Licence Appeal Tribunal File Number: 16909/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:

Michael Behiels

Appellant

and

Registrar of Motor Vehicles

Respondent

DECISION

ADJUDICATOR: Dr. Isla McPherson, Member

APPEARANCES:

For the Appellant: Michael Behiels, Appellant

For the Respondent: Ian Sookram, Agent

Held by teleconference: May 5, 2025

OVERVIEW

1Michael Behiels (the “appellant”) appeals from the decision of the Registrar of Motor Vehicles (“Registrar”) to suspend his 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 report stating that the appellant suffers from a medical condition that may affect his ability to drive a motor vehicle 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 cognitive impairment, that is 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. He denies that he suffers from cognitive impairment and denies that he suffers from a medical condition which interferes with his 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 his ability to drive a motor vehicle safely.

7To resolve that issue, I will address the following questions:

i. Does the appellant suffer from cognitive impairment?

ii. If so, is this likely to significantly interfere with his ability to drive a motor vehicle of the applicable class 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 his ability to drive a motor vehicle safely and I confirm the Registrar’s decision to suspend the appellant’s driver’s licence.

ROLE CLARIFICATION

10The appellant’s spouse was present at the onset of the hearing. The case conference report did not document that the appellant was calling a witness or bringing a support person, and the role of the appellant’s spouse was discussed.

11It was communicated by the appellant and his spouse that his spouse would be acting as a witness. The role of a witness and its differences with a support person were explained. After a discussion, submissions were taken from the Registrar regarding the appellant’s spouse attending as both a support person and a witness. The Registrar had no objection to the appellant’s spouse attending in both roles.

ANALYSIS

Does the appellant suffer from cognitive impairment?

12The evidence presented at the hearing establishes that the appellant suffers from a medical condition, namely cognitive impairment.

13The Registrar’s position is supported by a Medical Condition Report (MCR) dated February 5, 2025, completed by the appellant’s family physician, Dr. M.

14In the MCR, Dr. M, indicated the appellant suffers from dementia, a disorder resulting in cognitive impairment that affects attention, judgement and problem solving, planning and sequencing, memory, insight, reaction time or visuospatial perception, and results in substantial limitation of the person’s ability to perform activities of daily living. Dr. M added the following narrative comments to the MCR, “Marked abN [abnormal] trails B and MOCA of 12/30 with objective impairment in attention, language and visuospatial functioning”.

15Pursuant to s. 16(b) of the Statutory Powers Procedure Act, I as a physician duly licenced to practice medicine in Ontario take notice that the MoCA is a validated, in-office cognitive screening tool. It measures various cognitive domains including short term memory, visuospatial abilities, executive functions, attention, concentration and working memory, language and orientation to time and place. I further acknowledge that a score of 12/30 is considered abnormal.

16The appellant did not state whether he agrees or disagrees with the alleged medical condition of cognitive impairment. The appellant testified that he has rights under the Canadian Charter of Rights and Freedoms. It appeared to me that the appellant mentioned the Charter in passing, and he did not file a Notice of Constitutional Question alleging an act or omission by the government leading to a breach of any Charter right. Accordingly, I am prohibited from making any decision regarding any alleged breach, pursuant to s. 109 of the Courts of Justice Act.

17The appellant testified that he has to go to another memory assessment and that these tests drag on and nothing gets done. He testified that his wife helps him every day, but specifics were not provided as to how his wife assists him.

18Under cross-examination the appellant was asked if he had been told he had dementia or cognitive impairment by a physician. The appellant responded, “not really” and explained that he has a long, long memory. The appellant testified as to his previous career as a professor. The appellant provided no further testimony disputing the diagnosis of cognitive impairment.

19The appellant’s spouse testified that she had made an appointment with their family physician Dr. M when she had noticed there were concerns with the appellant’s memory. At the time of the appointment, the appellant’s spouse testified that it was not explained to her spouse what the potential consequences of this testing could be, and he did not consent to the testing. She testified her husband thought the purpose of the appointment was to share his memories and not test his memory.

