Licence Appeal Tribunal File Number: 16520/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:

Karen Opper

Appellant

and

Registrar of Motor Vehicles

Respondent

DECISION

PANEL:

Dimitri Louvish, M.D., Adjudicator

Avril A. Farlam, Vice-Chair

APPEARANCES:

For the Appellant:

Karen Opper, Self-represented

For the Respondent:

Ian Sookram, Representative

HEARD: December 31, 2024

OVERVIEW

1Karen Opper (the “appellant”) appeals the decision of the 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 a report from her treating physician at a hospital that the appellant suffers from alcohol use disorder. The appellant received a letter dated September 25, 2024 informing her of the suspension of her driver’s licence due to alcohol use disorder. The suspension was confirmed in another letter dated October 25, 2024.

2Section 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 physical condition or disability likely to significantly interfere with his or her ability to safely drive a motor vehicle of the applicable class. Under s. 14(2)(b) of the Regulation, the Minister may require a driver to provide satisfactory evidence that he or she is 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 her ability to drive safely.

4The appellant appeals the suspension under s. 50(1) of the Act. In summary, the appellant in her Notice of Appeal disputes the diagnoses of substance use disorder – alcohol, made by her two treating physicians in September and October, 2024, relies on a letter from a clinic treating her for alcohol use disorder and a letter from her addiction counselor at a hospital. The appellant states that there is “no factual basis” for medical suspension of her driver’s licence. The appellant also denies that her use of alcohol interferes with her ability to drive safely.

5Having considered all the evidence, and for the reasons which follow, we confirm the Registrar’s decision to suspend the appellant’s driver’s licence.

ISSUES

6The issue in dispute is whether the appellant suffers from a medical condition, namely alcohol use disorder, that is likely to significantly interfere with her ability to drive a motor vehicle safely.

7Resolution of that issue requires us to address the following questions:

i. Does the appellant suffer from alcohol use disorder?

ii. If so, is this likely to significantly interfere with her ability to drive a motor vehicle safely?

RESULT

8For 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.

ANALYSIS

The appellant suffers from alcohol use disorder

9We find that the appellant suffers from alcohol use disorder based on the medical evidence presented at the hearing.

10The Registrar’s position is supported by a September 17, 2024 medical condition report from Dr. Veronica Youssef, hospitalist, who treated the appellant at the hospital. Dr. Youssef diagnosed the appellant with substance use disorder - alcohol.

11Dr. Roman Zassoko, the appellant’s family physician, completed a Substance Use Assessment October 18, 2024. Dr. Zassoko diagnosed severe substance use disorder (alcohol).

12The appellant testified that although she has used alcohol in the past, she no longer does so, that the respondent does not have any proof that she has alcohol use disorder, and she does not drink and drive and never has.

13Despite her earlier testimony that she no longer drinks, the appellant later admitted that she last consumed alcohol two weeks before the December 31, 2024 hearing.

14The appellant testified that she is receiving treatment at the Halton & Mississauga Rapid Access Addiction Medicine Clinic (“RAAM”) for alcohol use disorder. The letter from RAAM’s Lana Phemister, physician assistant for Dr. Damji, confirms that the appellant is being followed for treatment of alcohol use disorder, and describes her appointments and treatment. Ms. Phemister reports that “She reports her last alcohol consumption was on September 16, 2024”. This information is no longer reliable given that the appellant testified at the hearing that she consumed alcohol some two weeks before the hearing. However, we do take the RAAM letter to confirm that the appellant is being treated for alcohol use disorder, which is consistent with the diagnoses of Drs. Youssef and Zassoko.

15The appellant submitted an undated letter from Halton Healthcare confirming that she is being treated at the Integrated Addiction Medicine Clinic located at Halton Healthcare, Milton District Hospital and has attended five appointments there, the most recent of which was on December 2, 2024 (“Halton Healthcare letter”). This letter gives no details of treatment, or progress achieved and indicates only that they “look forward to continuing to work with her". The Halton Healthcare letter confirms that the appellant is being treated for addiction although the type of addiction is not specified.

