended treatment for her ongoing MH disorder, and does not have support from her specialist for reinstatement of her driver’s licence.

33After a careful review of all of the evidence, I find, on a balance of probabilities, that the appellant suffers from a MH disorder that is likely to significantly interfere with her ability to drive a motor vehicle safely.

ORDER

34For the reasons set out above, pursuant to subsection 50(2) of the Act, the Registrar’s decision to suspend the Appellant’s driver’s licence is confirmed.