Licence Appeal Tribunal File Number: 17056/MED

In the 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:

Byron Downing

Appellant

and

Registrar of Motor Vehicles

Respondent

DECISION

ADJUDICATOR:

Dr. Kailey Minnings, Member Bernard Trottier, Member

For the Appellant:

Byron Downing

For the Respondent:

Ian Sookram

HEARD: May 30, 2025

1Byron Downing (the “appellant”) appeals from the decision of the Registrar of Motor Vehicles (the “Registrar”) to suspend their 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 a treating health care provider that the appellant suffers from a medical condition that may affect his 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 epilepsy with medication change, 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 acknowledges that he suffers from epilepsy and underwent a medication change, but he 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 their ability to drive a motor vehicle safely.

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

i. Does the appellant suffer from epilepsy with medication change?

ii. If so, is this likely to significantly interfere with his 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, we find that the Registrar has not 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 we set aside the Registrar’s decision to suspend the appellant’s driver’s licence.

ANALYSIS

Background

10The appellant works as an avionics technician. In March of 2025, his work required him to test and monitor electrical systems, which he described as a series of cognitively complex tasks performed within the cockpit of an aircraft. During this testing, there were also workers present in the cockpit doing welding and other loud structural work within the confined space. The appellant’s job involved reading off measurements and calculations and sending and receiving verbal communications via a headset. The appellant submitted that in this environment, on two occasions, he experienced episodes where he had difficulty reading out the measurements. The episodes lasted 10-15 seconds each and then fully resolved. There was no altered consciousness, no motor involvement or deficits, and no post-ictal symptoms – that is, he returned to his baseline function immediately. The appellant testified that despite these episodes, he was still able to successfully perform the cognitive tasks required of him and there were no resulting performance or safety concerns.

11The appellant testified that on April 8, 2025, he had an appointment with his neurologist, Dr. Reshmi Roy, to discuss these episodes and to request a note for work accommodations, as he wished to avoid the avionics work environment and return to his previous job duties in electrical assembly.

12On April 8, 2025, Dr. Roy faxed a Medical Condition Report (“MCR”) to the Registrar indicating that the appellant “has had auras consisting of speech difficulties, but no loss of function or awareness. I support the maintenance of his license as there seemed to be clear provoking factors. I am however increasing the dose of his lamotrigine to 150mg PO BID [by mouth twice daily].” The form also indicates that the appellant has epilepsy, that he last had a generalized seizure on June 15th, 2024, and that he had been stable on lamotrigine 125mg PO BID.

13In response to the MCR, the Registrar sent the appellant a letter on April 10, 2025 indicating that his driver’s licence was suspended due to epilepsy with medication change. The Registrar requested that the applicant take this letter to his treating specialist to provide more information.

14Dr. Roy wrote a narrative letter, undated, which was faxed to the Registrar on April 17, 2025. In the letter, Dr. Roy writes that the appellant had two focal aware seizures in March which were provoked by very loud noises at work. Dr. Roy writes that these episodes did not result in loss of awareness, or consciousness, or reaction time, and that “during these episodes he cannot speak but has no motor compromise”. Dr. Roy further indicated that the appellant has increased his antiseizure medication dose, that the appellant is compliant with his medications, and that they have arranged an EEG.

15On April 30, 2025, a letter was sent from the Registrar to the appellant indicating that his licence was suspended due to seizure. However, an amended letter was subsequently sent on May 16, 2025, indicating that the licence was suspended due to epilepsy with medication change, and that the appellant should disregard the April 30, 2025 letter. During the hearing, the respondent’s representative confirmed that the appellant’s licence is not suspended due to the medical condition of seizure, but rather, due to epilepsy with medication change.

16On April 30, 2025, Dr. Roy completed and signed a Seizures and Loss of Consciousness (“SLOC”) form. On the form, Dr. Roy indicates that the appellant has epilepsy with medication change and has been seizure-free for less than three months. Dr. Roy writes, “In March 2025 [he] experienced two focal aware seizures which were likely provoked by an extreme environment and sounds (working in avionics was in cockpit under extreme sounds during an equipment test). Following this, dose of lamotrigine was increased to 150mg PO BID. He has had no seizures since then. Dose increase was prescribed on April 8th. He will change jobs so he does not risk the same exposure to that environment. I would support the reinstatement of his licence.”

17The appellant underwent an EEG on May 23, 2025, which was normal, and submitted the report to the Registrar.

18On May 27, 2025, the Registrar sent a letter to the appellant indicating that the appellant’s driver’s licence remains suspended due to epilepsy with medication change, and that in order to be considered for reinstatement, the appellant was required to submit confirmation that he has remained seizure-free for a period of three months since the change in medication.

