An 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 licence pursuant to Section 47(1) of the Act.
Between:
Hakimullah Afghanzada
Appellant
-and-
Registrar of Motor Vehicles
Respondent
DECISION & ORDER
ADJUDICATOR: Dr. Katie Awad, M.D., Member Raymond C. Ramdayal, Member
APPEARANCES:
For the Appellant: Hakimullah Afghanzada, Self-represented
For the Respondent: Steve Grootenboer, Agent
Heard by teleconference: November 9, 2022
Background
1By letter dated January 4, 2019, the Registrar of Motor Vehicles (the “respondent”) advised Hakimullah Afghanzada (the “appellant”) that his licence was being suspended for medical reasons, specifically substance use disorder and a psychiatric condition. This decision was made after the respondent received an unsolicited medical report dated January 3, 2019. At that time, the appellant was asked to have his physician, specialist or nurse practitioner complete a Ministry of Transportation Substance Use form and a Mental Health Assessment form. The appellant chose not to provide these forms and they currently remain outstanding. Instead, he provided other information to the respondent for consideration. In response to the new information, the respondent communicated to the appellant on February 25, 2020 and April 23, 2020 and November 2, 2022 that his licence would remain suspended.
2The most recent letter from the respondent identifies the following medical conditions:
a. Substance Use Disorder
b. Mental Health Condition
3To properly assess the appellant’s ability to safely operate a motor vehicle, the respondent once again requested that the requisite forms be completed by the appellant’s doctor, specialist, or nurse practitioner. They would then be reviewed by the Ministry of Transportation’s Medical Review Team.
4In addition to the forms, the respondent is also seeking confirmation of a 3-month period of mental and emotional stability, that the condition has been successfully treated or resolved, that the appellant adheres to the recommended treatment regimen and/or has insight into his condition and confirmation of improvement in his judgement.
Issue
5The issue to be determined is whether the appellant’s medical condition, if any, is likely to significantly interfere with his ability to drive a motor vehicle safely.
Result
6For the reasons set out below, we confirm the respondent’s decision.
Law
7The respondent 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 (g) states that a licence may be suspended for “any other sufficient reason not referred to in clause (d), (e) or (f).”
8One 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 that is 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:
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.
9Section 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 may be persuasive they are not binding. In this matter, the Registrar is relying on the CCMTA standard in determining driver fitness.
10Under 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.
11The respondent 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 respondent.
Evidence and Analysis
12Prior to the hearing, the appellant submitted additional information to the respondent for consideration. This comprised of a handwritten note from Dr. H. Al-Ward confirming that the appellant is known to the clinic, and he takes his medication on a regular and monthly basis. The note is dated October 21, 2022. In addition to this, the appellant also submitted a letter from Lakeridge Health dated October 28, 2022, confirming his attendance at a Residential Withdrawal Management program for five (5) days in May 2022.
13The respondent reviewed the information and maintained the position that the documentation is not sufficient to deem him a suitable driver at this time. We agree with the respondent’s position that the new information does not provide any reassurance that the appellant’s medical condition has been resolved. Further, we were not persuaded by any of the evidence put forward by the appellant to suggest that he can safely operate.
14The appellant suffers from an uncontrolled cannabis use disorder. He has also been diagnosed with schizophrenia and thought disorder. These two conditions render him unable to safely operate a motor vehicle. We are satisfied that the continuation of these unaddressed issues will significantly impair his ability to operate a motor vehicle safely and may place the public at undue risk.
15We also heard evidence that the appellant had several hospital visits in the past as a result of substance abuse and auditory hallucinations. It was noted that although the respondent requested information from the appellant on numerous occasions to assess his ability to drive, he continued to send the same information resulting in a similar response that his licence remained suspended.
16We received evidence relating to his residential treatment program, however, there was nothing from the counsellor on whether his condition was stable or if he gained insight as a result of treatment and/or program participation. There was no mention about whether the appellant abstained from drugs. We note that the counsellor is not a medical doctor, therefore, the respondent has not ascribed the same weight as it would to the medical opinions being sought.
17The fact that the appellant failed to provide the completed forms requested by the responded is an aggravating factor. The appellant has a family doctor and other health professionals he accesses through walk-in clinics. He has also had ample time to obtain a medical diagnosis and opinion on his suitability to drive.
18In his oral submissions, the appellant stated that he does not have a mental disability. He described past trauma which has negatively affected him, however he still feels he should be allowed to drive. He claims that the loss of his licence prevents him from going to school. We did not receive any evidence to confirm that the appellant is registered in any educational programs.
