Licence Appeal Tribunal File Number: 14953/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:

Marcus Badley

Appellant

and

Registrar of Motor Vehicles

Respondent

DECISION

ADJUDICATOR:

Dr. Erica Weinberg, Member

APPEARANCES:

For the Appellant:

Marcus Badley, Self-represented

For the Respondent:

Stephen Grootenboer, Representative

HEARD by Teleconference: July 10, 2023

OVERVIEW

1Marcus Badley (the “appellant”) appeals the decision of the Registrar of Motor Vehicles (the “Registrar”) to suspend his Class G2 driver’s licence under s. 47(1) of the Highway Traffic Act, R.S.O. 1990, c. H.8 (the “Act”), effective October 11, 2019.

2Following the receipt of an unsolicited Medical Condition Report (“MCR”) dated September 30, 2019, the Registrar suspended the appellant’s driver’s licence for the medical condition of psychiatric disorder (mental health condition). The MCR was sent to the Ministry of Transportation as required under s. 203 of the Act.

3Under the Act the Registrar is responsible for ensuring that drivers are medically fit to drive vehicles on the highway. In this case, the Registrar acted pursuant to s. 47(1) of the Act and s. 14(1) of O. Reg. 340/94 under the Act (the “Regulation”). Section 14(1)(a) of 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 his or her ability to drive a motor vehicle of the applicable class safely. Under s. 14(2)(b) of the Regulation, the Registrar may require a driver to provide satisfactory evidence that he or she is able to drive safely.

4Following a hearing, the Tribunal may, under s. 50(2) of the Act, confirm, modify or set aside the decision or order of the Registrar.

5The Registrar takes the position that the appellant is a person living with a medical condition, namely a mental health condition, that is likely to significantly interfere with his ability to drive safely.

6The appellant appeals the suspension under s. 50(1) of the Act. He denies that he is a person living with a mental health condition and he denies he has any medical condition which interferes with his ability to drive safely.

7Having considered all of the evidence, and for the reasons which follow, I find that the Registrar has met the burden of establishing that the appellant’s mental health condition is likely to significantly interfere with his ability to drive a vehicle safely.

8Accordingly, I confirm the decision of the Registrar to suspend the appellant’s driver’s licence for medical reasons.

ISSUES

9The issue in dispute is whether the appellant is a person living with a medical condition, namely a mental health condition, that is likely to significantly interfere with his ability to drive a motor vehicle safely.

10To resolve that issue, I will address the following questions:

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

ii. If the appellant is a person living with a mental health condition, is it likely to significantly interfere with his ability to drive a motor vehicle safely?

ANALYSIS

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

11I find that the evidence presented at the hearing supports that the appellant is a person living with a mental health condition.

12The Registrar’s position that the appellant is a person living with a mental health condition is supported by the reports of the appellant’s treating physicians, namely Dr. N. (September 2019), Dr. B. (November 2019), Dr. J. (December 2020) and Dr. K. (November 2022). These reports all identify the appellant as having a certain, specific mental health condition.

13The appellant denies that he is a person living with a mental health condition. Although the appellant testified that he currently attends appointments at a Canadian Mental Health Association program (“CMHA program”), has been hospitalized in the past for his mental health and has taken medications for his mental health, he is of the opinion that he does not suffer from a mental health condition.

14I prefer the evidence of Drs. N., B., J. and K., all qualified physicians, over that of the appellant, and find that the appellant is a person living with a specific mental health condition. The named doctors are all qualified to make such a diagnosis and are all in a position to determine whether the appellant suffers from that condition. I assign limited weight to the appellant’s denial that he is a person living with a mental health condition. As a licenced and duly qualified physician in the province of Ontario, I am aware that, due to their mental health condition itself, many persons suffering from the specific mental health condition attributed to the appellant lack the insight, awareness or perception that they suffer from the symptoms or signs of their mental health condition (anosognosia). I take notice of this fact pursuant to s. 16(b) of the Statutory Powers Procedure Act, R.S.O. 1990, c. S.22. Dr. K. in his November 12, 2022 report stated that the appellant has “zero insight”.

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

If the appellant is a person living with a mental health condition, is it likely to significantly interfere with his ability to drive a motor vehicle safely?

