Licence Appeal Tribunal File Number: 15212/MED
In a 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:
Joshua Oliver
Appellant
and
Registrar of Motor Vehicles
Respondent
DECISION & ORDER
ADJUDICATORS: Dr. Isla McPherson, M.D., Member Raymond C. Ramdayal, Member
APPEARANCES:
For the Appellant: Joshua Oliver For the Respondent: Stephen Grootenboer, Representative
Heard: December 11, 2023
OVERVIEW
1Joshua Oliver (the “appellant”) appeals from the decision of the Registrar of Motor Vehicles (the “Registrar” or “respondent”) to suspend their Class G/M2 licence under s. 47(1) of the Highway Traffic Act, R.S.O. 1990, c. H.8 (the “Act”) after the Registrar received a medical condition report from a treating health care provider that the appellant suffers from a medical condition that may affect their ability to drive safely.
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 alcohol use disorder, 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 deny that they suffer from the medical condition alleged and deny that they suffer from a medical condition which interferes with their ability to drive safely.
5By letter dated August 15, 2023, the Registrar advised appellant that his licence was being suspended for the above-mentioned medical condition. They reached this decision after receiving an unsolicited medical condition report (“MCR”) dated August 9, 2023. On that day, the appellant attended Scarborough Hospital Network where he was assessed by an emergency room psychiatrist. He was formally diagnosed with an uncontrolled substance use disorder for alcohol. The MCR also stated there was suspicion that the appellant had operated a motor vehicle while under the influence of alcohol.
ISSUE
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, we will address the following questions:
i. Does the appellant suffer from the medical condition alleged?
ii. If so, is this likely to significantly interfere with their ability to drive a motor vehicle safely?
RESULT
8Having considered all the evidence and submissions and for the reasons that follow, we 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 their ability to drive a motor vehicle safely and we confirm the Registrar’s decision to suspend the appellant’s driver’s licence.
ANALYSIS
Does the appellant suffer from the medical condition alleged?
9The appellant acknowledges that he uses alcohol as a coping mechanism for his pain. He has submitted a medical report from Dr. S. Jamal dated September 26, 2023, which confirms that he suffers from multiple ailments. He currently takes multiple medications to manage these ailments, however, with limited success.
10The Substance Use Assessment form submitted to the respondent by the appellant was completed by Dr. J. Fletcher, Addiction Medicine Specialist, on November 20, 2023. Dr. Fletcher’s assessment confirms a diagnosis of severe alcohol use disorder. It also confirmed that the appellant was attending a RAAM (Rapid Access Addiction Medicine) clinic with Dr. Fletcher. While the form states that the appellant has maintained sobriety since August 2023, it notes that a urine sample result tested positive for alcohol on two occasions on October 4th and 18th 2023. The appellant disputes this finding despite the laboratory results. We received no evidence to challenge the validity of the laboratory results, therefore, accepted them as legitimate.
11Furthermore, the appellant continues to deny any alcohol use disorder despite the fact that he was diagnosed by two doctors on two separate occasions: the first by the attending emergency room psychiatrist on August 9, 2023 and then Addiction Medicine Physician, Dr. Fletcher on November 20, 2023.
12The appellant testified that he did not trust the findings of the attending emergency room psychiatrist. He still attended programs with RAAM though he did not think it was necessary. He also sought help from an Addictions Counsellor at Pinewood Scarborough Community Withdrawal Management where he attended as an outpatient. There are virtual calls twice a week and he attends an early stage recovery group. During his testimony, he stated that he finds the program interesting and he enjoys talking to people and sharing his experience.
13At the hearing, we received evidence showing both the emergency room psychiatrist and Dr. Fletcher at the RAAM clinic expressing concern for the appellant’s substance use. The emergency room doctor diagnosed the appellant as having uncontrolled alcohol use disorder. Dr. Fletcher diagnosed the appellant as having severe alcohol use disorder. It is clear that this is beyond a mild or moderate alcohol use disorder. Furthermore, the appellant confirmed that he previously interacted with the RAAM clinic in 2016, suggesting a long-standing issue with substance abuse.
14During the hearing, the panel received testimony from the appellant which describes his consumption of spirits of between 500 – 700 mL servings. He stated that he does not drink every day but became evasive when speaking about his specific drinking habits.