16The appellant’s husband Kenneth Opper testified that he became concerned about the appellant’s alcohol consumption some five years ago. Mr. Opper also testified that despite leading he and his wife to believe that he would change or retract his medical opinion, Dr. Zassoko has not done so.

17We find that the Registrar has established on a balance of probabilities that the appellant suffers from a medical condition, namely alcohol use disorder, based on the medical opinions of Drs. Youssef and Zassoko, the letters from RAAM and Halton Healthcare, the admission of the appellant that she is not abstinent, and the concerns about her consumption of alcohol expressed by Mr. Opper.

The appellant’s medical condition is likely to significantly interfere with her ability to drive safely

18We are satisfied that the appellant’s medical condition is likely to significantly interfere with her ability to drive safely.

19The Registrar relies on the Canadian Council of Motor Transport Administrators Medical Standards for Drivers (the “CCMTA Standards”) and submits that the licence suspension should be confirmed by the Tribunal. The Tribunal may take the CCMTA Standards into consideration, although they are not binding on us.

20The CCMTA Standards, specifically 15.6.3, recommends that a driver with substance use disorder be considered eligible for a licence if they meet the criterial for remission and/or has abstained from the use of alcohol for 12 months. It is recommended that 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, and other criteria, if applicable.

21We are not bound by the CCMTA Standards but here, we have decided to follow them for the following reasons.

22The appellant testified that she consumed alcohol two weeks before the hearing. This on-going consumption of alcohol is at odds with the achievement of abstention from the use of alcohol for 12 months, or any significant period of time. Dr. Zassoko indicated in his report that the appellant has abstained from alcohol for “less than six months”. As at the date of the hearing, based on the appellant’s testimony, this information is no longer accurate. It is now evident that the actual period is two weeks.

23The appellant’s family doctor and treating physician Dr. Zassoko has not expressed support of the appellant’s return to driving a motor vehicle.

24The RAAM Clinic and Halton Healthcare both indicate in their respective letters that the appellant is continuing to undergo treatment and has not yet successfully completed a rehabilitation program. This is consistent with the report of Dr. Zassoko who answered the question “Has the patient recently completed a supervised treatment program…” with “No”.

25Further, although Ms. Phemister states in the November 22, 2024 RAAM letter that “At this time we do not feel that Karen’s licence requires suspension as she continues to be compliant with her treatment recommendations and continues to be motivated to maintain her abstinence from alcohol”, we give little weight to this statement which has proven to no longer be reliable. The appellant’s admission that she consumed alcohol two weeks prior to the hearing establishes that the appellant is no longer motivated to maintain her abstinence.

26Further, the Halton Healthcare letter does not address the appellant’s ability to drive a motor vehicle safely, or recommend re-instatement of her driver’s licence at this time.

27There is no documentation from Dr. Zassoko retracting or amending his diagnosis in his Substance Use Assessment, or opining that he is supportive of her return to driving a motor vehicle at this time, despite the appellant’s suggestion in her Notice of Appeal and Mr. Opper’s testimony that he understood that this would be provided.

28Mr. Opper testified that he is not concerned about the appellant drinking and driving as her drinking is an issue separate from the appellant’s driving, a view also expressed by the appellant in her testimony and submissions. Mr. Opper testified that her drinking has never affected her driving and she has never been involved in an incident of drinking and driving.

29We find that the evidence, viewed in totality, does not support this contention. The appellant’s physicians are in a better position to assess her ability to operate a motor vehicle safely, given her alcohol use disorder, than she or her husband are due to her physicians’ medical education, training and experience. The fact that the appellant does not have any drinking and driving incident on her driving record to date is not evidence that her alcohol use disorder is unlikely to affect her ability to safely operate a motor vehicle, just that it has not done so to date.

30For the above reasons, we are satisfied that the appellant’s medical condition is likely to significantly interfere with her ability to drive safely.

Conclusion

31We find that the appellant suffers from a medical condition, namely alcohol use disorder, that is likely to significantly interfere with her ability to drive a motor vehicle safely.

ORDER

32For 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.