Licence Appeal Tribunal File Number 15252/MED

In the matter of an appeal under subsection 50(1) of the Highway Traffic Act, R.S.O. 1990, c. H.8 (the “Act”), from a decision of the Registrar of Motor Vehicles to suspend a licence pursuant to Section 47(1) of the Act.

Between:

Kathryn Livia Lord

Appellant

and

Registrar of Motor Vehicles

Respondent

DECISION

ADJUDICATOR:

Dr. Erica Weinberg

APPEARANCES:

For the Appellant:

Kathryn Livia Lord, Appellant

For the Respondent:

Stephen Grootenboer, Representative

HEARD by teleconference: October, 27 2023

OVERVIEW

1Kathryn Livia Lord (the “appellant”) appeals from the decision of the Registrar of Motor Vehicles (“Registrar”) to suspend their Class G licence under s. 47(1) of the Highway Traffic Act, R.S.O. 1990, c. H.8 (the “Act”) after the Registrar received a report from a treating health care provider that the appellant suffers from a medical condition that may affect their safety to drive.

2The Registrar has the authority under s. 47(1)(g) of the Act to suspend or cancel a driver’s licence for any sufficient reason. Section 14(1)(a) of O. Reg. 340/94 under the Act (the “Regulation”) states 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 their ability to safely drive a motor vehicle of the applicable class safely. Under s. 14(2)(b) of the Regulation, the Minister of Transportation may require a driver to provide satisfactory evidence that they are able to drive safely.

3The Registrar takes the position that the appellant suffers from a medical condition, namely a mental health condition, that is likely to significantly interfere with their ability to drive safely and that this provides sufficient reason to suspend their licence under s. 47(1)(g) of the Act.

4The appellant appeals the suspension under s. 50(1) of the Act. They acknowledge that they suffer from a mental health condition but deny that they suffer from a medical condition which interferes with their ability to drive safely.

5Pursuant to section 50(2) of the Act, after a hearing the Tribunal may confirm, modify, or set aside the decision or order of the Registrar.

ISSUES

6The issue in this appeal is whether the appellant suffers from a medical condition that is likely to significantly interfere with their ability to drive a motor vehicle safely.

7To resolve that issue, I will address the following questions:

i. Is the appellant a person living with a mental health condition?

ii. If so, is this likely to significantly interfere with their ability to drive a motor vehicle safely?

8The Registrar bears the burden of proving on a balance of probabilities that the answer to each of the above questions is “yes.”

RESULT

9Having considered all the evidence and submissions and for the reasons that follow, I find that the Registrar has not satisfied its burden to establish that the appellant suffers from a medical condition that is likely to significantly interfere with their ability to drive a motor vehicle safely and I set aside the Registrar’s decision to suspend the appellant’s driver’s licence.

ANALYSIS

Is the appellant a person living with a mental health condition?

10The evidence presented at the hearing establishes on a balance of probabilities that the appellant is a person living with a mental health condition.

11The Registrar’s position is supported by medical reports completed by Drs. P. and V.

12In an August 16, 2023 completed Mental Health Disorder form, the appellant’s family physician, Dr. P., indicated the appellant’s primary mental health diagnoses.

13In an April 19, 2023 and a July 17, 2023 hospital discharge summary, in-patient psychiatrist, Dr. V., indicated that the appellant’s mental health diagnoses.

14The appellant acknowledges that they are a person living with these mental health conditions.

15I find that the Registrar has established on a balance of probabilities that the appellant is a person living with a mental health condition.

Is the appellant’s mental health condition likely to significantly interfere with their ability to drive a motor vehicle safely?

16I find that the Registrar has not proven on a balance of probabilities that the appellant’s medical condition is likely to significantly interfere with their ability to drive a motor vehicle safely.

17The Registrar argues that a mental health condition can and will interfere with a driver’s ability to drive safely and presents a safety risk to other road users. They further argue that in order to consider reinstatement of the appellant’s driver’s licence they require confirmation of a minimum of a six-month period of mental and emotional stability.

18Section 14(2)(a) of the Regulation allows the Registrar to consider the Canadian Council of Motor Transport Administrators Medical Standards for Drivers [February 2021] (the “CCMTA Standards”), when determining whether the requirements of s. 14(1) are met. The Tribunal may take the CCMTA Standards into consideration, although they are not binding on the Tribunal.

19The Registrar relies on the CCMTA Standards, in particular Chapter 14.6.1 (Psychiatric disorder – All drivers) and internal policies at the Ministry of Transportation. Chapter 14.6.1 provides that all drivers suffering from psychiatric (mental health) disorders are eligible for a licence if: the condition is stable; the driver has sufficient insight to stop driving if the condition becomes acute; the functional abilities necessary for driving are not impaired; and a treating physician supports a return to driving, for drivers who have stopped driving due to a psychiatric disorder. The Registrar’s representative acknowledged that this CCMTA Standard does not provide a specific time frame for mental and emotional stability prior to re-instatement of a driver’s licence, however they emphasized that a six-month period of stability is reasonable in this case due to the number of mental health hospitalizations the appellant has had in the past 12 months. In addition, the Registrar’s representative argued that although the appellant’s therapist, Mr. O., by letter dated September 27, 2023, states that the appellant’s mental health does not have an impact on the appellant’s ability to operate a motor vehicle and supports re-instatement of their driver’s licence, Mr. O. is not a physician. The respondent emphasized that nowhere in the completed Mental Health Disorder form, does Dr. P. overtly indicate that they support the appellant’s return to driving.

