Licence Appeal Tribunal File Number: 18084/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:

Josep Perez De Arce

Appellant

and

Registrar of Motor Vehicles

Respondent

DECISION

ADJUDICATOR: Dr. Isla McPherson, Member

APPEARANCES:

For the Appellant: Angelique Cordina, Representative

For the Appellant: Josep Perez De Arce, Appellant

For the Respondent: Stephen Grootenboer, Agent

Held by teleconference: January 21, 2026

OVERVIEW

1Josep Perez De Arce (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.

6The Open Court Principle was reviewed at the outset of the hearing.

ISSUES

7The 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.

8To 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 safely?

9The Registrar bears the burden of proving on a balance of probabilities that the answer to each of the above questions is “yes.”

PRELIMINARY MATTERS

10There were two issues discussed as preliminary matters:

i. The multiple roles of the appellant’s representative.

ii. The appellant’s late submissions.

11The appellant’s representative indicated she intended to act as a witness and an interpreter in addition to being the appellant’s representative. She stated that the appellant would not be testifying himself, and that she was representing him as a family relation who resides with the appellant, and this had been reviewed at the case conference. She planned to testify on the events that occurred at the appellant’s medical appointments that she had attended.

12The Registrar submitted that he had a different understanding of the representative’s anticipated roles following the case conference but, nonetheless, had no objection to the appellant’s representative acting as an interpreter and a witness. The Tribunal accepted the appellant’s representative would additionally act as a witness and an interpreter.

13It was discussed that the appellant’s representative had submitted over 200 pages of documentation the day prior to the hearing which was after the disclosure date. The appellant’s representative explained that the materials submitted were to assist in understanding the proposed argument and the appellant’s position, but did not include new medical documentation regarding the appellant’s alleged medical condition.

14The Registrar’s position on the late submission was sought. The Registrar submitted that given the contents of the submissions comprising case law and a blank Montreal Cognitive Assessment (“MoCA”), they had no objection to the late submissions. The Tribunal accepted the appellant’s late submissions.

RESULT

15Having 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.

ANALYSIS

Does the appellant suffer from cognitive impairment?

16The evidence presented at the hearing establishes that the appellant suffers from a medical condition, namely cognitive impairment.

17The Registrar’s position is supported by:

i. a Medical Condition Report (“MCR”) completed by geriatrician, Dr. G, dated October 30, 2025, and

ii. a Functional Driving Assessment completed on December 3, 2025.

18The MCR supports the Registrar’s position that the appellant suffers from cognitive impairment. Dr. G checked the box on the MCR indicating the appellant suffers from 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 due to dementia. Dr. G added the narrative comments on the form, “Not to drive unless he goes for on road test”.

19The Registrar responded to the MCR by suspending the appellant’s driver’s licence and communicating to the appellant that in order to determine if they could safely operate a vehicle, they were required to complete a Functional Driving Assessment from an approved centre.

20At the hearing, the Registrar addressed results of the Functional Driving Assessment completed December 3, 2025. The Registrar commented the Assessment record documented that the appellant denied having any medical issues and felt suitable to drive at the time of the assessment; the appellant scored 12/20 on the Road Sign Quiz which was in the fail range, and the appellant scored 23/30 on the MoCA which was also in the fail range.

21The appellant’s representative questioned the Registrar as to whether there were any screenings or testing that was undertaken by Dr. G. The Registrar responded that there was no specific indication as to what was done to make the diagnosis of dementia, but they trust the physician undertook appropriate testing. The Registrar was questioned as to whether there was an indication of Dr. G’s history with the appellant. The Registrar responded that they did not know how long the appellant had been a patient of Dr. G’s.

22The appellant’s representative stated the appellant’s position is that he does not have cognitive impairment. The appellant’s representative testified that the appellant’s medical practitioner of many years passed away, so she sought out a physician to provide a general check-up of the appellant and booked an appointment with Dr. K, a family physician. The appellant’s representative testified that the appellant saw Dr. K who ordered bloodwork, a CT scan and referred the appellant to a geriatrician. She testified there were no concerns with the bloodwork, and the CT scan was done with the purpose of determining neurological factors in a cognitive assessment and the CT scan indicated there were no concerns found.

23She testified that at the appointment with geriatrician Dr. G, she was told they would be asking the appellant some questions, but she was not told the purpose of the questioning or whether the appellant would have a MoCA test or that the purpose of a MoCA test was to evaluate cognitive functioning. She testified she was asked to wait outside the room while the appellant was examined. Following the testing, she was called into the room and told there were issues regarding the appellant’s memory and she was shown a form, which subsequently through her research she understood to be a MoCA Standard Form.