Does the appellant suffer from epilepsy with medication change?

19The evidence presented at the hearing establishes that the appellant suffers from a medical condition, namely epilepsy with medication change.

20The Registrar’s position is supported by medical reports completed by Dr. Roy, including the April 8, 2025, MCR, the undated narrative letter, and the April 30, 2025 SLOC form described above. These reports indicate that the appellant has epilepsy and that the dose of his antiseizure medication, lamotrigine, was increased on April 8, 2025.

21The appellant was forthcoming during his testimony that he has a diagnosis of epilepsy. He testified that his last generalized seizure was on June 15, 2024, and it occurred in the context of switching from one antiseizure medication, Dilantin (phenytoin), to lamotrigine. At that time, Dilantin had to be slowly decreased while lamotrigine was added. This switch was made under the direction of his neurologist.

22The appellant testified that he had been on lamotrigine, 125 mg twice daily since June 2024, and that the dose was increased by Dr. Roy on April 8, 2025.

23We find that the Registrar has established on a balance of probabilities that the appellant suffers from epilepsy with medication change.

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

24We find that the Registrar has not 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.

25The Registrar argues that epilepsy with medication change interferes with the appellant’s ability to drive safely in that medication changes may pose a risk of seizure. With seizure, there is a risk of loss of consciousness or sudden impairment in the functions necessary for driving which cannot be compensated for.

26The Registrar relies on the Canadian Council of Motor Transport Administrators Medical Standards for Drivers, February 2021 (the “CCMTA Standards”), specifically Chapter 17.6.11, which lays out the standard for epilepsy with medication change for non-commercial drivers. The standard states that non-commercial drivers are eligible for a licence if it has been 3 months since the change, they have not had a seizure during this time, and that the conditions for maintaining a licence are met. Those conditions are that the driver routinely follows treatment regime and physician’s advice regarding prevention of seizures, and that the driver cease driving and report to the authority and their physician if they have a seizure. This standard applies to non-commercial drivers who undergo a prescribed change to an effective antiepileptic medication, and it only applies where the driver’s treatment was effective (i.e., their epilepsy was controlled) prior to the change to medication.

27Section 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.

28The appellant argues that the increased dose of lamotrigine does not impact his ability to drive safely. The appellant points to clinical follow-up notes from Dr. Roy, dated April 25, 2025, to support his position that his condition is stable. In the note, Dr. Roy indicates that this visit was “in follow up for recent breakthrough seizures and to ensure stable as we are increasing dose of lamotrigine.” Dr. Roy writes that the appellant has been stable from a seizure perspective. There is a normal physical exam documented. In their impression/plan, Dr. Roy writes “stable epilepsy with both generalized and coal aware seizures. No seizures since earlier in March… will continue the dose of 150mg PO twice daily of lamotrigine”.

29Additionally, the appellant points to the April 20, 2025, SLOC form, on which his neurologist wrote, “I would support the reinstatement of his licence”. He also points to his EEG on May 23, 2025, which is reported as normal to support his position that his epilepsy is well controlled.

30The appellant testified that he is fully adherent to his medication. He uses a dosette and sets a reminder to ensure he does not miss any doses.

31While we find the CCMTA Standards reasonable, every case must be considered on its own merits.

32We find that the Registrar has not provided evidence to support how or why an increase in his antiseizure medication dose would affect his safety to drive. We note that his last generalized tonic-clonic seizure occurred in June of 2024 and that he has not had any recurrence of generalized seizures since being on lamotrigine. We find that it is unlikely that an increased dose of an effective anti-seizure medication would cause an increased risk of seizures or sudden incapacitation. We note too that at the time of the hearing, the appellant has been on the increased dose of lamotrigine for seven weeks. During that time, he had a follow up appointment with his neurologist, and the stability of his condition is documented in the clinical note. There is no indication of any adverse effects resulting from the medication change. Importantly, his neurologist is supportive of his return to driving.

33We are not satisfied on a balance of probabilities that the appellant’s medical condition is likely to significantly interfere with his ability to drive safely.

Conclusion

34We find that the Registrar has not met its onus of establishing on a balance of probabilities that the appellant suffers from a medical condition, namely epilepsy with medication change, that is likely to significantly interfere with his ability to drive a motor vehicle safely.

ORDER

35For the reasons set out above, pursuant to subsection 50(2) of the Act, we set aside the Registrar’s decision to suspend the appellant’s driver’s licence.

Released: June 18, 2025

__________________________

Kailey Minnings

Adjudicator