Nastacia T. Dunchie v. Registrar of Motor Vehicles, 2025 CanLII 13539

Licence Appeal Tribunal File Number: 16530/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:

Nastacia T. Dunchie

Appellant

and

Registrar of Motor Vehicles

Respondent

DECISION & ORDER

ADJUDICATORS: Dr. Erica Weinberg, Member Raymond C. Ramdayal, Member

APPEARANCES:

For the Appellant: Nastacia T. Dunchie For the Respondent: Ian Sookram, Representative

Heard: January 15, 2025

OVERVIEW

1Nastacia T. Dunchie (the “appellant”) appeals from the decision of the Registrar of Motor Vehicles (the “respondent”) to suspend her driver’s licence under s. 47(1) of the Highway Traffic Act, R.S.O. 1990, c. H.8 (the “Act”) after the respondent received an unsolicited Medical Condition Report from a treating health care provider 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 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 a heart condition, 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 acknowledges that she sought medical attention after feeling dizzy on three separate occasions. She denies having any heart condition and attributes the dizziness to the stress associated with recently losing her job. It is the appellant’s position that she does not suffer from a medical condition which interferes with her ability to drive safely.

5After a hearing, section 50(2) of the Act provides that the Licence Appeal Tribunal (the “Tribunal”) may confirm, modify, or set aside the decision or order of the Registrar.

ISSUE

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, 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 her ability to drive a motor vehicle of the applicable class safely?

The Registrar bears the burden of proving on a balance of probabilities that the answer to each of these questions is ‘yes.’

RESULT

8Having considered all the evidence and submissions and for the reasons that follow, we find that the respondent has satisfied its burden to establish that the appellant suffers from a medical condition, namely a heart condition, that is likely to significantly interfere with her ability to drive a motor vehicle of the applicable class safely and we confirm the respondent’s decision to suspend the appellant’s driver’s licence.

ANALYSIS

9By letter dated November 20, 2024, the respondent advised the appellant that her driver’s licence was being suspended due to a heart condition. They reached this decision after receiving an unsolicited Medical Condition Report, authored by the appellant’s family physician, Dr. J. Persaud, dated November 14, 2024, indicating the appellant presented with a new onset of light-headedness which she describes as having a sudden onset with no triggers, and lasting seconds. Dr. Persaud also mentions in his report that the appellant’s light-headedness began shortly after she lost her job but is silent on whether it is the cause. In addition, Dr. Persaud indicated that the appellant is currently being worked up (i.e., investigations into her light-headedness are underway), and that he has referred her to internal medicine/cardiology.

10In addition to suspending the appellant’s driver’s licence, the respondent also requested that the appellant have her treating physician, specialist or nurse practitioner complete a Cardiovascular Assessment form on her behalf for review by the Ministry of Transportation (MTO) Driver Medical Review Office.

11To date, the appellant has not provided this information. At the hearing, the appellant testified that she does not have a heart condition that interferes with her ability to operate a motor vehicle safely. She further states she has been complying with all tests and examinations that her treating doctors have ordered which, to her understanding, have all come back normal.

12While the appellant did not provide a completed Cardiovascular Assessment form, she did provide copies of an Ambulatory Blood Pressure Measurement report, a Transthoracic Echocardiography report and an Exercise Stress Test report to the respondent for consideration. Dr. N. Ravindran from Brampton Internal Medicine ordered the tests. The appellant testified that Dr. Ravindran’s requested 48-hour Holter Monitor test was completed the morning of the hearing, but the test results were not yet available. The appellant advised at the hearing that she will provide any new test results to the respondent as soon as they are available.

13The appellant testified that the three (3) incidents of dizzy spells she experienced occurred while in different positions, followed no pattern, and that there were no warning signs or other symptoms. The first time she experienced dizziness was while she was sitting on her bed and then stood up. The second time, she was in her living room when she experienced a sudden onset. Finally, the third time occurred while she was standing and speaking with friends. It was then that she sought medical attention.

Does the appellant suffer from the medical condition alleged?

14We find, on a balance of probabilities, that the appellant suffers from the medical condition asserted by the respondent.

