Jason Gendron v. Registrar of Motor Vehicles, 2024 CanLII 118767

Licence Appeal Tribunal File Number: 16341/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 subsection 47(1) of the Act.

Between:

Jason Gendron Appellant

and

Registrar of Motor Vehicles Respondent

DECISION

ADJUDICATOR: Dr. David To, Member

APPEARANCES:

For the Appellant: Jason Gendron, self-represented

For the Respondent: Ian Sookram, Representative

HEARD: November 12, 2024

OVERVIEW

1Jason Gendron (the “appellant”) appeals from the August 15, 2024 decision of the Registrar of Motor Vehicles (“Registrar”) to suspend his Class AC driver’s 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 physician that the appellant suffers from two medical conditions that may affect his 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. Paragraph 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 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 two medical conditions, a mental health condition and brain injury, that are likely to significantly interfere with his ability to drive safely and that this provides sufficient reason to suspend his licence under s. 47(1)(g) of the Act.

4The appellant appeals the suspension under s. 50(1) of the Act.

5The appellant denies that he suffers from a mental health condition.

6The appellant agrees that he was diagnosed with a traumatic brain injury but denies that this medical condition interferes with his ability to drive safely.

7Pursuant to s. 50(2) of the Act, after a hearing the Tribunal may confirm, modify, or set aside the decision or order of the Registrar.

ISSUES

8The issue in this appeal is whether the appellant suffers from a medical condition that is likely to significantly interfere with his ability to drive a motor vehicle of the applicable class safely.

9To resolve that issue, I will address the following questions:

i. Does the appellant suffer from one or both of the medical conditions alleged by the Registrar?

ii. If so, is one or both of these medical conditions likely to significantly interfere with his ability to drive a motor vehicle of the applicable class safely?

10The Registrar bears the burden of proving on a balance of probabilities that the answer to each of the above questions is “yes.”

RESULT

11Having considered all the evidence and submissions, I find that the Registrar has satisfied its burden to establish that the appellant suffers from a medical condition that is likely to significantly interfere with his ability to drive a motor vehicle of the applicable class safely.

12I confirm the Registrar’s decision to suspend the appellant’s driver’s licence.

ANALYSIS

Does the appellant suffer from a medical condition?

13The evidence presented at the hearing establishes that on a balance of probabilities, the appellant suffers from a mental health condition.

14The Registrar’s position is supported by a medical report completed by a physician and by the appellant’s testimony.

15On August 13, 2024, Dr. NL, a psychiatry specialist physician, completed a Medical Condition Report (“MCR”), which notes that the appellant suffers from a “mental or emotional illness – unstable” and an “acquired brain injury”. This report also states that the appellant has a “mental health illness with thought disorganization, no insight and untreated”.

16The appellant presented a Mental Health Disorder form, dated October 12, 2024 by a different physician, Dr. SL, which notes that the appellant has no mental illness, no symptoms and has not been admitted to the hospital in the last 12 months.

17Considering the discrepancies between these two medical reports, I place greater weight on the report provided by Dr. NL over the more recent report by Dr. SL. This is because Dr. SL’s report notes that Dr. SL assessed the appellant for the first time in a walk-in clinic and relied on the appellant’s self reporting. Based on their report, Dr. SL did not know about the hospitalization or the opinion of Dr. NL, either of which may have impacted Dr. SL’s opinion. Further, based on the appellant’s testimony that he was hospitalized as an inpatient when he was assessed by Dr. NL, this suggests that Dr. NL likely had a more complete view of the appellant’s mental health condition because there was a longer period of observation.

18Based on the reports provided and the appellant’s testimony, there was no specific mental health diagnosis that was provided for this appeal. A specific diagnosis is not necessary, as s. 14(1)(a) of the Regulation only requires that the appellant “not suffer from any mental…or physical condition” likely to significantly interfere with his ability to drive safely.

19For the second medical condition, “brain injury” on which the suspension is based, the appellant acknowledges that he experienced a traumatic brain injury many years ago. He agrees he has the diagnosis of traumatic brain injury and is currently working with a community brain injury centre for support.

20I find that the Registrar has proven on a balance of probabilities that the appellant suffers from a mental health condition and a traumatic brain injury.

Is the appellant’s medical condition likely to significantly interfere with his ability to drive a motor vehicle safely?

21I find that the Registrar has proven 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.

22Based on the evidence available, several factors make the appellant unsafe to drive. The appellant was involuntarily hospitalized for 16 days, which indicates a significant mental health condition. The fact that he was prescribed a medication on discharge and that the appellant is not taking this medication indicates that this condition is ongoing and likely not appropriately treated. The appellant’s lack of understanding why he was in the hospital and reluctance to accept the diagnosis made by his physician shows there is no insight into the condition.

23As a licensed physician in Ontario, and as authorized by s.16 of the Statutory Powers Procedure Act, R.S.O. 1990, c. S.22, I acknowledge that a traumatic brain injury from the past can lead to mental health disorders and cognitive changes over time. It is not clear whether the appellant may have multiple medical conditions or whether there are cognitive changes from his traumatic brain injury which have resulted in symptoms. It may be his mental health condition or cognitive changes from his traumatic brain injury, or a combination of both conditions, that resulted in his stay in hospital. Nevertheless, based on the evidence available in this appeal, the appellant’s overall medical condition is likely to significantly interfere with his ability to drive a motor vehicle safely.

