Date: 2022-09-19

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:

Helan Hall

Appellant

and

Registrar of Motor Vehicles

Respondent

DECISION AND ORDER

Adjudicators: Dr. Peter Savage, Member Jeffery Campbell, Vice-Chair

Appearances

For the Appellant: Helan Hall, Self-represented For the Respondent: Sanjay Kapur, Agent

Heard by Teleconference: August 30, 2022

REASONS FOR DECISION AND ORDER

A. Overview

1By letter dated May 13, 2022, the Registrar of Motor Vehicles (the Registrar) suspended the appellant’s Class G1 licence under s. 47(1) of the Highway Traffic Act, R.S.O. 1990, c. H.8 (the “HTA”), for medical reasons. The appellant appeals the suspension and asks the Tribunal to reinstate her licence.

2Having considered all the evidence and for the reasons that follow, we confirm the Registrar’s decision to suspend the appellant’s driver’s licence.

B. Issue

3The issue in this appeal is whether the appellant suffers from a medical condition that is likely to significantly interfere with her ability to drive a motor vehicle safely.

4To resolve that issue, we will address the following questions:

1. Does the appellant suffer from a medical condition, namely a cognitive impairment?

2. If the appellant does suffer from a cognitive impairment, is this likely to significantly interfere with her ability to drive a motor vehicle safely?

C. The Law

5The Registrar has the authority under s.47(1) of the HTA to suspend or cancel a driver’s licence for any 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).”

6One sufficient reason to suspend a driver’s licence under s.47(1)(g) of the HTA is if the driver suffers from a medical condition or addiction likely to significantly interfere with his or her ability to drive safely.

7Subsection 14(1)(a) of O. Reg. 340/94 enacted under the HTA requires that a holder of a driver’s licence must not 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.”

8Section 203(1) of the HTA requires medical professionals to report prescribed medical conditions to the Registrar, while s. 203(2) gives medical professionals the discretion to report medical conditions that they believe might make it dangerous for a person to drive.

9Section 14(2)(a) of O. Reg. 340/94 allows the Registrar to consider the Canadian Council of Motor Transport Administrators (“CCMTA”) Medical Standards for Drivers when determining whether the requirements of s. 14(1) are met. The CCMTA Standards are not binding on the Registrar or on this Tribunal.

10The Registrar has the burden of establishing on a balance of probabilities that one or more grounds for suspending a driver’s licence has been made out.

11Pursuant to section 50(2) of the HTA, after a hearing, the Tribunal may confirm, modify or set aside the decision or order of the Registrar.

D. Evidence and Analysis

a. Does the appellant suffer from a cognitive disorder?

12In support of its allegation that the appellant suffers from a cognitive impairment, the Registrar relies on the Medical Condition Report (“MCR form”) from the consulting geriatric psychiatrist, Dr. Geoffrey Daniel (“Dr. Daniel”) dated May 2, 2022, a Cognitive Disorder form (“CD form”) from family physician, Dr. Alex Pearce (“Dr. Pearce”) dated June 17, 2022, and a neurological report dated July 11, 2014 authored by Dr. John Maher.

13In the MCR form of May 2, 2022 Dr. Daniel advised that the appellant suffers from dementia due to Moya Moya disease (a rare, progressive cerebrovascular disorder caused by blocked arteries at the base of the brain). In the MCR form Dr. Daniel reported the following:

“Cognitive decline involving frontal lobe areas of the brain affecting insight, judgment & function. Drove thru stop sign, red light, stops abruptly, into ditch, family afraid to be in car with her driving.”

14In the CD form, Dr. Pearce advised that the appellant suffers from mild cognitive impairment and requires a functional driving assessment. In the CD form, Dr. Pearce reported the following:

“Helan does demonstrate some cognitive deficits as a result of vascular damage to her frontotemporal lobes – largely around emotional stability, withdrawals from others, impulsive behaviour, etc. It is certainly possible she is unsafe to drive, but given her young age (52), it is important to preserve her independent function as long as it is safe. I would support whatever opinion is formed by the Skill Builders conducting her assessment and will monitor Helan closely if things change.”

15In the neurological report by Dr. Maher dated July 11, 2014, Dr. Maher diagnosed the appellant with Moya Moya disease.

16The appellant testified that she realizes that she does suffer from vascular dementia.

17We find that the Registrar has established on a balance of probabilities that the appellant suffers from a medical condition, namely cognitive impairment.

b. Is the appellant’s medical condition of cognitive impairment likely to significantly interfere with her ability to drive a vehicle safely?

18The Registrar has the burden of establishing that the appellant’s cognitive impairment is likely to significantly interfere with her ability to drive a motor vehicle of the applicable class safely. We find that the Registrar has satisfied this burden.

19The Registrar relies on the CCMTA National Safety Code, chapter 6 which describes cognitive impairment and dementia and the concerns with driving with respect to that condition. The Registrar relies on chapter 6.6.1 which recommends, if required, functional driving assessments to show the condition does not affect ability to drive.

20The Registrar submits that, as per the CCMTA chapter 6, even mild-moderate cognitive deficiencies can result in catastrophic result in some drivers.

21In a letter from the Registrar, dated June 14, 2022, the appellant was advised that the Registrar requires a satisfactory functional driving assessment from an approved Functional Assessment Centre. On June 27, 2022, the Registrar issued a Temporary Driver’s Licence to the appellant for the purpose of completing the functional driving assessment.

22The appellant was assessed by occupational therapist, M. Bell at Skill Builders Physio and Rehab (“Skill Builders”). On July 11, 2022, Skill Builders issued a Functional Driving Assessment (the “Assessment”) form which assessed, among other criteria, that the appellant scored a 47% chance of cognitive impairment on the road. The Assessment recommended on-road and in-class driving lessons to learn driving skills. The appellant was subsequently enrolled in six lessons with Skill Builders. The final lesson and assessment was to take place the day after this hearing.

23As stated earlier, the appellant testified that she has vascular dementia. The appellant confirmed that this condition is progressive, and her mild cognitive impairment will progress. She further testified that she understands that, in the future, her condition may affect her driving ability, but that it doesn’t at the present.

24The appellant testified that she has had five accidents since she was 19 years of age. She advised that after a major accident in 2016, she is more cautious while driving.

25The appellant testified that she believes that her driving is further improving with the lessons from Skill Builders.

26We find that the Registrar has established on a balance of probabilities that the appellant’s medical condition of cognitive impairment is likely to significantly interfere with her ability to drive a motor vehicle. We agree with the Registrar that the CCMTA Standard, chapter 6.6.1 is reasonable and relevant to the appellant, and we are to apply it here. The appellant has not currently completed her instruction and assessment by Skill Builders. Until the completion of this instruction and assessment, we find that reinstating the appellant’s Class G licence would present a significant risk to the safety of the appellant, her potential passengers, and others using the roadways.

E. Order

27For the reasons set out above, pursuant to subsection 50(2) of the HTA, we confirm the Registrar’s decision to suspend the appellant’s Class G Licence.