Licence Appeal Tribunal

Safety, Licensing Appeals and Standards Tribunals Ontario

Tribunal d’appel en matière de permis Tribunaux de la sécurité, des appels en matière de permis et des normes Ontario

Date: 2020-11-12

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 pursuant to section 47(1) of the Act to suspend Driving Privileges

Between:

Mohammad Fazil Appellant

and

Registrar of Motor Vehicles Respondent

DECISION AND ORDER

Panel: Constantine Petrou, M.D., Member Stephen Scharbach, Member

Appearances: For the Appellant: Mohammad Fazil, Self-represented Respondent: Kyle Biel, Agent

Overview

1The appellant appeals a decision by the Registrar of Motor Vehicles to suspend his driver’s licence on medical grounds.

2According to the Registrar, the available medical information indicates that the appellant suffers from cognitive impairment that affects his ability to drive safely.

3In the appellant’s view, he does not suffer from a cognitive impairment. He asks that the Registrar’s decision to suspend his licence be set aside and his licence reinstated.

ISSUE

4Does the appellant suffer from a medical condition likely to significantly interfere with his ability drive safely?

DECISION

5The Registrar received medical condition reports from three physicians stating that the appellant suffers from cognitive impairment. The appellant was asked to submit a satisfactory functional driving assessment which would asses his practical ability to drive safely. No assessment has yet been completed. The Registrar’s decision to suspend the appellant’s driver’s licence is confirmed.

THE LAW

6The Registrar has the authority under s. 47(1) of the Highway Traffic Act (the “Act”) and s.14(1) of Ontario Regulation 340/90 (“Regulation”) to suspend or cancel a driver’s licence if the driver suffers from any physical or mental condition likely to significantly interfere with the driver’s ability to operate a motor vehicle safely.

7Information about a driver’s physical or mental condition is often provided to the Registrar by health care practitioners. They are required by the Act to report to the Registrar the names and clinical condition of any person who, “… in the opinion of such medical practitioner is suffering from a condition that may make it dangerous for such person to operate a motor vehicle.”

8A person whose licence is suspended on medical grounds may appeal the suspension to this Tribunal and, following a hearing, the Tribunal may confirm, modify, or set aside the decision of the Registrar.

9In determining whether a driver suffers from a condition that may disqualify him/her for a driver’s licence, the Regulation allows the Registrar to consider the medical standards set out in the Canadian Council of Motor Transport Administrators Medical Standards for Drivers (“CCMTA Standards”).

10The CCMTA Standards have been developed and published in order to establish consistent medical standards for assessing driving eligibility. While they are relevant and may be considered, the CCMTA Standards are not binding on either the Registrar or the Tribunal.

11Section 6.6.1 of the CCMTA Standards deals with eligibility for licencing of those who suffer from cognitive impairment or dementia. That section states that a person who suffers from cognitive impairment or dementia is eligible for licencing if:

• a medical assessment indicates cognitive functions necessary for driving are not impaired, or,
• where required, functional driving assessment shows the condition does not affect the ability to drive.

EVIDENCE AND ANALYSIS

(a) Registrar’s Decision to Suspend

12In a letter dated March 9, 2020, the Registrar informed the appellant that his driver’s licence was being suspended because the Ministry of Transportation (“Ministry”) had received a report indicating that he had a condition – cognitive impairment - that affected his ability to drive safely.

13That was based on a medical condition report dated February 25, 2020 which was submitted to the Ministry by a physician who had initially treated the appellant after he was admitted to a hospital suffering from a possible stroke and delirium. According to the physician, the appellant had a recent history of cognitive decline and required a cognitive assessment before returning to driving.

14In his March 9, 2020 letter, the Registrar informed the appellant that to be considered for re-instatement, he would have to arrange for a cognitive assessment form to be completed by a physician and submitted to the Registrar. That assessment would be reviewed against the CCMTA standards and a decision would be made as to whether his licence could be reinstated.

