Appeal under section 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:
Nicholas Giannoylis
Appellant
and
Registrar of Motor Vehicles
Respondent
DECISION AND ORDER
Adjudicator: Dr. Peter Savage, Member
Appearances:
For the Appellant: Nicholas Giannoylis, Self-Represented Appellant Sophia Giannoylis, Witness for Appellant
For the Respondent: Stephen Grootenboer, Agent for the Registrar
Heard by Teleconference: March 2, 2022
A. OVERVIEW:
1On June 24, 2021, the Registrar suspended the appellant’s G licence under s. 47(1) of the Highway Traffic Act, R.S.O. 1990, c. H.8 (the “HTA”), after receiving a report from a physician that the appellant suffers from a mental health condition likely to significantly interfere with his ability to drive safely. The appellant appeals the suspension and asks the Tribunal to reinstate his licence.
2Having considered all of the evidence and for the reasons that follow, the Tribunal confirms the Registrar’s decision to suspend the appellant’s driver’s licence for medical reasons.
B. ISSUES:
3The issue in this appeal is whether the appellant suffers from a medical condition, specifically, a mental health condition, which is likely to significantly Interfere with his ability to drive a vehicle safely.
4To answer that issue, I will address the following questions:
a. Does the appellant suffer from a medical condition?
b. If the appellant suffers from a medical condition, is it likely to significantly interfere with his ability to drive a vehicle safely?
C. LAW:
5Under the HTA the Registrar is responsible for ensuring that drivers are medically fit to drive vehicles on the highway. In this case, the Registrar acted pursuant to s. 47(1) of the HTA and s. 14(1)(a) of O. Reg. 340/94 under the HTA (the “Regulation”).
6Section 14(2)(a) of the Regulation states that the Ministry may take the CCMTA Medical Standards for Drivers into consideration when determining whether the holder of a driver’s licence suffers from a mental, emotional, nervous or physical condition or disability likely to significantly affect their ability to drive a motor vehicle safely. Likewise, for this hearing, the Tribunal may also take into consideration the CCMTA Standards but it is not bound by them.
7Under s.14(2)(b) of the Regulation, the Registrar may require a driver to provide satisfactory evidence that he or she is able to drive safely.
8A person whose licence is suspended under these provisions may appeal the suspension to the Tribunal under s. 50(1) of the HTA.
9On appeal, the Registrar has the burden of establishing, on a balance of probabilities, that the appellant’s ability to drive safely is significantly affected by a medical condition.
10Following a hearing, the Tribunal may, under s. 50(2) of the HTA, confirm, modify or set aside the decision or order of the Registrar.
D. EVIDENCE AND ANALYSIS:
a. Does the appellant suffer from a medical condition?
11The Registrar alleges that the appellant suffers from a mental health condition based on the unsolicited medical report of Dr. V., an emergency room physician, as well as a police request for a driver examination from PC Quinton Malfara of the Toronto Police Service. Both reports were submitted on June 20, 2021. On that day the appellant was admitted to the Centre for Addiction and Mental Health (CAMH).
12The appellant denied he has a mental health condition and maintains he is safe to drive a motor vehicle.
13The appellant was taken to hospital on June 20, 2021 by his sister at the request of police. He was admitted to CAMH and was interviewed by Officer Malfara and Dr. V. Both the police officer and the emergency physician submitted reports to the Registrar. The emergency physician indicated an admitting diagnosis of acute psychosis. The appellant was admitted to CAMH and was kept in as an involuntary patient at CAMH until August 4, 2021.
14The appellant’s sister was called as a witness and testified that on June 20, 2021, she was contacted by police and told that her brother had been trying to get into a secure area of Billy Bishop Airport and behaving in a bizarre manner. An hour or so later when he arrived at the family home, she took him to CAMH where the police and the emergency staff interviewed and admitted him.
15The appellant testified that while in hospital from June 20, 2021 to August 4, 2021, he took no medication and followed a self-directed regime of isolation and maintaining silence. The appellant testified that a consent and capacity hearing was held during his hospitalization but due to the incompetence of his lawyer, this hearing did not lead to his release. The appellant submitted part of a discharge summary with his notice of appeal. The one page of the discharge summary that was submitted, stated he was discharged August 4, 2021 on no medication as he had refused all treatment.
16The appellant denies the diagnosis of a mental health condition. In addressing his June 20, 2021 hospitalization, he testified this was due to the stress that resulting from the death of his dog and unfair treatment he had been receiving from his employer. The appellant testified he took no medication and did not take part in any treatment during his 6-week hospital stay. The appellant points to the fact he was released with no medication and he is of the opinion that he wouldn’t have been released from hospital if he had any form of mental illness.
17The appellant testified that he is being followed by a psychiatrist and has a good relationship with her but he had never been told a diagnosis and he declined to answer any questions about current medication or ongoing treatment.
18The appellant’s position was his hospitalization was caused by his grief reaction stemming from the death of his dog as well as stress caused by poor treatment at his workplace. The appellant also testified that he stopped his medication a few weeks prior to the June 20, 2021 episode but felt that this did not have an effect on his behaviour and declined to name the medications he had been on.
