Licence Appeal Tribunal
Licence Appeal Tribunal File Number: 17574/MED
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:
Krystle Miller
Appellant
and
Registrar of Motor Vehicles
Respondent
DECISION
ADJUDICATOR: Dr. Isla McPherson, Member
APPEARANCES:
For the Appellant: Krystle Miller, Appellant
For the Respondent: Stephen Grootenboer, Agent
Held by teleconference: October 21, 2025
OVERVIEW
1Krystle Miller (the “appellant”) appeals from the decision of the Registrar of Motor Vehicles (“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 an unsolicited Medical Condition Report (MCR) from a physician stating that the appellant suffers from a medical condition that may affect her 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 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 substance use disorder, that is likely to significantly interfere with her ability to drive safely and that this provides sufficient reason to suspend her licence under s. 47(1)(g) of the Act.
4The appellant appeals the suspension under s. 50(1) of the Act. She agrees she has been diagnosed with substance use disorder but states she has been abstinent for several weeks and denies that she suffers from a medical condition which interferes with her ability to drive safely.
5Pursuant to section 50(2) of the Act, after a hearing the Tribunal may confirm, modify, or set aside the decision or order of the Registrar.
ISSUES
6The 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.
7To resolve that issue, I will address the following questions:
i. Does the appellant suffer from substance use disorder?
ii. If so, is this likely to significantly interfere with her ability to drive a motor vehicle safely?
8The Registrar bears the burden of proving on a balance of probabilities that the answer to each of the above questions is “yes.”
RESULT
9Having considered all the evidence and submissions and for the reasons that follow, 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 her ability to drive a motor vehicle safely and I confirm the Registrar’s decision to suspend the appellant’s driver’s licence.
PRELIMINARY ISSUE
10Two preliminary issues arose at the start of the hearing. First, the Open Court Principle was explained at the outset of the hearing as it had not been discussed during the Case Conference.
11Second, during the entering of exhibits, the Registrar noted that two documents referenced by the appellant had not been submitted to the Registrar.
12Submissions were taken from the Registrar regarding a late admission of these two documents. The Registrar objected to the documents being admitted at the time of the hearing as they did not have an opportunity to review them nor have them submitted to the Medical Review Section for a formal response.
13The parties discussed the documents not submitted to the Registrar. An adjournment was not sought by the appellant. As part of the discussion, the appellant was asked whether she was comfortable referencing the contents of these documents during her testimony. She was agreeable to proceeding with this option, and the Registrar did not object to the appellant referencing the content of these letters.
ANALYSIS
Does the appellant suffer from substance use disorder?
14The evidence presented at the hearing establishes that the appellant suffers from a medical condition, namely substance use disorder.
15The Registrar’s position is supported by:
i. Three MCRs from the appellant’s family physician, Dr. S, dated September 11, 2024, November 29, 2024, and August 6, 2025, and
ii. two Substance Use Assessment Forms from Dr. S dated November 12, 2024, and May 10, 2025.
16The September 11, 2024, MCR from Dr. S reports that the appellant suffers from an uncontrolled substance use disorder due to crystal meth.
17Following receipt of the MCR, the Registrar suspended the appellant’s driver’s licence effective September 27, 2024, and requested the completion of a Substance Use Assessment Form.
18The requested Substance Use Assessment Form was completed by Dr. S November 12, 2024, and indicated that the appellant suffered from severe substance use disorder due to cannabinoids and illicit substances and/or non-prescribed pharmaceuticals, that the appellant had not been abstinent from these substances, and that the appellant had completed a treatment program. In the comments section, Dr. S added that the appellant had stopped taking illicit substances but was still using cannabis. Following receipt of this form the Registrar continued the suspension and requested that the appellant remain abstinent from drugs for a period of one year, but this period may be reduced to six months with confirmation from a healthcare practitioner of completion of a drug treatment program and support for driving privileges.
19Dr. S submitted a second MCR dated November 29, 2024, reporting again the appellant suffered from an uncontrolled substance use disorder and documented, “Crystal meth – relapse”.
20A second Substance Use Assessment Form completed by Dr. S was submitted to the Registrar dated May 10, 2025. This form documented the appellant had moderate substance use disorder due to cannabinoids and illicit substances and/or non-prescribed pharmaceuticals, and she had been abstinent for less than six months but had not completed a supervised treatment program as a result of the reported condition. Dr. S added further narrative comments that drug testing on the appellant done May 1, 2025, was positive for cannabis only, but lab work was delayed for over 3 months due to the appellant having difficulty finding a ride. Dr. S added a further comment that the appellant presented with dermatitis that she had when she was known to be using drugs.
21Following the receipt of this Substance Use Assessment Form, the Registrar reinstated the appellant’s driver’s licence in a letter dated May 21, 2025.
22Dr. S subsequently submitted a third MCR dated August 6, 2025, reporting the appellant suffered from an uncontrolled substance use disorder due to cannabis and crystal meth. The Registrar responded to this submission by suspending the appellant’s licence again effective August 17, 2025.