19The appellant states that he has seen several health professionals, and all have refused to complete the medical forms requested by the respondent. He submits that he is getting better and is currently taking mood stabilizers. He also receives injections to treat his condition of schizophrenia.
20To his credit, the appellant has expressed his intention of working to get better and remaining compliant with his medication. He would also like to attend a local gym so that he can lose weight and improve his health.
21The respondent argues that the appellant’s substance use and mental health condition are serious and neither have been resolved.
22The appellant submits that the loss of his licence makes it difficult for him to get his life back on track.
23In considering this case there are two elements that need to be satisfied:
a. Does the appellant have a medical condition; and,
b. Will that condition significantly interfere with his ability to drive safely.
Does the appellant have a medical condition?
24At the hearing, we received evidence from the respondent that the appellant suffers from a substance use disorder. This was not denied by the appellant. The medical condition report dated January 3, 2019, confirms that the appellant has an uncontrolled substance use disorder relating to cannabis. He was also diagnosed with a psychiatric illness. The clinical notes state that although the appellant is receiving treatment for schizophrenia, he presents with a thought disorder, attentional difficulties and has not followed through with treatment for his substance use disorder. The attending doctor stated that his current symptoms render him unable to safely operate a motor vehicle.
25While the appellant did attend a substance use program after his hospital visit, there was no evidence of his progress or achievements. There was also no relapse prevention plan or indication of abstinence since attending the program.
26According to other medical records presented by the respondent, the appellant has also engaged in other recreational drugs in the past including crystal methamphetamine and cocaine. He also has a history of binge drinking alcohol. These records confirm a long-standing substance use problem and mental health deficits that remain unresolved today.
27There is an abundance of evidence that the appellant does have the alleged conditions. The appellant’s admission that he suffers from mental health issues and that he has engaged in illicit drug use corroborates his diagnosis and supports a finding that he has a medical condition capable of satisfying the first element of the test.
Is this condition likely to significantly interfere with his ability to drive safely?
28The appellant submits that he should be granted his licence so that he can go to school and attend the gym is an effort to make positive changes in his life. He further states that he has not used drugs for some time, however, he lacked credibility as he could not answer with confidence on his drug use, pattern of use or insight gained from past treatment.
29We find that at times the appellant was not forthcoming with his substance use problem. This is further exasperated by his mental health condition. At times during the hearing, he did not provide clear responses, reliable evidence, and spoke about matters not relating to the issue at hand.
30The respondent submits that the appellant’s substance use and mental health condition are significant and requires additional information (already requested) in order for them to assess his suitability to drive.
31The respondent also argues that Regulation 340/94 clearly states that an individual must not be addicted to alcohol or drugs which may significantly interfere with an individual’s ability to drive. The appellant does not meet any of the criteria set out in the CCMTA (Canadian Council of Motor Transport Administrators) guideline to suggest reinstatement is appropriate at this time.
Conclusion
32We find that the appellant suffers from a condition of substance use disorder. The fact that he attended some treatment does not provide us with confidence that his addiction issues have been adequately addressed. We also note that he appears to have limited family and personal supports to assist him with his current substance use problem. The appellant also suffers from a mental health condition. According to a note from Dr. H. Al-Ward, he does attend for appointments and takes medication on a regular and monthly basis. While the appellant is commended for this, his current pattern of substance use and related hospitalizations suggest a serious problem that requires ongoing professional intervention and monitoring.
33In the end, we find that the appellant has not been able provide confirmation of a 3-month period of mental and emotional stability. He has provided some evidence confirming that he is taking appropriate medication, however, he does not appear to have significant insight into his condition nor an improvement in judgement. Finally, there is no evidence to suggest that the appellant’s condition is improving.
34Along with the HTA, the respondent relied on the CCMTA Standards which provides the guidelines for assessment. We find that it is prudent to apply the CCMTA Standards in this case. The medical standards are clearly established in this guideline. The appellant has also fallen short of providing the respondent with the information needed to perform a reasonable assessment of his suitability to drive.
35Based on a careful consideration of all the evidence before us, we are satisfied on a balance of probabilities that the appellant’s medical condition is likely to significantly interfere with his ability to drive a motor vehicle safely. Therefore, the respondent’s decision is confirmed.
WE ORDER AS FOLLOWS:
36For the reasons set out above, pursuant to subsection 50(2) of the HTA, the Registrar’s decision to suspend the appellant’s driver licence is confirmed.
LICENCE APPEAL TRIBUNAL
_____________________________
Dr. Katie Awad, M.D., Member
____________________________
Raymond C. Ramdayal, Member
Released: December 14, 2022