19The appellant spoke in a clear steady voice and read a well-organized opening statement. He was often repetitive and often suspicious of possible reasons that mental health questions were being asked. He declined to answer questions regarding his medications or health care issues. The appellant expressed a strong desire not to have a mental health diagnosis linked to his driver’s licence.
20The appellant acknowledged he had received the mental health questionnaire but stated he had not wanted to have his psychiatrist fill it out and he did not have a family doctor.
21The only medical evidence presented at the hearing supports the conclusion that the appellant suffers from a mental health condition even though a specific diagnosis was not made. This non-specific diagnosis of acute psychosis was made by Dr. V. in the unsolicited medical condition report submitted June 20, 2021 and confirmed by the partial discharge summary submitted by the appellant.
22The appellant’s testimony also revealed some degree of paranoid thinking and repetitiveness. Pursuant to s. 16(b) of the Statutory Powers Procedure Act, a tribunal may take notice of any generally recognized scientific or technical facts, information or opinions within its scientific or specialized knowledge. I, as a duly licenced medical practitioner in the province of Ontario, know that the behaviour exhibited by the appellant is often associated with mental health conditions.
23On the basis of balance of probabilities, I find the Registrar has established the appellant has a poorly defined form of mental health condition.
b. If the appellant suffers from a medical condition, is it likely to significantly interfere with his ability to drive a vehicle safely?
24The Registrar has the burden of establishing that the appellant’s medical condition is likely to significantly interfere with his ability to drive a motor vehicle safely. I find that the Registrar has met that burden.
25The Registrar drew attention to the CCMTA (Canadian Council of Motor Transport Administrators) standards and recommendations. The Registrar pointed out the dangers that a mental health condition could cause while driving. The Registrar outlined the requirements that would be needed to consider licence reinstatement (15.6.3). This would include the condition being stable and the patient having sufficient insight to stop driving if the condition worsened. It would also include having functional abilities testing if needed and the support of a physician recommending a return to driving.
26The Registrar made the following submissions with respect to how the appellant’s condition affects the appellant’s ability to drive safely:
The appellant’s condition is confirmed by a physician.
The appellant has failed to provide a completed mental health assessment questionnaire.
The appellant denies he has a mental health condition and has no plans to change his approach to the possible need for medication or treatment.
The Registrar submits that the appellant has a limited understanding of his diagnosis.
The Registrar is concerned that the appellant would not have the insight to stop driving if his condition worsened.
The Registrar notes that the appellant has not discussed his return to driving or the need for a completed mental health questionnaire with his psychiatrist. The psychiatrist has not endorsed the appellant’s desire to return to driving
The Registrar maintains the appellant does not meet the standards recommended by the CCMTA for re-licencing (15.6.3).
27The appellant maintains he has been driving for many years, he is a safe driver, has no history of accidents, has a spotless driving record confirmed in the Ministry of Transportation’s submission. He argues that in his opinion there is no reason his mental health could affect his driving.
28The appellant addressed the Registrar’s concerns about his psychiatrist’s support. The appellant testified that the psychiatrist has said that he is making good progress and she feels he was bright and would be capable of attending university. He testified he is reluctant to have any reference to mental health associated with any of his official documentation. His strategy is to stay silent about mental health matters. He testified he will move towards opening the topic of driving and mental health diagnosis with his doctor and passing information forward to the Registrar.
29The appellant addressed the failure to have the mental health questionnaire completed. He testified he was reluctant to talk about this with his psychiatrist as he feared this information would be attached to his licence and could be used against him by the police.
30The appellant maintains he is stable. He has been released from hospital on no medication and no follow up. He is coping well with daily life. The appellant maintains his attendance at this hearing helps proves his stability. He attributes his refusal to answer questions about his current medications, treatment and support systems to the fact that none of these factor into his ability to drive safely.
31The appellant maintains he is functionally capable of safe driving.
32As mentioned before, the Tribunal may take into consideration, but is not bound by, the CCMTA Standards when determining whether a person can be licenced, and I consider them very important guidelines in this case. The CCMTA highlights the dangers of driving with a psychotic or mental health condition. It recommends that drivers with a psychiatric condition may be suitable for re-licencing if their condition is stable, they have the insight into their condition and the ability to stop driving if their condition gets worse, they have the functional ability to drive, and a medical care provider recommends a return to driving.
33The evidence supports the Registrar’s submissions. I find, on a balance of probabilities, that the appellant’s medical condition is likely to significantly interfere with his ability to drive a vehicle safely. A review of the evidence and the appellant’s submissions shows that he has a mental health condition and that none of the conditions recommended for re-licencing outlined in the CCMTA recommendations have not been met. In particular, he does not appear to have insight into his condition. He did not attend CAMH voluntarily, but was taken by his sister and became an in-patient involuntarily for two months and does not have documented support for returning to driving from his treating psychiatrist. These are major causes for concern.
E. ORDER:
34For the reasons set out above, pursuant to subsection 50(2) of the HTA, I confirm the Registrar’s decision to suspend the appellant’s driver’s licence for medical reasons.
LICENCE APPEAL TRIBUNAL
Dr. Peter Savage, Member
RELEASED: March 15, 2022