16On appeal, the Registrar has the burden of establishing, on a balance of probabilities, that the appellant’s medical condition is likely to significantly interfere with his ability to drive a motor vehicle safely. I find that the Registrar has met that burden.

17The Registrar relies on the Canadian Council of Motor Transport Administrators Medical Standards for Drivers [February 2021] (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 requirements.

18The Registrar relies specifically on Chapter 14.6.1 of the CCMTA Standards (Guidelines for assessment; Psychiatric disorder – all drivers) which recommends that a driver who has been diagnosed with a mental health condition is eligible for a licence if:

i. the condition is stable;

ii. the driver has sufficient insight to stop driving if condition becomes acute;

iii. the functional abilities necessary for driving are not impaired;

iv. a treating physician supports a return to driving, for drivers who have stopped driving due to a psychiatric disorder; and

v. the conditions for maintaining a licence are met.

19The Registrar argues that Dr. K.’s November 2022 report states that the appellant’s mental health condition “is not stable” and “he should not be given a driver’s licence”.

20The Registrar further argues that it has not received any up-to-date medical information from a qualified health care professional despite its more recent requests for a completed Mental Health Disorder form on November 14, 2022, June 16, 2023 and at the case conference. The Registrar argues that these requests are reasonable, prudent and supported by law.

21The appellant argues that his driver’s licence should be reinstated. He testified that he: voluntarily attends the CMHA program every week; finds the inconsistency in the staff at the CMHA program problematic; no longer takes any injectable mental health medication; is “trying to do better”; and does not have any medical condition that is likely to significantly interfere with his ability to drive a motor vehicle safely.

22While the CCMTA Standards are well-reasoned and provide assistance, every case should be considered on its own facts.

23In this case, I am persuaded by the CCMTA Standards and take them into consideration.

24The CCMTA Standards provide useful information regarding how mental health conditions can negatively affect the functions necessary for driving. According to the CCMTA Standards, 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 condition. Insight means that a driver: is aware of their medical condition; understands how the condition may impair their functional ability to drive; and has the judgment and willingness to comply with their treatment regime and any conditions of licensing. Furthermore, the rationale stated for Chapter 14.6.1 of the CCMTA Standards is “given the nature of psychiatric disorders, assessment must rely primarily on the clinical judgment of health care professionals involved in treatment”.

25I prefer the evidence of Dr. K. over that of the appellant, and find that the appellant’s mental health condition is likely to significantly interfere with his ability to drive a motor vehicle safely. I acknowledge that in November 2022, Dr. K. had been the appellant’s treating psychiatrist for only four months. However, Dr. K. would have access to the appellant’s mental health history for his entire attendance at the CMHA program. Although the appellant was unwilling to disclose how long he had been a client at the CMHA program, I take note of the fact that Dr. J.’s medical evidence (2020) lists the same CAMH program address as that of Dr. K. Knowing the circumstances and having met with the appellant, Dr. K. concluded in November 2022 that there were safety concerns with the appellant’s driving. In his medical report, Dr. K. indicated that the appellant has no issues with cognition, however the appellant’s mental health condition “is unstable”, he “remains psychotic with residual delusions”, he has “zero insight” and “poor judgment”. Moreover, Dr. K. indicated that the appellant “should not be given a driver’s licence”. The appellant has been given ample opportunity to provide updated medical information from a treating health care professional. Yet, despite testifying that he attends the CMHA program weekly, he has not done so. Furthermore, I acknowledge that due to the appellant’s mental health condition itself, he denies/is not aware/lacks insight that he is a person living with a mental health condition. Thus, due to this lack of insight into his mental health condition, I find on a balance of probabilities that the appellant cannot appreciate, perceive or understand how his mental health condition may affect or impair his functional ability to drive.

26Based on the above, I find, on a balance of probabilities, that the appellant’s medical condition is likely to significantly interfere with his ability to drive safely.

Conclusion

27After a careful consideration of the totality of the evidence before me, I find that the Registrar has discharged the onus of establishing on a balance of probabilities that the appellant’s medical condition is likely to significantly interfere with his ability to drive a motor vehicle safely.

ORDER

28For the reasons set out above, pursuant to subsection 50(2) of the Act, I confirm the Registrar’s decision to suspend the appellant’s driver’s licence for medical reasons.