Licence Appeal Tribunal File Number: 17117/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:

Saakithyan Kiritharan

Appellant

and

Registrar of Motor Vehicles

Respondent

DECISION

ADJUDICATOR: Dr. Isla McPherson, Member

APPEARANCES:

For the Appellant: Did Not Attend

For the Respondent: Stephen Grootenboer, Agent

Held by teleconference: June 18, 2025

OVERVIEW

1Saakithyan Kiritharan (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 Condition Report stating that the appellant suffers from two medical conditions 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 Registrar 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 two medical condition, namely a mental health condition and substance use disorder, that are 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. In the appellant’s Notice of Appeal (NOA), he does not deny that he has mental health condition but does state that he has been abstinent from cannabis, suggesting he disagrees that he has a substance use disorder. He denies that either of these conditions 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 a medical condition?

a. Does the appellant suffer from a mental health condition?

b. Does the appellant suffer from substance use disorder?

ii. If so, are either of these conditions 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 i and ii is “yes.” The Registrar does not need to prove that both medical conditions exist; proving that one of the conditions exists and is likely to significantly interfere with safe driving will be sufficient to meet the Registrar’s burden.

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 both from a mental health condition and substance use disorder and that they are both 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.

PRELIMINARY ISSUE: Appellant did not attend the hearing June 18, 2025

10The appellant did not appear at the onset of the hearing. The Tribunal reached out to the appellant by phone and left a message.

11The Tribunal had previously issued a revised Notice of Hearing to the appellant’s email address on file on June 3, 2025. This Notice communicated the date and time of the hearing and the call-in information.

12Neither the appellant nor anyone on the appellant’s behalf reached out to the Tribunal to notify of his absence or request an adjournment.

13After thirty minutes elapsed without communication from the appellant, I took submissions from the Registrar. The Registrar submitted their position to continue with the hearing in the absence of the appellant.

14Section 7(3) of the Statutory Powers Procedure Act (“SPPA”), states that, where notice of an electronic hearing has been given to a party in a proceeding and the party does not attend the hearing and has not sought a change of hearing format under s. 6(5)(c), the Tribunal may proceed in the absence of the party and the party is not entitled to any further notice in the proceeding. Further, Rule 3.7.1 of the Licence Appeal Tribunal Rules, 2023 (“Rules”) states that if a party, who has been given notice of a hearing in accordance with the SPPA, does not attend their hearing within thirty minutes of the scheduled start time, the Tribunal may proceed with the hearing in the absence of that party and/or make any order it considers appropriate under the circumstances.

15In addition to not attending the hearing, the appellant did not attend the scheduled case conference on May 30, 2025, nor did the appellant respond to the Registrar’s request for an adjournment of the original hearing date.

16I considered the appellant’s pattern of non-response regarding his appeal over several weeks along with the Registrar’s submissions to continue with the hearing in the appellant’s absence. I therefore decided to proceed with the hearing without the appellant’s present in accordance with the discretion afforded by s. 7(3) of the SPPA and Rule 3.7.1 of the Rules.

17Although the appellant did not attend this hearing, I considered the information in his NOA and accompanying documents as they contain his position.

PRELIMINARY ISSUE: Late submission from the Appellant

18While entering exhibits, the Registrar stated they had not received the narrative letter from psychiatrist Dr. C dated April 8, 2025, that was submitted to the Licence Appeal Tribunal as part of the appellant’s Notice of Appeal (NOA) package.

19I verbally read the letter to the Registrar and took their submissions regarding entering the letter from Dr. C as a late submission.

20The Registrar had no objection to Dr. C’s letter being accepted as a late submission and I admitted the letter into evidence.

ANALYSIS

Does the appellant suffer from a mental health condition?

21The evidence presented at the hearing establishes that the appellant suffers from a mental health condition.

22The Registrar’s position is supported by:

i. a Medical Condition Report (MCR) dated, March 12, 2024, from Emergency Room physician, Dr. Z;

ii. a narrative letter dated April 8, 2025, from psychiatrist Dr. C.

23Dr. Z checked the box on the MCR indicating that the appellant suffers from a psychiatric condition and added in the comments, “Acute mania with psychotic features”.