15A second medical condition report (dated March 12, 2020) was submitted to the Registrar by Dr. F., another physician who treated the appellant while in the hospital. According to his report, cognitive testing indicated that the appellant suffered from impairments in cognitive functions consistent with dementia in the mild to moderate range. In Dr. F’s opinion, the appellant was medically incapacitated from driving.

16In his notice of appeal, the appellant states that he took the cognitive assessment form required by the Registrar to his doctor and further cognitive tests were done but he has not received the results. In fact, the Registrar’s file contains an incomplete medical condition report signed on June 30, 2020 and apparently submitted by Dr. D. (a geriatric specialist). It also includes an unsigned but completed cognitive assessment form. Although it is not entirely clear, it appears that a cognitive assessment form was submitted to the Registrar by Dr D. along with his medical condition report. The assessment form describes the appellant’s condition as “mild cognitive impairment or mild dementia”.

17In a letter dated September 15, 2020 the Registrar informed the appellant that his file had recently been reviewed and, to consider reinstatement of his licence, the Registrar required a satisfactory functional driving assessment completed at an approved Functional Assessment Centre. A list of such centers was enclosed.

18The appellant has not arranged for a functional driving assessment and his licence remains suspended.

(b) Appellant’s Evidence

19The appellant’s position is that he does not suffer from any cognitive difficulties that affect his ability to drive safely.

20According to the appellant, he was admitted to a hospital late February 2020 after losing consciousness in a hot tub. He was kept in the hospital so that tests could be conducted but, according to the appellant, the findings were inconclusive. He states that he completed a subsequent cognitive assessment but has not received the results. The appellant states that his health has improved, and his licence should not remain suspended based on the cognitive testing that was done shortly after his hospitalisation in February 2020.

(c) Decision

21Under s. 50(2) of the Act, the Tribunal may confirm, modify or set aside a decision of the Register made under s. 47 of the Act. In this case we confirm the Registrar’s decision to suspend the appellant’s driver’s licence.

22Two physicians at the hospital where the appellant was treated after the loss of consciousness incident apparently believed the appellant was suffering cognitive impairment that may make it dangerous for him to operate a motor vehicle and they reported that condition to the Registrar. According to the second report, the appellant suffered from cognitive impairments and was medically incapacitated from driving.

23The Registrar immediately suspended the appellant’s licence but asked the appellant to submit a more detailed cognitive assessment form completed by his physician. In our opinion the Registrar’s decision to suspend was appropriate given the available medical information.

24It seems that a cognitive assessment form was completed in June 2020 in which a third physician concluded that the appellant suffers from mild cognitive impairment or mild dementia. After reviewing that information, the Registrar informed the appellant that for his licence to be reinstated he must submit a satisfactory functional assessment to determine whether his condition impairs his ability to drive safely.

25That decision was consistent with the CCMTA Standards. According to the Standards, in the case of mild cognitive impairment a functional assessment is usually the most appropriate means of assessing whether a driver’s specific cognitive limitation impairs his or her ability to drive safely. Section 6.5 of the Standards state:

The effects of mild cognitive impairment may be subtle and difficult to assess in an office setting. Judgement and insights are important for driving yet the usual battery of tests to assess the extent of cognitive limitations do not evaluate these functions. Hence, a functional driving assessment is usually the most appropriate means of assessing the effects of cognitive limitations upon driving unless severe dementia had been demonstrated.

26In summary, based on the available medical information, we find that the appellant has a medical condition likely to significantly interfere with his ability to drive. That finding is based on the opinions of three separate physicians. In our view, the appellant’s licence should remain suspended until he submits a functional driving assessment that supports the conclusion that his condition does not affect his ability to drive safely.

ORDER

27Pursuant to s. 50 (2) of the Highway Traffic Act, the decision of the Registrar to suspend the appellant’s driver’s licence is confirmed.