Date: 2019-03-29

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:

R.H.

Appellant

and

Registrar of Motor Vehicles

Respondent

DECISION AND ORDER

Panel: Isla McPherson, M.D., Member Avril A. Farlam, Vice-Chair

Appearances:

For the Appellant: R.H., Self-Represented

For the Respondent: Kyle Biel, Agent

Heard by Teleconference: February 28, 2019

REASONS FOR DECISION AND ORDER

Overview

1The appellant appeals the February 1, 2018 suspension of his driver’s licence by the Registrar of Motor Vehicles (the “Registrar”). Pursuant 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. The Registrar suspended the appellant’s driver’s licence under s. 47(1) of the HTA, after receiving a report from a specialist in internal medicine dated January 15, 2018, due to the appellant’s alcohol dependence and alcohol related seizure.

PRELIMINARY ISSUE

2The Registrar’s agent stated at the beginning of the hearing that the Registrar is no longer relying on both the diagnosis of alcohol dependence and the diagnosis of alcohol related seizure as two separate grounds for the suspension of the appellant’s licence. Given the amount of time that has elapsed since the appellant’s seizure, the Registrar is now solely relying on the ground of alcohol dependence. That being said, the Registrar’s agent confirmed that the evidence of alcohol related seizure would be relied on in support of the respondent’s submission that the appellant has alcohol dependence.

ISSUE

3The issue in this appeal is whether the appellant has a medical condition, specifically alcohol dependence, likely to significantly interfere with his ability to drive a motor vehicle safely. This issue can be broken down into the following two parts:

(a) Does the appellant have a medical condition, alcohol dependence?

(b) Is the appellant’s medical condition of alcohol dependence, if any, likely to significantly interfere with his ability to drive safely?

CONCLUSION

4For the reasons that follow, we find that the appellant suffers from a medical condition, specifically alcohol dependence that 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.

LAW

5The Registrar has the power under s. 47(1) of the HTA to suspend or cancel a driver’s licence for any of the grounds listed in paragraphs (d), (e), (f) or (g) of that section. Paragraph (d), (e) and (f) are not applicable to this appeal as they relate to misconduct, convictions and commercial motor vehicles respectively. Paragraph (g) states that a licence may be suspended for “any other sufficient reason not referred to in clause (d), (e) or (f).”

6One sufficient reason to suspend a driver’s licence under s. 47(1)(g) of the HTA is that the driver suffers from a medical condition likely to significantly interfere with his or her ability to drive safely. Subsection 14(1) of O. Reg. 340/94 (the “Regulation”) under the HTA states:

(1) An applicant for or a holder of a driver’s licence must not, …

(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.

7Section 14(2)(a) of the Regulation allows the Minister of Transportation (“Minister”) to consider the Canadian Council of Motor Transport Administrators Medical Standards for Drivers (“CCMTA Standards”) when determining whether the requirements of s. 14(1) are met. Similarly, the Tribunal may take the CCMTA Standards into consideration, although they are not binding requirements.

8Under s. 14(2)(b) of the Regulation, the Minister may also require a driver to provide satisfactory evidence that he or she is able to drive safely. The Tribunal may consider whether a driver has complied with such a request.

9The Registrar has the burden of establishing the ground for suspending the licence on a balance of probabilities. Following a hearing, the Tribunal may, under s. 50(2) of the HTA, confirm, modify or set aside the decision or order of the Registrar.

EVIDENCE AND ANALYSIS

(c) Does the appellant suffer from alcohol dependence?

10As set out below, we find that the appellant has alcohol dependence and that this medical condition is likely to significantly interfere with the appellant’s ability to drive safely. Based on the appellant’s alcohol dependence we confirm the Registrar’s decision to suspend the appellant’s driver’s licence.

11The Registrar filed a medical condition report dated January 15, 2018 from Dr. S., a specialist in internal medicine, diagnosing the appellant with alcohol dependence and alcohol related seizure. In his report Dr. S. noted “…admitted to hospital due to alcohol withdrawal seizure. Given circumstances in which he was found, and brought to hospital, he is a threat to road safety.”

12The Registrar also filed a substance use assessment report dated September 24, 2018, from the appellant’s family physician Dr. V. which sets out a diagnosis of alcohol dependence. Dr. V. reports that “…patient has not abstained from alcohol.” Dr. V. answers “no” to the question “Has the patient successfully completed a formal addictions treatment program or formal counselling with a physician, nurse practitioner or ICADC (International Certified Alcohol and Drug Counsellor) certified addictions counsellor.” In the report Dr. V. also notes, with respect to the appellant, “Has underlying anxiety to some degree. Longstanding. Was abstinent for couple months post seizure Jan 2018. Now back drinking moderately – reports max 4 beers at a time, avg 2 days per week. Labs remain normal. No signs of intoxication or withdrawal ever in office.”

13In a letter dated September 27, 2018, Dr. V. wrote that the appellant “…informs me that while he did not attend in-person AA meetings he did do an online AA program. I am not sure what all that entails or how comparable it is to the traditional model, but regardless, he did do it. He is currently gainfully employed and states that he requires a valid driver’s licence to maintain his employment.”

14The appellant testified that he used to drink alcohol but has not had a drink for six months. He stopped drinking alcohol around the time he saw his family physician Dr. V. in the fall. He admitted that Dr. V.’s report dated September 24, 2018 records that he was drinking at that time but said he was driving in order to work but then stopped drinking after he saw Dr. V. on that office visit.