24Following the receipt of the MCR, the Registrar suspended the appellant’s driver’s licence due to a mental health condition and requested the completion of a Mental Health Assessment Form. The Registrar then issued an amended letter ten days letter indicating the appellant’s driver’s licence was also suspended due to a substance use disorder and additionally requested the completion of a Substance Use Assessment Form.

25The appellant submitted a narrative letter from psychiatrist Dr. C as part of their NOA. The letter was addressed to the Crown Attorney and referenced a criminal charge on February 11, 2025. The letter reported the appellant was admitted to the Centre for Addiction and Mental Health (CAMH) on March 16, 2025, for psychosis and cannabis use disorder. He was still in hospital under Dr. C’s care at the time of the letter dated April 8, 2025.

26In the NOA, the appellant wrote that he was admitted to Trillium Health Partners Hospital (Trillium), March 9 – 14, 2025 for cannabis-induced psychosis. In his NOA, he states that he was recommended treatment with Aripiprazole, but he declined the medication due to concerns about side effects, and was discharged with a provisional diagnosis of bipolar disorder. His letter further narrates that on March 16, 2025, he was admitted to CAMH for treatment of psychosis and cannabis use disorder where he remained an inpatient for 40 days. During this time, he reported he started treatment with Aripiprazole.

27All medical evidence submitted by both the Registrar and the appellant supports the diagnosis of a mental health condition, and the appellant’s NOA does not dispute that he has a mental health condition. I find the Registrar has proven on a balance of probabilities that the appellant has a mental health condition.

Does the appellant suffer from a substance use disorder?

28The evidence presented at the hearing establishes that the appellant suffers from a substance use disorder.

29The Registrar’s position is supported again by:

i. the Medical Condition Report (MCR) dated, March 12, 2024, from Emergency Room physician, Dr. Z;

ii. the narrative letter dated April 8, 2025, from psychiatrist Dr. C.

30On the MCR, Dr. Z has also indicated that the appellant suffers from a diagnosis of an uncontrolled substance use disorder and written that the substance is cannabis.

31As mentioned, Dr. C’s narrative letter reported that the appellant was admitted to CAMH for cannabis use disorder in addition to psychosis.

32The appellant’s NOA reports that after suffering from cannabis-induced psychosis resulting in a hospital admission from March 9 – 14, 2025, he continued to use cannabis following his hospital discharge, with his last reported use of the substance on March 16, 2025. He additionally reports that he now understands the impact using cannabis has had on his health and his family and he is committed to staying sober.

33The medical evidence before the Tribunal comprises two medical forms completed by two physicians that confirm a substance use disorder. The appellant has not clearly stated in the NOA whether he disputes this diagnosis, but has submitted no medical evidence inconsistent with the medical evidence. Based on the submitted evidence, I find that the Registrar has established on a balance of probabilities that the appellant suffers from a substance use disorder.

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

34I 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.

35The Registrar’s position is supported by:

i. The Canadian Council of Motor Transport Administrators Medical Standards for Drivers [February 2021] (the “CCMTA Standards”).

36The Registrar relies on the CCMTA Standards Chapter 14. This Chapter documents that psychiatric disorders can result in either a persistent or episodic impairment of the functions necessary for driving and highlights that a driver’s level of insight is a critical consideration when assessing the risk of an episodic impairment of functional ability due to a psychiatric disorder.

37The Registrar relies on Standard 14.6.1. This Standard indicates a driver is eligible for a licence if the condition is stable, the driver has sufficient insight to stop driving if the condition becomes acute, the functional abilities necessary for driving are not impaired, and a treating physician supports a return to driving. In addition to this Standard, the Registrar relies on their internal policies when they require confirmation of six months of mental and emotional stability before considering reinstatement of the appellant’s driver’s licence. The Registrar highlights in the appellant’s case that he has required two hospitalizations in the past three months for his mental health condition.

38The Registrar stated that the decision to suspend the appellant’s driver’s licence and request further medical information is reasonable and supported by the law, and until further medical information is received, on the balance of probabilities, the appellant’s mental health condition is likely to interfere with his ability to drive a motor vehicle safely.

39Section 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.

40The appellant’s NOA documents that during his admission to CAMH he was fully cooperative with his treatment plan, taking Aripiprazole, and his mental health condition has significantly improved. He writes that since his discharge from CAMH he has remained well, returned to work, returned to social activities, and has a stable daily routine. He further writes that he continues to take his prescribed medication Paliperidone. It is not clear whether he is on both anti-psychotic medications, Aripiprazole and Paliperidone or if one was discontinued and the other started.

