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:
Samantha Suarez
Appellant
and
Registrar of Motor Vehicles
Respondent
DECISION AND ORDER
ADJUDICATORS: Dr. Peter Savage, Member
APPEARANCES
For the Appellant: Samantha Suarez, Self-represented
For the Respondent: Kyle Beal, Agent
Heard by Teleconference: October 12, 2022
REASONS FOR DECISION AND ORDER
A. Overview
1By letter dated April 6, 2022, the Registrar of Motor Vehicles (the Registrar) suspended the appellant’s Class G 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, I set aside 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, I will address the following questions:
Does the appellant suffer from a medical condition, namely a mental health condition?
If the appellant does suffer from a mental health condition, 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 mental health condition?
12In support of its allegation that the appellant suffers from a mental health condition, the Registrar relies on two Medical Condition Reports (“MCR form”) from the Wellesley Hospital emergency department and St. Joseph’s Hospital in Hamilton as well as two mental health questionnaires: one filled out by Dr. Lall, the family doctor, and the other filled out by Dr. Ford, the appellant’s current psychiatrist.
13The MCR forms submitted both confirm a mental health diagnosis. One indicating mania and the other indicating bipolar disorder. The mental health questionnaires both confirm a bipolar diagnosis.
14The appellant testifies she suffers from and is being treated for bipolar disorder.
15I find that the Registrar has established on a balance of probabilities that the appellant suffers from a medical condition, namely bipolar disorder, a mental health condition.
b. Is the appellant’s medical condition of cognitive impairment likely to significantly interfere with her ability to drive a vehicle safely?
16The Registrar has the burden of establishing that the appellant’s mental health condition is likely to significantly interfere with her ability to drive a motor vehicle of the applicable class safely. I find that the Registrar has not satisfied this burden.
17The Registrar relies on the CCMTA National Safety Code, chapter 14, which describes mental health conditions and the concerns with driving with respect to those conditions. The Registrar relies on chapter 14.6.1 which states:
All drivers eligible for a licence if the condition is stable, the driver has sufficient insight to stop driving if condition becomes acute, the functional abilities necessary for driving are not impaired, a treating physician supports a return to driving, for drivers who have stopped driving due to a psychiatric disorder, and the conditions for maintaining a licence are met.
18The Registrar submits that a six-month period of stability is requested for drivers who have had two hospitalizations in the last year. The Registrar admits this is not a CCMTA recommendation but an internal policy of the Ministry of Transportation.
19The Registrar points out the time discrepancy in the mental health questionnaires. The family doctor indicated 3-6 months of stability and the psychiatrist indicated less than 3 months of stability. The appellant testifies she has been stable since her discharge from hospital on May 19, 2022 and this is only a period of approximately 5 months. The Registrar’s position is there have been two hospitalizations in the last year and neither a medical practitioner nor the appellant herself have stated there has been a full six months of stability.
20The Registrar points out that the appellant had an accident prior to her first hospitalization and admitted in her own testimony that she should not have been driving.
21The appellant testifies that following the accident in April she was taken to the emergency department where she was diagnosed as manic, and she left hospital the next day. She continued to feel unwell the next day and went to hospital again and the diagnosis of bipolar was made. She was discharged after a week of inpatient treatment but after a few days she continued to feel unwell and called an ambulance and returned voluntarily to hospital. She maintains these hospitalizations were all part of a four or five week process where her mental health diagnosis was made and a proper treatment plan was formulated. She left hospital on May 19, 2022 on a voluntary basis with a firm diagnosis and appropriate medication and has been well since. It is her position that these hospitalizations were really part of one continuum.
22During the course of her treatment the appellant has developed a very specialized and comprehensive team. She has a psychiatrist who she sees every month as well as a nurse practitioner who works with the psychiatrist and she sees this professional every two weeks. The appellant also has weekly visits with a psychologist and her family doctor is part of the treatment team and helps coordinate her treatment and sees her when needed. With this team in place the appellant argues any deterioration in her condition would be detected, treated, and reported very quickly.
23The appellant testifies she is on two medications, Lithium and Loxapine. She has regular blood tests to confirm her blood levels of Lithium and she is working with the psychiatrist to titrate the best dose of Loxapine. The appellant testifies it is likely she will have to stay on medications like these for the rest of her life. She testifies that she has insight into her condition and is committed to keeping her mental health condition under control with the help of her medical team and the medications that they prescribe and monitor.
24The appellant testified she has a supportive family and she is now living at home with her parents. The stressful situation which existed in March 2022 has been resolved. The appellant feels with her proper diagnosis established and medication she will be able to handle stresses in the future. She admits she should not have been driving when she had her accident but at that time she had not been diagnosed or treated.
25The appellant pointed out both her psychiatrist and family doctor documented that her condition was now stable and she was compliant with treatment and follow up.
26The appellant pointed to her driving record which showed no convictions or other infractions.
27I find that the Registrar has not established on a balance of probabilities that the appellant’s mental health condition is likely to significantly interfere with her ability to drive a motor vehicle. I agree with the Registrar that the CCMTA Standard, chapter 14.6.1 is reasonable and relevant to the appellant, and I have considered it here. In my view she satisfies the requirements of 14.6.1. The appellant has insight into her illness and she testifies her medical team have told her she is fit to drive although they are not willing document that opinion. her stable and fit.
28The appellant has not met the Registrar’s requirement for a period of six months stability. While it is hard to be sure exactly how long the appellant has been stable, on a balance of probabilities I find that the appellant has been stable for approximately 5 months. The Ministry has a policy that six months are required if there have been two hospitalizations. The Ministry is entitled to formulate its own internal policies, and it may be that in many cases a person who has been hospitalized twice in one year requires a six-month period of stability.
29However, I also agree with the appellant that each case must be judged on its own merits. In any event I further agree that her hospitalizations should be regarded as one as they were close together and the second was really driven by the same underlying cause as the first—the appellant was eventually electively discharged May 19, 2022 on appropriate medication with appropriate out-patient follow up. In this case I am not satisfied on the evidence before me that the appellant’s mental health condition is likely to significantly interfere with her ability to drive safely.
30I am satisfied that the appellant is receiving appropriate treatment with her follow-up team. With this tight team-based follow up, the appellant will be closely monitored and non-compliance would be noted and reported very quickly. Moreover, the evidence establishes that the appellant has insight into her condition. She voluntarily sought treatment upon feeling unwell and candidly acknowledges that she should not have been driving when she was involved in her pre-diagnosis accident.
E. Order
31For the reasons set out above, pursuant to subsection 50(2) of the HTA, I set aside the Registrar’s decision to suspend the appellant’s Class G Licence.
LICENCE APPEAL TRIBUNAL
Dr. Peter Savage, Member
Released: October 20, 2022