15The appellant testified that he was taken by ambulance to the hospital when the OPP found him in his vehicle at the side of the road after his seizure. He said this seizure was an alcohol withdrawal seizure and he had no alcohol in his system at that time.

16The appellant further testified that he did drink alcohol after the seizure at social events but has been abstinent from alcohol for the last six months and doesn’t drink any more. The appellant confirmed that in his Notice of Appeal he wrote that his family doctor indicated his licence should be reinstated and also confirmed that he doesn’t have anything in writing from his family doctor that says that.

17In support of his appeal the appellant filed his medical laboratory reports dated June 22, 2018 and September 21, 2018 and said that these prove his abstinence from alcohol. The appellant testified that he took an online AA course which was three weeks long. He said he finished the program about three months after January, 2018 and did not have any proof of completion of this course because it is online. Appellant confirmed Dr. V. is his family doctor and that he saw her three or four weeks ago.

18Appellant said he has to have his licence for work because there is no public transit available to him and he has had to walk or bike to work. He believes his licence should be reinstated because he has not had alcohol for six months and has done an online AA course.

19The appellant did not put forward any medical evidence other than the reports from the laboratory testing on June 22, 2018 and September 21, 2018 to refute the report of the appellant’s substance use assessment report in which Dr. V. states the appellant is alcohol dependent.

20Even in considering the lab reports, we note that this testing was ordered by Dr. V., and was completed prior to Dr. V.’s substance use assessment report dated September 24, 2018. Despite appellant’s lab test results which were noted in the report as normal, Dr. V. diagnosed the appellant on September 24, 2018 with alcohol dependence.

21We find that the evidence of the Registrar to be more persuasive. The reports presented were prepared by the appellant’s doctors who are best qualified to objectively report on the appellant’s medical condition. The appellant’s doctors are better qualified to assess and objectively report on the appellant’s medical condition than the appellant himself or his lab tests of June 22, 2018 and September 21, 2018 considered in isolation and we accept the evidence in the two medical reports filed by the Registrar. The appellant brought forward no more recent medical evidence to support his view that he is not dependent on alcohol and able to drive safely. Accordingly, we find, based on the totality of the evidence, that the Registrar has proven on a balance of probabilities that the appellant has a medical condition, namely alcohol dependence.

(d) Is the appellant’s medical condition likely to significantly interfere with his ability to drive safely?

22The appellant’s position is that he feels he can drive safely. He stated that he hasn’t had a drink for over six months, he has completed an AA online course and he needs his licence for work and believes his licence should be reinstated.

23The Registrar submits that the appellant’s medical condition is severe enough that he should not be permitted to drive at this time. The Registrar relies on the guidelines contained in the CCMTA Medical Standards for Drivers (“CCMTA Standards”) with respect to substance abuse or dependence (chapter 15).

24Chapter 15 of the CCMTA Standards indicates that individuals who are under the influence of alcohol and illicit drugs such as opioids, cocaine, amphetamines are at a higher risk for adverse driving outcomes.

25Guideline 15.6.3 states that an individual who is under the influence of alcohol and illicit drugs such as opioids, cocaine, amphetamines is eligible for a licence if he or she:

• Meets the criteria for remissions and/or has abstained from the substance for 12 months.

• Earlier re-licencing may be considered upon favourable recommendation from an additional specialist and/or treating physician and successful completion of a drug rehabilitation program.

• The functional abilities necessary for driving are not impaired.

• Where required, a road test or other functional assessment shows the functional abilities for driving are not impaired.

26Based on the above Guideline, the appellant would not be eligible for a licence. The appellant’s evidence that he has abstained for six months is not corroborated by any medical evidence. The lab results from June 22, 2018 and September 21, 2018 do not prove abstinence. Dr. V.’s report dated September 24, 2018 confirms he is “…now back drinking moderately – reports max 4 beers at a time, average 2 days per week. Labs remain normal.” There is no medical evidence before us that proves the appellant has abstained from alcohol for six months or twelve months.

27Re-licencing at this time is not appropriate because there is also no evidence before us of a favourable recommendation from an additional specialist and/or treating physician and successful completion of a rehabilitation program. Dr. V.’s comment in the September 27, 2018 letter that “…he requires a valid drivers licence to maintain his employment…he informs me he did do an online AA program…” is not a recommendation that the appellant be allowed to drive and is not confirmation that the appellant has successfully completed a rehabilitation or treatment program in 2018. Dr. V. simply repeats what the appellant has said. By the appellant’s own admission, he completed the online AA course. He said he finished the program about three months after January, 2018. Not only did he not have any proof of completion of this course but, if completed, the course was not an effective treatment program for the appellant because Dr. V. records that he is drinking again in the report dated September 24, 2018 – a time when the appellant said he completed the online AA course.

28The Tribunal is not bound by CCMTA Guidelines but in this case chooses to follow them given the appellant’s medical condition of alcohol dependence.

29The only medical evidence before us of the appellant’s ability to drive is in Dr. S.’s medical condition report dated January 15, 2018 which describes the appellant as “…a threat to road safety.”

30We appreciate that the loss of a driver’s licence can have significant consequences for the individual affected. While we understand the appellant’s desire to have his licence reinstated, we must apply the provisions of the HTA and regulations, keeping in mind the objective of ensuring public road safety.

31After considering the evidence and submissions of the parties, we find on a balance of probabilities that the appellant has a medical condition and that this medical condition, specifically alcohol dependence, is likely to interfere with his ability to drive a motor vehicle safely at this time.

ORDER

32For 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.