23Under cross-examination the appellant questioned the Registrar as to whether they had received and reviewed any urine drug testing results when making their decision to suspend her licence effective August 17, 2025. The Registrar responded that they had not, and the decision was based on the MCR completed by Dr. S on August 6, 2025.
24The appellant testified that she had completed a treatment program for substance use in October 2024, waited six months and then had her licence reinstated while using only cannabis recreationally and not crystal meth. She testified she had planned to attend a second treatment program, Westover, on August 4, 2025, but had been denied access because she had a positive urine drug screen for a prescribed medication, Ativan. As a result, she testified that she checked herself into a detox program instead where a urine drug screen was positive for cannabis, and this result was forwarded to Dr. S which led to the suspension of her licence. She testified she was not using crystal meth at the time of the urine drug screen and had not used cannabis for ten days prior. The appellant’s NOA argues that it didn’t make sense that her licence was reinstated in May 2025 with known cannabis use and then suspended in August for cannabis use, particularly when she had been sober for the ten days.
25The appellant further testified that as of the hearing date, she has been abstinent from crystal meth for 89 days and cannabis for 50 days. She testified that she recently completed the first pat of a treatment program at Westover which was 19 days, is attending appointments with an addiction counselor, is also attending narcotics anonymous (NA) meetings where she has a sponsor, and she plans to attend a 22 week concurrent disorder program at a local hospital in November 2025. She testified that following completion of the concurrent disorder treatment program, she plans to return for the second part of the Westover treatment program. She testified as to the understanding and awareness she has of her addiction and is ready to do the work to maintain abstinence. She testified she had an appointment with Dr. S on October 14, 2025, where she had presented him with confirmation of her completion of the first part of the Westover program and attendance at NA meetings and requested he complete the Registrar’s Substance Use Assessment Form. She testified Dr. S had requested she complete a urine drug screen which she has not been able to do because she is waiting for a ride to the lab. The Registrar confirmed that as of the day of the hearing, they had not received an updated Substance Use Assessment form from Dr. S.
26Under cross-examination the Registrar questioned why Dr. S would have reported his concern for her using crystal meth on August 6, 2025, if she had last used at the end of July 2025. The appellant responded that this had confused her as well as the urine drug screen sent to him had only been positive for cannabis. She testified she keeps a careful record of her sobriety and confirmed she has been abstinent from crystal meth since July 29, 2025.
27Under cross-examination the appellant testified she began using cannabis and crystal meth in 2022 in response to stressful and traumatic circumstances. In response to further questioning, she testified she gradually increased her drug use until she was using cannabis two to three times per week and crystal meth daily. She testified she had quit using crystal meth initially in the fall of 2024 when she attended a treatment program, but relapsed in November 2024, and relapsed again in July 2025.
28While I understand the appellant has testified as to a period of abstinence and that she has attended treatment programs and continues to be actively engaged in her recovery, she has submitted no medical evidence from a physician to dispute that she no longer has a diagnosis of a substance use disorder. The latest medical evidence is from Dr. S and reports that she has an uncontrolled substance use disorder two months ago. I have also considered that the appellant has requested an updated Substance Use Assessment Form be completed by Dr. S and it has not been received by the Registrar.
29Based on the information available, I find that the Registrar has established on a balance of probabilities that the appellant suffers from substance use disorder.
Is the appellant’s medical condition likely to significantly interfere with her ability to drive a motor vehicle safely?
30I find that the Registrar has proven on a balance of probabilities that the appellant’s medical condition is likely to significantly interfere with her ability to drive a motor vehicle safely.
31The Registrar submitted that uncontrolled substance use disorder can and will interfere with the safe operation of a motor vehicle and that the Registrar took the appropriate action in suspending the appellant’s driver’s licence.
32The Registrar’s submitted their position is also supported by the Canadian Council of Motor Transport Administrators Medical Standards for Drivers [February 2021] (the “CCMTA Standards”). Within these Standards, the Registrar relies on Chapter 15. This Chapter describes substance use disorders in general and the concerns with driving safely. This chapter cites scientific research in the form of a meta-analysis and a systematic review that document that cannabis use elevates the relative risk of a car accident and that a driver cannot compensate for the effects of psychotropic drug use. It further outlines the effects of cannabis use include delays in decision-making and information processing and the euphoric phase induced by THC affects judgement, and the longer-lasting motor and cognitive effects affect coordination and short-term memory. The CCMTA Standards further document that psychotropic drugs contribute to impairment in driving performance, and a study by the Canadian Centre on Substance Abuse found approximately 35% of people killed in accidents in Canada had drugs in their system.