41The appellant further documents that his psychiatrist told him his licence is suspended for six months because of the two different hospital admissions, and he argues that this is excessive as he was only at Trillium for five days and did not receive treatment. He further describes the hardships that losing his licence has had on his family, as he is unable to assist with errands and responsibilities at home to support his parents, and not able to be a dependable source of income for his family. He requests that if a full reinstatement of his licence is not possible, then the suspension be shortened based on his recovery. He concludes that he is committed to maintaining his health and fulfilling all medical and legal obligations moving forward.

42I appreciate the appellant’s position that his mental health condition has significantly improved, but he has not submitted any medical evidence that documents his recovery or his medical stability. As the appellant did not attend the hearing, I have no testimony to support his position and no opportunity for cross-examination. I also acknowledge that the Registrar has not suspended his licence for six months, but instead has requested further information in the form a completed Mental Health Assessment Form. The appellant did not describe in his NOA why he did not complete the requested form, nor submit any medical evidence to support his position.

43I appreciate that the appellant reports that his psychotic episode was treated with medication, and he is now under care of a psychiatrist. However, I also take note that psychotic episodes due to psychiatric illness may be the most urgent psychiatric situation regarding fitness to drive and an acute psychotic episode is incompatible with safe driving. I considered this with the appellant’s insight into his diagnosis of bipolar disorder. Insight is an important consideration when considering safety to drive. Insight means that a driver is aware of their medical condition, understands how the condition may impair their functional ability to drive and has the judgment and willingness to comply with a suggested treatment regimen. I am concerned that the appellant indicated in his NOA that he refused treatment during his five-day admission to hospital March 9 – 14, 2025 and then following discharge continued to use cannabis which was described as the precipitant of his psychotic episode. I appreciate that he indicated his intention to fulfill his medical obligations, but in the absence of his testimony or any medical evidence, I do not give weight to his intentions. Given that the appellant has not adhered to medical recommendations in the past, I find that medical evidence to support his adherence to medical treatments is important in this case yet lacking.

44What the CCMTA Standards highlight prior to considering reinstatement is a period of stability. I appreciate that there is no medical evidence from a healthcare practitioner documenting any disease stability. I further note that the appellant’s NOA has indicated he references taking two different anti-psychotics. There is no information as to whether he was switched from one to the other, why this might have happened or how long he may have been taking the new anti-psychotic medication. I consider the lack of information or medical evidence regarding the length of time he has been stable on the current medication regimen to be important in this case.

45I appreciate the hardships that the appellant is undergoing with the loss of his driver’s licence but given the medical evidence and the individual merits of this case, I find that a confirmed period of disease stability is reasonable and prudent for road safety given the risks associated with driving during a psychotic episode.

46Although 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.

47As 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.

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

48I find that the Registrar has proven on a balance of probabilities that the appellant’s substance use disorder is likely to significantly interfere with his ability to drive a motor vehicle safely.

49In addition to the MCR submitted by Dr. Z, the Registrar’s position is also supported by the CCMTA Standards.

50Within 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.

51Specifically 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.

52As mentioned before, section 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.

53The Registrar stated that it has not received any medical information to show that the medical condition has resolved or improved to the point that it would not affect the appellant’s ability to drive safely. 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 his ability to drive safely.

54The appellant’s NOA indicates that he has not used cannabis since March 16, 2025, and his intentions are to remain sober. There is no further information provided in the NOA to support the appellant’s position. Specifically, there is no reference to attending any treatment program, nor any medical evidence to support a period of abstinence, and no support for reinstating driving privileges by a healthcare provider.

55I also appreciate that substance use disorders are chronic relapsing disorders that often require long term interventions to prevent relapse. For these reasons, I agree with the CCMTA Standards that requires a treatment program be completed to consider early reinstatement, and there is no information provided that documents attendance at any treatment program.

56Although 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.

57As 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

58I find that the Registrar has discharged the onus of establishing on a balance of probabilities that the appellant suffers from both medical conditions, namely a mental health condition and substance use disorder, and that each of these conditions is likely to significantly interfere with his ability to drive a motor vehicle safely.

ORDER

59For 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: June 26, 2025

__________________________

Isla McPherson MD