20The appellant argues that their mental health condition does not affect their ability to drive safely, that none of their treating physicians have ever expressed a concern with respect to driving and this mental health condition and that they have never had suicidal ideations with respect to driving/using a motor vehicle to hurt themselves or others. The appellant acknowledges that they have had five hospitalizations for mental health reasons this year but emphasized that their last admission (July 2023) was the result of being instructed by their treating psychiatrist to discontinue a specific medication. The appellant followed the psychiatrist’s instruction and their condition deteriorated to the point of being hospitalized. The appellant testified that they rapidly restabilized once the medication was restarted. The appellant further argues that they: are compliant with all medications and health care appointments; have no cognitive impairment or issues with reaction times; have no side effects from their medications; have a good understanding of their mental health, its symptoms and triggers, and their limitations; have gained and maintained full-time employment since August 2023 (the first time in over three years); and are currently residing independently in their family home.

21While the CCMTA Standards are well-reasoned and provide assistance, every case must be considered on its own facts.

22Although I am not bound by the CCMTA Standards, I find them to be reasonable. Chapter 14 of the CCMTA Standards indicates that a driver’s level of insight is a critical consideration when assessing the risk of an episodic impairment of functional ability due to a mental health disorder. It states, “Drivers with good insight are more likely to be diligent about their treatment regime and to seek medical attention and avoid driving when experiencing acute episodes and have the judgment and willingness to adapt their driving to these limitations”.

23I accept the appellant’s testimony that no treating physician has expressed any concern with respect to driving and their underlying chronic mental health condition. The appellant’s “Extended Driver Record Search For Criminal Code Convictions” shows only one suspension for medical reasons, that being on March 10, 2023 after Dr. V. reported the appellant under s. 203 of the HTA for a medical condition unrelated to the present matter, not for their underlying chronic mental health condition, which Dr. V. would have been aware/have knowledge of. By letter dated May 10, 2023, the appellant’s unrelated medical condition was no longer a concern to the Registrar, however the appellant’s driver’s licence remained suspended, now for the medical condition of mental health condition.

24I agree with the respondent that nowhere in the completed Mental Health Disorder form does Dr. P. overtly indicate support for the re-instatement of the appellant’s driver’s licence. However, the eligibility criterion in question from the CCMTA Standard specifically states, “a treating physician supports a return to driving, for drivers who have stopped driving due to a psychiatric disorder”. In my view, this distinction is important, since, in the case of a driver who initially stopped driving as a result of a mental health condition, that would have been the result of a medical report stating that a mental health condition is likely to significantly impact their ability to drive safely. In this case, there has been no such opinion expressed by a physician with respect to the appellant’s underlying chronic mental health condition. The requirement that a physician specifically support reinstatement of a driver’s licence is less important where, as in this case, no physician has recommended suspension on the basis of the appellant’s underlying chronic mental health condition.

25Furthermore, I note that the rationale behind Chapter 14.6.1 of the CCMTA Standards states, “Given the nature of psychiatric disorders, assessment must rely primarily on the clinical judgment of health care professionals involved in the treatment”. Although the appellant’s therapist, Mr. O., is a social worker not a physician, they are a health care professional who is/has been highly involved in the appellant’s treatment for over seven months. I find the opinion of Mr. O. to be persuasive in the circumstances.

26I prefer the evidence and submissions of the appellant over that of the Registrar, and find on a balance of probabilities, that the appellant’s mental health condition is not likely to significantly interfere with their ability to drive a motor vehicle safely. The appellant demonstrates good insight into both the understanding and limitations of their mental health, is compliant with medications and health care appointments and has a viable “safety plan” in place. The appellant’s testimony is consistent with the information in Dr. P.’s completed Mental Health Disorder form, specifically that: their condition is stable and controlled; they have no difficulties in cognition, attention, memory or judgment; they are compliant with recommended treatment regimen including appointments; they have appropriate insight/sufficient understanding of their medical condition and the impacts on their functional ability to drive; and the appellant does not require an independent functional assessment. Moreover, the appellant testified that since August 2023 they have full-time employment and are able to live and manage independently in their family home with minimal stress.

27Based on the above, I am not satisfied on a balance of probabilities that the appellant’s medical condition is likely to significantly interfere with their ability to drive safely.

Conclusion

28I find that the Registrar has not discharged the onus of establishing on a balance of probabilities that the appellant suffers from a medical condition, namely mental health condition, that is likely to significantly interfere with their ability to drive a motor vehicle safely.

ORDER

29For the reasons set out above, pursuant to subsection 50(2) of the Act, I set aside the Registrar’s decision to suspend the appellant’s driver’s licence.

Erica Weinberg

Adjudicator