33Specifically Standard 15.6.3 states that drivers would be eligible for a licence if they:
i. Meet the criteria for remission and/or has abstained from the substance for 12 months.
ii. Earlier re-licensing may be considered upon favourable recommendation from an addictions specialist and/or treating physician recognized by the licensing authority, and the successful completion of a drug rehabilitation program.
iii. The functional abilities necessary for driving are not impaired.
iv. Where required a road test or other functional assessment shows that the functional abilities for driving are not impaired.
34The Registrar stated that no medical information has been received to demonstrate that Standard 15.6.3 has been met. The Registrar stated that the law has been applied reasonably and correctly, that their decision is in line with the national medical standards, and on the balance of probabilities, the appellant does have a condition that will interfere with her ability to drive safely.
35Section 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 but are not bound by them.
36The appellant argued that she does not have a medical condition that will impair her ability to drive safely. She testified as to having a clean driving record, no history of charges for impaired driving and no unpaid parking tickets. She further testified she is committed to her sobriety and continues to follow up with Dr. S in addition to the multiple treatment programs and supports. She testified to the necessity of having a licence to do her job. She had previously taken a leave from her job that required travel, and she now has a job interview following the hearing and plans to return to work and will need her licence.
37The appellant submitted three written letters in support of her position. The first letter is from her husband and narrates that he has known the appellant for 14 years, and described that she is dependable, conscientious and understands the importance of safety at home and on the road. He attests to driving with her countless times and is confident she does not pose any danger to other drivers and describes the necessity of her licence to support their family. The second letter is from the appellant’s addiction sponsor. She documents she has known the appellant for three years and witnessed the appellant’s commitment to her recovery. She further outlines that the appellant having her driver’s licence is essential for several reasons and that marijuana can be detected for extended periods. The third letter is from a prior employer, and he attests to having known the appellant for 15 years in a personal and professional capacity, and that the appellant has a strong sense of responsibility and an impeccable driving record. When the appellant worked under his supervision, she demonstrated safe and professional driving practices, the suspension has imposed significant hardship on her family and livelihood and he would support her reinstatement.
38I considered the appellant’s position that her substance use disorder will not impact her ability to drive safely. However, this is weighed against the scientific research that drug use is associated with an increased risk of adverse driving outcomes. I have also considered that the appellant has engaged with many programs and services and continues to see Dr. S. However, I also note that despite this engagement there is no submitted medical evidence from a treating physician that confirms her recovery from having an uncontrolled substance use disorder nor any support from a physician for reinstatement of her driver’s licence.
39I have considered the appellant’s letters of support for reinstatement of her driver’s licence from her husband, addiction sponsor and prior employer. However, I recognize those writing these letters are not from regulated healthcare professionals treating the appellant, and therefore are not able to provide a professional opinion on the appellant’s substance use disorder nor her recovery. Further, it is not clear from the letters whether they understand that the appellant’s substance use disorder includes cannabis and crystal meth use. The appellant’s spouse does not reference the use of any substances at all and the appellant’s sponsor and prior employer reference only a history of cannabis use and not crystal meth.
40Although not bound by the CCMTA Standards, they can be considered when making the decision for the reason that 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. I am persuaded to apply them here. My review of the evidence shows that none of the conditions recommended for relicensing outlined in the CCMTA Standards have been met.
41Given the extent of illicit drug use, the history of repeated relapses even after completion of a treatment program, no evidence or testimony of completing a full treatment program since the latest relapse, and no submitted medical evidence from a treating physician that confirms her recovery from having an uncontrolled substance use disorder nor any physician support for reinstatement of her driver’s licence, I accept and apply the CCMTA guidance that having a period of abstinence is reasonable. With only a quarter of the period of abstinence outlined in the CCMTA Standards elapsed for crystal meth use, and less time for cannabis use, I find this insufficient to set aside the suspension.
42I appreciate that substance use disorders are chronic relapsing disorders that often require long term pharmacological and psychosocial interventions to prevent relapse, and the appellant has a demonstrated history of several relapses. For these reasons, I agree with the CCMTA Standards that require a treatment program be completed to consider early reinstatement. While the appellant has testified that she is currently involved in multiple services to support her recovery, there is no medical evidence that she has completed any program since her latest relapse, and she has no immediate completion date soon, which is corroborated by her testimony. I recognize the appellant has testified she completed the first part of a treatment program at Westover but acknowledge this is only the first part of a two-part program, with the second part of the program being much longer in duration. I do not consider the completion of the first part to be the completion of a program, and do not find this requirement has been met. There are additionally several new services that she plans to engage with in coming weeks and months.
43As such, for the reasons cited, I am satisfied on a balance of probabilities that the appellant’s medical condition is likely to significantly interfere with her ability to drive safely.
Conclusion
44I find that the Registrar has discharged the onus of establishing on a balance of probabilities that the appellant suffers from a medical condition, namely substance use disorder, and that condition is likely to significantly interfere with her ability to drive a motor vehicle safely.
ORDER
45For 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.
Released: November 5, 2025
__________________________
Dr. Isla McPherson, Member
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