Licence Appeal Tribunal File Number: 14511/MED

In the matter of an 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 licence pursuant to Section 47(1) of the Act.

Between:

Thi Dong Nguyen

Appellant

and

Respondent

Respondent

DECISION

PANEL:

Peter Savage, M.D., Adudicator Colin Osterberg, Vice-Chair

APPEARANCES:

For the Appellant:

Thi Dong Nguyen, Self-represented

For the Respondent:

Ian Sookram, Representative

Heard by Teleconference:

March 9, 2023

OVERVIEW

1Thi Dong Nguyen (the “appellant”) appeals the decision of the Registrar to suspend her 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 physician that the appellant suffers from alcohol use disorder.

2Section 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 physical condition or disability likely to significantly interfere with his or her ability to safely drive a motor vehicle of the applicable class. Under s. 14(2)(b) of the Regulation, the Minister may require a driver to provide satisfactory evidence that he or she is able to drive safely.

3The Registrar takes the position that the appellant suffers from a medical condition, namely alcohol use disorder, that is likely to significantly interfere with her ability to drive safely.

4The appellant appeals the suspension under s. 50(1) of the Act. She denies that she suffers from alcohol use disorder and denies that her use of alcohol interferes with her ability to drive safely.

5Having considered all the evidence, and for the reasons which follow, we confirm the Registrar’s decision to suspend the appellant’s driver’s licence.

ISSUES

6The issue in dispute is whether the appellant suffers from a medical condition, namely alcohol use disorder, that is likely to significantly interfere with her ability to drive a motor vehicle safely.

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

i. Does the appellant suffer from alcohol use disorder?

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

ANALYSIS

The appellant suffers from alcohol use disorder

8The evidence presented at the hearing supports the Registrar’s allegation that the appellant suffers from a medical condition, namely alcohol use disorder.

9The Registrar’s position is supported by the medical reports by Dr. Jai Hong Dai, psychiatry resident at the Canadian Association for Mental Health (“CAMH”) and Dr. Kayla Walderman, the appellant’s family doctor.

10On December 27, 2022, Dr. Dai completed a Medical Condition Report (“MCR”) stating that the appellant suffers from an uncontrolled substance use disorder involving alcohol and is non-compliant with treatment recommendations. The MCR was sent to the Ministry of Transportation as required under s. 203 of the Act.

11On January 5, 2023, Dr. Walderman prepared a Substance Use Assessment (“SUA”) report which stated that the appellant was suffering from a severe substance use disorder involving alcohol. In that SUA report, Dr. Walderman states that the appellant was starting a treatment program that day which included counselling and medication.

12On January 23, 2023, Dr. Walderman submitted a further MCR which states that, on January 20, 2023 the appellant went to the emergency department for shortness of breath related to drinking beer and long-COVID. In this MCR, Dr. Walderman diagnoses uncontrolled alcohol use disorder and non-compliance with treatment.

13Also on January 23, 2023, Dr. Walderman prepared a SUA report in which she diagnoses severe alcohol use disorder. The SUA report states that the appellant is still drinking beer despite recommendations to abstain.

14Blood testing conducted January 20, 2023, shows elevated GGT and ALT results. Panel member, Dr. Savage, recognized these results are commonly associated with patients drinking large amounts of alcohol. The Tribunal takes notice of this fact pursuant to s. 16(b) of the Statutory Powers Procedure Act, R.S.O. 1990, c. S.22.

15The appellant denies that she suffers from alcohol use disorder. She says that she only drinks at social gatherings and after work on some days. The appellant says that, when she does drink, she only has three or four light beers. The appellant says that her attendance at hospital on December 27, 2022 was after drinking tequila at a family Christmas gathering, after which she felt sick. She disagrees with her family doctor’s diagnosis of severe alcohol use disorder.

16We prefer the evidence of Dr. Dai and Dr. Walderman over that of the appellant. They had sufficient opportunity to assess the appellant and to provide the diagnosis they did. Their opinions are supported by the blood tests performed January 20, 2023.

17The appellant’s opinion that she does not suffer alcohol use disorder does not persuade us that Dr. Dai and Dr. Walderman are in error in their assessments. The appellant has provided no medical evidence in support of her opinion despite alleging that her liver specialist, Dr. Wong, does not believe she has an alcohol use disorder.

18We find that the Registrar has established on a balance of probabilities that the appellant suffers from a medical condition, namely alcohol use disorder.

The appellant’s medical condition is likely to significantly interfere with her ability to drive safely

19We are satisfied that the appellant’s medical condition is likely to significantly interfere with her ability to drive safely.

20The Registrar relies on the Canadian Council of Motor Transport Administrators Medical Standards for Drivers (the “CCMTA Standards”) and argues that the licence suspension should be confirmed by the Tribunal. Section 14(2)(a) of the Regulation allows the Registrar to consider 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 us.

21The CCMTA Standards recommend that a driver who has been diagnosed with alcohol use disorder be considered eligible for a licence if they have abstained from the use of alcohol for 12 months. It is recommended that earlier re-licensing may be considered upon favourable recommendation from an addictions specialist or treating physician recognized by the licensing authority, and the successful completion of a drug rehabilitation program.

22Although we are not bound by the CCMTA Standards, we find them to be reasonable. The use of alcohol effects the functions necessary for driving including reaction times, visual acuity, judgement and insight, alertness, and motor co-ordination. It impairs a driver’s judgment and behaviour towards others, including in determining whether they are fit to drive or not. Although a person may, when not under the influence of alcohol, determine never to drive when intoxicated, their assessment of their ability to drive will likely be affected by having consumed alcohol.

23In the present case, the appellant’s family doctor has diagnosed severe alcohol use disorder which is defined as “the repetitive inappropriate use of alcohol…associated with loss of control, inability to abstain, a preoccupation with obtaining alcohol…, and withdrawal symptoms.”

24The appellant has been required to attend hospital twice in a one-month period due to alcohol related illness. Two of her treating doctors have sent MCRs to the Registrar indicating their belief that the appellant is not safe to drive. The appellant specifically asked Dr. Walderman to write a letter in support of the re-instatement of the appellant’s licence and Dr. Walderman declined to do that. She did not ask her liver specialist, Dr. Wong to write a letter of support.

25The appellant appears to be unable, or unwilling, to curtail her use of alcohol. She has a chronic liver disease, namely Hepatitis B, which she has been told is negatively affected by alcohol. She has been told to abstain or decrease her use of alcohol. On December 27, 2022, the appellant became so sick by drinking that she had to attend hospital. Her licence was suspended due to her use of alcohol on December 30, 2022. Despite that, the appellant continued to use alcohol and drank enough on January 20, 2023, that she was required to attend hospital again.

26Although the appellant testifies that she never drives after drinking, an allegation that is supported by her cousin Lisa Nguyen who testified at the hearing, the Registrar’s position that the appellant’s alcohol use disorder makes her unsafe to drive is supported by Dr. Dai and Dr. Walderman, as well as the CCMTA Standards. In our view, the appellant lacks insight into the nature and severity of her alcohol use disorder and we accept the Registrar’s submissions.

27We are satisfied that the appellant’s medical condition is likely to significantly interfere with her ability to drive safely.

Conclusion(s)

28We find that the appellant suffers from a medical condition, namely alcohol use disorder, that is likely to significantly interfere with her ability to drive a motor vehicle safely.

ORDER

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