15As a licenced and duly qualified physician in the province of Ontario, Dr. Weinberg knows that the tests Dr. Ravindran ordered are cardiac (heart) and/or cardiovascular (heart and blood vessels) tests. Dr. Weinberg takes notice of these facts pursuant to s. 16(b) of the Statutory Powers Procedure Act, R.S.O. 1990, c. S.22 (the “SPPA”).

16We acknowledge that the appellant disagrees with the diagnosis of heart condition and attributes her three episodes of dizziness to the stress associated with recently losing her job. However, we assign less weight to the appellant’s assertions. The appellant has failed to provide any written supporting medical documentation from any treating healthcare provider to confirm that her episodes of dizziness were caused by the stress associated with recently losing her job. As stated above, in the Medical Condition Report, Dr. Persaud mentions that the appellant’s light-headedness began shortly after she lost her job, but Dr. Persaud is silent on whether it is the cause of her episodes. Moreover, Dr. Persaud referred the appellant to internal medicine/cardiology for further investigation of her three episodes of light-headedness.

17We acknowledge that the appellant believes that all of her heart tests to date have come back normal. However, we disagree. The appellant’s Exercise Stress Test has been reported as abnormal, showing the presence of ‘ST elevations’ and that ‘electrically this is a positive stress test’. Review of the actual Stress Test tracings by Dr. Weinberg, shows the presence of ST depressions, which are the hallmark of a positive test. In either event, Dr. Weinberg knows that a ‘positive stress test’ suggests the possible presence of ischemic heart disease (i.e., a heart condition) and is abnormal, not normal, unless further, more advanced, cardiac testing shows otherwise. Dr. Weinberg takes notice of these facts pursuant to s. 16(b) of the SPPA.

18The abnormal Exercise Stress Test, without any more advanced cardiac testing showing the contrary, supports the respondent’s position that a heart condition exists. It is the most compelling report on which we place the heaviest weight.

19Based on the above, we find on a balance of probabilities that the appellant suffers from the medical condition alleged.

Is the appellant’s medical condition likely to significantly interfere with her ability to drive a motor vehicle of the applicable class safely?

20We find that the appellant’s medical condition is likely to significantly interfere with her ability to drive a motor vehicle of the applicable class safely.

21The respondent’s representative stated that a heart condition can interfere with a driver’s ability to drive safely and presents a safety risk to other road safety. They further stated that the respondent has not received the completed MTO Cardiovascular Assessment form, requested by letter dated November 20, 2024.

22The appellant denies that she has a medical condition that is likely to significantly interfere with her ability to drive safely.

23We share the respondent’s concerns regarding the appellant’s ability to drive a motor vehicle safely given the uncertainty and lack of medical documentation which would support reinstatement. The appellant testified that she had no warning signs or symptoms prior to her three episodes of dizziness, which she testified lasted less than one minute each. Dr. Persaud wrote that the episodes of light-headedness had sudden onset and no triggers.

24The appellant appears to be in the early stages of obtaining the necessary tests and assessments in order to clearly define and effectively treat her medical condition. As stated by the appellant at the hearing, Dr. Ravindran was not yet willing to complete the requested MTO form as not all of her test results were back. We find that her medical condition is active and unresolved.

25Furthermore, Dr. Persaud, having taken the appellant’s history of her episodes of dizziness/light-headedness in mid-November 2024, including the history of her recent loss of employment, not only sent the appellant to a specialist for further testing/workup, but also sent a Medical Condition Report to the MTO. This suggests that Dr. Persaud had concerns about the impact of the appellant’s medical condition on her safety to drive.

26Most importantly, there is no evidence before us from any treating healthcare provider supporting the appellant’s ability to drive safely at this time. The Tribunal holds the public interest and safety as paramount and the evidence satisfies us that the appellant’s heart condition poses a significant risk to that consideration.

27Based on the totality of the evidence and submissions before us, we find, on a balance of probabilities, that the appellant has a medical condition, namely a heart condition, which affects her ability to safely operate a motor vehicle safely.

28For these reasons, we agree with the respondent’s position that, on a balance of probabilities, the appellant’s medical condition is likely to significantly interfere with her ability to drive a motor vehicle of the applicable class safely.

Conclusion

29We find that the respondent 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 her ability to drive a motor vehicle of the applicable class 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.