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:
Yasmine Ali
Appellant
and
Registrar of Motor Vehicles
Respondent
DECISION AND ORDER
ADJUDICATOR: Dr. Peter Savage, Member
APPEARANCES
For the Appellant: Yasmine Ali, Self-represented
For the Respondent: Stephen Grootenboer, Agent for the Registrar
Heard by Teleconference: March 7, 2023
REASONS FOR DECISION AND ORDER
A. Overview
1By letter dated January 9, 2023, 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)(g) of the HTA to suspend or cancel a driver’s licence if the driver suffers from a medical condition or addiction likely to significantly interfere with his or her ability to drive safely.
6Section 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.”
7Section 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.
8Section 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.
9The 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.
10Pursuant 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?
11The Registrar relies on two types of documents, the Medical Condition Reports (“MCR”) and the mental health questionnaire, in support of its allegation that the appellant suffers from a mental health condition.
12A January 4, 2023 MCR from the Ottawa General Hospital, as well as a February 10, 2023 MCR completed by the appellant’s family doctor, both diagnose a bipolar mental health condition.
13The appellant testified she suffers from, and is being treated for, a bipolar mental health condition. The appellant further testified she has had this condition since adolescence.
14I find that the Registrar has established that the appellant suffers from a mental health condition.
b. Is the appellant’s mental health condition likely to significantly interfere with her ability to drive safely?
Registrar’s Evidence
15The 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.
16The Registrar relies on the CCMTA National Safety Code, chapter 14, which describes mental health conditions in general and the concerns with driving safety 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.
17The Registrar submits that a three-month period of stability is required to guarantee a mental health condition is stable and points out there has not been a three-month period of stability. The Registrar admits the three-month stability is not a CCMTA recommendation but an internal policy of the Ministry of Transportation.
18The Registrar points out the family doctor has indicated there has been episodes of noncompliance with medication in the past and this further supports the need for three months of stability.
Appellant’s Evidence
19The appellant testifies she was taken to the Ottawa General Hospital on January 4, 2023 by the Ottawa Police Service. She stated she was making excessive noise with her car horn and was in a state of mania.
20The appellant states this mania was brought on by her own decision to stop taking her prescribed lithium medication. Pursuant to s. 16(b) of the Statutory Powers Procedure Act, as I am a physician duly licenced to practice medicine in Ontario, it is within my specialized knowledge that lithium is commonly prescribed by medical doctors to stabilize bipolar behaviour. She admits and takes responsibility for making a bad decision by stopping her medication.
21The emergency visit and subsequent hospitalization resulted in several positive developments:
(i) she has a good relationship with a psychiatrist who has restarted her lithium and sees her on a monthly basis and monitors her medication;
(ii) she has developed a better relationship with her father and sister. She lives at home with family and either father or sister attend appointments with the appellant. She has new respect for her father’s input into her mental health and will take his advice in the future;
(iii) she has a better understanding of the condition and the need for long term medication to stabilize her condition;
(iv) she has had a period of stability from January 4, 2023 to the present day; and
(v) she has improved her ability to focus and allowed her to re-enter the work force in a responsible position in the 911 response centre in Ottawa.
22The appellant testified she is on prescribed medications and is taking them each night. The medications are Seroquel (which I recognize is an anti-psychotic drug) and lithium (which, as I indicated earlier, is a mood stabilizing drug). The lithium level in the blood is monitored in monthly blood tests and the results are followed by her psychiatrist and her family doctor. The appellant testifies she is committed to stay on her medications.
23The appellant testifies her father and sister monitor her condition and are involved in her ongoing medical care. The appellant states she is grateful and accepting of this monitoring and support.
24The appellant testified that she has a good driving record and has no serious driving infractions.
25The appellant stated out that she has insight into her mental health condition and knows it is important to stay on her medication for the long term.
26The appellant’s family doctor notes in the mental health questionnaire that with medication compliance her condition should remain stable.
27The appellant points out she does not smoke, take alcohol or drugs, and lives a healthy lifestyle.
ANALYSIS
28I find the Registrar has presented ample medical evidence to establish the appellant has a mental health condition. However, I am not satisfied that there is sufficient medical evidence to conclude that this condition is likely to significantly interfere with the appellant’s ability to drive a motor vehicle safely.
29I agree with the Registrar that the CCMTA Standard chapter 14.6.1 is reasonable and relevant to the appellant, and I have considered it in making this decision. In my view the appellant satisfies the requirements of 14.6.1. The appellant has insight into her illness and is stable at this time and her medical team have told her she is doing well even though they have not given her documentation stating that they recommend she return to driving.
30While the appellant has not met the Registrar’s requirement for a period of three months of stability, I find that the appellant has been stable for a period of eight weeks. The Ministry has a policy that three months are required. The Ministry is entitled to formulate its own internal policies, and it may be that in many cases a period of three months’ stability is essential, however in this case I find eight weeks is a sufficient period of time.
31I am also persuaded by the mental health questionnaire completed by the family doctor, which adds support to the appellant’s position. The appropriate lithium level and the compliance and understanding of the appellant is very positive.
32The family support and involvement of the appellant’s father and sister in her medical treatment, management and follow up are very reassuring to me that her condition will be well managed and followed up.
33I am satisfied that the appellant is receiving appropriate treatment with the family doctor and the psychiatrist. 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 accepted treatment upon feeling unwell and I feel if that situation were to arise again she would quickly seek and accept help.
34I agree with the appellant that each case must be judged on its own merits. In this case I am not satisfied based on the evidence before me that the Registrar has established on a balance of probability that the appellant’s mental health condition is likely to significantly interfere with her ability to drive safely.
E. Order
35For 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: March 10, 2023