24The appellant testified that after his initial traumatic brain injury approximately 15 years ago, he returned to his education and career without issue. He was employed driving a truck for ten hours a day. He testified during his years of truck driving, until 2021, he had no physical or cognitive symptoms that limited his work or driving ability.

25The appellant explains that in August 2024, he was brought to the hospital after police officers found him sleeping in his car. He testifies that he was not driving or doing any behaviours that would affect his ability to drive safely. He states that he was held in the hospital against his will for 16 days. The appellant is unsure why he was held in the hospital for that period and declined to share further details about any possible diagnosis. There were no medical records provided related to this hospitalization.

26The appellant describes that the hospital did not allow for him to be discharged until he was injected with a mental health medication. He explained that a physician recommended that he continue to take a medication after discharge; however, he has not taken this medication since his discharge because he does not believe he has a mental health condition.

27After his discharge from hospital, he has been working with a community brain injury centre for support for his traumatic brain injury condition.

28The appellant testifies he has never caused any harm to the community while driving in the past.

29However, based on the events in August 2024, it is likely that the appellant’s health has changed over the recent years.

30I am aware as a physician that in traumatic brain injury, there can be possible cognitive impairments including deficits in attention, memory, executive functioning, processing speed and visuo-spatial abilities. There can also be anosognosia, or unawareness of impairment, which is common in individuals with traumatic brain injury.

31Although the report by Dr. SL from October 9, 2024 states that the appellant’s traumatic brain injury has stabilized or resolved and has no functional impairments, I place little weight on this report because, as discussed above, Dr. SL notes that the appellant was seen for the first time in a walk-in clinic and the form was completed based on the appellant’s reporting. Given that the appellant had been hospitalized, the fact that the form instead indicates that the appellant was not hospitalized in the preceding 12 months shows that Dr. SL completed the form with incomplete information from the appellant.

32The Registrar submits that the appellant’s mental health condition and brain injury are likely to significantly interfere with the appellant’s ability to drive safely. There was limited medical information provided for the period after the appellant’s discharge from the hospital. The Registrar submits that to consider reinstatement, they require confirmation that the appellant’s mental health is stable and that the appellant’s functional abilities necessary for driving are not impaired. Similarly, because of the brain injury, they require a satisfactory functional driving assessment.

33The Registrar relies on the Canadian Council of Motor Transport Administrators Medical Standards for Drivers [February 2021] (the “CCMTA Standards”).

34Paragraph 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 Registrar relies on the CCMTA Standards, in particular Chapter 14.6.1 (Psychiatric Disorder) and Chapter 20.6.1 (Traumatic Brain Injury).

35Although not bound by the CCMTA Standards, the Tribunal may consider them when making its decision. These Standards are the result of a lengthy and intensive process to provide medical standards based on the best evidence available and with a focus on functional ability to drive rather than exclusively on medical diagnoses. While each appeal including this one must be judged on its own merits, I am persuaded to apply the CCMTA Standards here. My review of the evidence shows that the conditions recommended for licensing outlined in the CCMTA Standards have not been met.

36Standard 14.6.1 describes the criteria for licence eligibility for drivers with a psychiatric disorder. Based on the evidence, it is unlikely that the appellant’s mental health condition has been stable for a sufficient period because the appellant was required to be hospitalized in August 2024 – it has only been three months since his discharge. The fact that he was hospitalized involuntarily for 16 days indicates that there was an unstable mental health condition, which likely improved to a certain degree by discharge. Further, a treating physician has not supported the appellant’s return to driving – the walk-in clinic physician Dr. SL notes his report was only based on the appellant’s narrative.

37In addition, there is no evidence of insight into his condition based on psychiatrist Dr. NL’s report and from the appellant’s testimony. I acknowledge the important role of driver insight and judgment in maintaining road safety. Unawareness of impairment is also common in individuals with traumatic brain injury and is a concern for driving. The appellant’s limited understanding of why he was hospitalized involuntarily and his decision not to take the medication prescribed to him at discharge from the hospital in August 2024 both demonstrate limited insight into his medical condition.

38Standard 20.6.1 describes the criteria for licence eligibility for drivers with traumatic brain injury. Based on the appellant’s testimony, he had been safely driving in the past, and denies that he has any physical impairments. However, he has not completed a functional assessment, which could be helpful in determining whether any functions necessary for driving are impaired.

39The appellant does not meet the criteria in the CCMTA Standards for either traumatic brain injury and psychiatric disorder, which includes requirements that cognitive and functional abilities necessary for driving are not impaired.

40I do commend the appellant’s goals to resume his career. The appellant explained in detail how important his driver’s licence is for his future ambitions. However, based on the Act, I am only able to consider whether the appellant’s medical condition is likely to significantly interfere with his ability to drive safely.

41I accept the Registrar’s submissions that, considering road safety, it is reasonable to require further medical documentation and a functional driving assessment.

42I am satisfied on a balance of probabilities that the appellant’s medical condition is likely to significantly interfere with his ability to drive safely.

Conclusion

43I find that the Registrar has discharged the onus of establishing on a balance of probabilities that the appellant suffers from a medical condition that is likely to significantly interfere with his ability to drive a motor vehicle of the applicable class safely.

ORDER

44For the reasons set out above, pursuant to s. 50(2) of the Act, I confirm the Registrar’s decision to suspend the appellant’s driver’s licence.