20I acknowledge that Dr. M is bound by Section 203 of the Act and s. 14.1(3)(1) of the Regulation which require every physician in Ontario to report to the Registrar if the physician has determined that a driver appears to have a cognitive impairment.

21The appellant’s spouse testified that the appellant had broken his right humerus earlier in the year and he was right hand dominant. At the time of the testing, he was still recovering from this injury and had a shaky hand which wasn’t taken into consideration. The appellant’s spouse testified that Dr. M advised her after the cognitive testing to reach out to the Alzheimer’s Society. The appellant’s spouse testified that as a retired nurse, she knew that this diagnosis should not be based on a single test. She testified that her husband has been referred to a memory clinic, but the appointment has not taken place yet.

22Under cross-examination, the appellant’s spouse testified that she did not dispute that there were concerns with her husband’s memory, but felt that further testing was indicated before reaching a diagnosis. She was asked when she had first noticed her husband’s memory concerns and reported it was 2020 or 2021.

23The appellant did not produce any medical evidence provided to dispute the diagnosis relied upon by the Registrar.

24The medical evidence before the Tribunal comprises a MCR completed by the appellant’s family physician and an abnormal score on a validated cognitive screening tool that is consistent with a diagnosis of cognitive impairment and therefore supports the Registrar’s position.

25I find the medical evidence in this case relevant and persuasive. Based on the information available, I find that the Registrar has established on a balance of probabilities that the appellant suffers from cognitive impairment.

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

26I 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.

27The Registrar’s position is supported by The Canadian Council of Motor Transport Administrators Medical Standards for Drivers [February 2021] (the “CCMTA Standards”).

28Chapter 6 of the CCMTA Standards describes cognitive impairment, including dementia, and the concerns with driving safely. Research clearly indicates that those with dementia are at higher risk for adverse driving outcomes.

29Specifically, Standard 6.6.1 states that drivers who are diagnosed with cognitive impairment would be eligible for a licence if:

i. Complete medical assessment indicates cognitive functions necessary for driving are not impaired.

ii. Where required, functional driving assessment shows the condition does not affect ability to drive.

iii. Conditions for maintaining a licence are met.

30Section 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 is not bound by them.

31The appellant testified that he loves driving and has driven all over Canada and described several of the locations that he has driven. No further testimony was provided by the appellant that supported his position.

32The appellant’s spouse testified that her husband hasn’t driven in months because of his fractured right arm, but she has no safety concerns with him driving.

33Pursuant to s. 16(b) of the Statutory Powers Procedure Act, I as a physician duly licenced to practice medicine in Ontario take notice that the Trails B test referenced by Dr. M is an in-office cognitive assessment tool used to help identify those with at-risk driving. Dr. M has identified the appellant had a concerning result on the test when she has written “Marked abN [abnormal] trails B”.

34I considered the appellant’s position that the diagnosis of cognitive impairment will not impact his ability to drive safely. However, this is weighed against the scientific research that those with dementia are at higher risk for adverse driving outcomes, as outlined in the CCMTA Standards, and that the appellant has not provided a medical opinion or any evidence that is inconsistent with the medical evidence which supports the Registrar’s position that his condition is likely to significantly interfere with his ability to drive a motor vehicle safely.

35Although this Tribunal is 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. My review of the evidence shows that none of the conditions recommended for relicensing outlined in the CCMTA Standards have been met.

36I acknowledge the burden that the lack of a driver’s licence is having on the appellant. However, the medical evidence is compelling in this case.

37As 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 his ability to drive safely.

Conclusion

38I find that the Registrar has discharged the onus of establishing on a balance of probabilities that the appellant suffers from a medical condition, namely cognitive impairment, and that condition is likely to significantly interfere with his ability to drive a motor vehicle safely.

ORDER

39For 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.