15The appellant states that his driving privilege is very important to him. He explained that this incident has placed a strain on his family life. He also advised that his pain has worsened since stopping his alcohol consumption. Despite this, he expressed his commitment to abstaining from alcohol.
16The appellant states that he has not consumed alcohol, since August 8, 2023, although evidence in Dr. Fletcher’s assessment suggested otherwise. The panel notes that the appellant disputed the specific lab results Dr. Fletcher was referring to on the basis that he had been abstinent. Given the reliability of laboratory results, this was not enough to persuade us to dismiss the laboratory finding.
17We find that the Registrar has established that the appellant suffers from alcohol use disorder.
Is the appellant’s medical condition likely to significantly interfere with their ability to drive a motor vehicle safely?
18The original medical report from Scarborough Hospital Network suspected that he was drinking and driving. The appellant testified that he drove his vehicle to the hospital sober and entered while intoxicated. If we were to believe the appellant’s claim that he drank in the parking lot before entering the building, it is possible that he did not drink and drive. We have no evidence to confirm either way.
19The panel took into consideration Dr. Jamal’s letter in which he states that if the appellant’s driver’s licence was reinstated that he would benefit both mentally and physically. While we understand the positive impact and motivation licence reinstatement may have on the appellant, the privilege to drive must be balanced against the question of whether the appellant’s serious medical condition is likely to significantly interfere with his ability to drive safely.
20It is the respondent’s position that the appellant’s substance abuse is severe. His pattern of use supports this and we did not receive any information to counter this position aside from the appellant stating that he has never been charged with driving while under the influence.
21Our concern is that the appellant has a long-standing and severe alcohol use disorder which treatment has had limited success. He appears to be in the early contemplative stage of change and has not made significant progress which instills confidence in this panel. Furthermore, he remains in pain and his other medical conditions continue to be a challenge for which he has turned to alcohol in the past.
22Along with the Act, the respondent relied on Chapter 15.6 of the CCMTA Standards which provides the guidelines for assessment. Section 14(2)(a) of the Regulation states that the respondent may take into account the relevant medical standards set out in the CCMTA Medical Standards for Drivers. The CCMTA Standards are not binding on the respondent or this Tribunal; however, we agree that it is reasonable and prudent to apply the CCMTA Standards to this case. The appellant has failed in meeting the CCMTA Standards and presents with a serious substance use disorder that has not been adequately resolved.
23The CCMTA also provides guidance on the time period someone with substance use disorder should remain abstinent. In this case, the respondent required that the appellant provide confirmation that he has remained abstinent from alcohol for a period of six months and that he has the support of his healthcare provider for his driving privilege. The appellant was unable to provide this.
24For these reasons, we agree with the respondent’s position that not enough time has elapsed to consider lifting the licence suspension, especially in the absence of a healthcare provider who is clear in supporting the appellant’s driving privilege. We find Dr. Jamal’s letter falls short of this and does not address the concerns raised by other doctors who diagnosed and treated the appellant.
25In addition, we find that the appellant minimized his alcohol use at times during the hearing. There is nothing to suggest that his circumstances have changed significantly and is still subjected to the same triggers as before.
26In the end we find that the appellant has not demonstrated that his condition allows him to operate a motor vehicle safely until it is resolved by a significant period of sobriety and endorsement from his healthcare practitioner. Given his failed laboratory test results, a more fulsome relapse prevention plan is also warranted.
27We find that the appellant’s effort in attending alcohol abuse programs, while commendable, was likely not sufficient to address his issues and more intensive treatment may be necessary to address his addiction.
28We find that the Registrar has proven that the appellant’s alcohol use disorder is likely to significantly interfere with his ability to drive safely.
Conclusion
29We find that the Registrar has discharged the onus of establishing on a balance of probabilities that the appellant suffers from a medical condition, namely alcohol use disorder, that is likely to significantly interfere with their ability to drive a motor vehicle safely.
ORDER
30For 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.
LICENCE APPEAL TRIBUNAL
Dr. Isla McPherson, M.D., Adjudicator
Raymond C. Ramdayal, Adjudicator
Released: January 19, 2024