24The appellant’s NOA argues that he was not informed that cognitive testing would be completed at the appointment with Dr G, nor that the results would be forwarded to the Ministry of Transportation, and informed consent was not obtained. The appellant’s NOA indicated that this lack of informed consent and privacy is procedurally unfair and a breach of Section 39(1) of the Personal Health Information Protection Act, 2004 (“PHIPA”).

25The appellant’s representative testified that following the appointment with Dr. G, the suspension letter from the Registrar was received indicated a Functional Driving Assessment was required, and this was completed December 3, 2025. She testified the appellant had a score of 23/30 on the MoCA administered by the occupational therapist (“OT”), who indicated the appellant showed signs of cognitive impairment on the testing.

26The appellant’s representative testified she was present during the MoCA administered by the OT and was able to provide translation services for the instructions provided during the test, but not the exact words the appellant was asked to remember. She recalls asking the OT to speak more loudly several times. She also recalls that the OT was speaking very quickly, and testified she thought this was too quick even for someone who was not hearing impaired. She testified that she had been told by the OT that she was accredited or certified to administer the MoCA test.

27The appellant’s representative argued that the appellant is not fluent in English, and this would have had a bearing on his MoCA scores. She testified she was asked to sit outside of the examination room at Dr. G’s appointment and therefore unable to assist with interpretation. She further testified that the appellant has documented hearing impairment, supported by an audiogram dated December 22, 2025, and submitted as evidence, and at the time of the cognitive testing did not have access to an interpreter or a hearing aid. The appellant’s representative submitted that as a result of the language barrier and hearing impairment, the results of the cognitive testing are discriminatory, unreliable and inadmissible. The appellant’s representative argued that the standard version of the MoCA test is not designed for those with hearing impairment, and there is an adapted version to accommodate those with hearing impairment, and a blank copy of this version was submitted as evidence.

28The appellant’s NOA documents the appellant relies on the Accessible Canada Act (“ACA”), which is designed to identify, remove and prevent barriers to accessibility for people with disabilities, including those who are deaf or hard of hearing. It is argued in the NOA that that MCR and Functional Driving Assessment are inadmissible and constitute a violation of equality rights.

29Under cross-examination the Registrar asked the appellant’s representative whether she was a medical expert or qualified in the field of cognitive impairment, and she responded she is not. She was asked why there was a referral to the geriatrician, and she responded that she thought it was an appointment for seniors, and she had possibly made the suggestion to Dr. K that her mother had seen a geriatrician and that these doctors were specialists for those over the age of 80 years. She was questioned whether the appellant was having any symptoms at the time, and she responded no, but she has since become aware of a hearing issue.

30The Registrar further questioned whether she was in the room when the MoCA was administer in Dr. G’s office, and she indicated no. She was questioned as to how and what version of the MoCA test was administered, and she indicated she did not know exactly what was done, and had no proof of what language or version but presumed it was done in English because Dr. G was not Spanish speaking. She responded that according to her research, she believes it was the standard version of the MoCA. She was asked if she had a copy of the MoCA, and she responded she did not.

31The Registrar further questioned whether she agreed that a CT scan of the head does not test for decline or memory. The appellant’s representative disagreed, and that if someone is diagnosed with memory loss it could be affected. The Registrar further questioned whether a CT scan of the head tests for a decline in memory and the appellant’s representative responded she could not say from a medical perspective.

32The Registrar questioned that if the concern regarding the cognitive test results were as a result of hearing impairment, why would the appellant do so poorly on the Road Sign Quiz, a visual test, with a fail result of 12/20. The appellant’s representative responded that this result has to do to with his knowledge of what road signs are, which maybe the appellant’s knowledge of is not great.

33The appellant’s representative was questioned as to whether the appellant had taken an adapted version of the MoCA to accommodate his hearing loss or language barrier, and the appellant’s representative responded he had not. She was questioned whether this had been considered, and it was reported this had not been pursued.

34I first deal with the appellant’s allegations of a breach of s. 39(1) of PHIPA in the context of a driver’s licence suspension ordered by the Registrar, for medical reasons.

35I find that s. 39(1) of the PHIPA is not relevant to the disclosure of personal health information to the Registrar of Motor Vehicles for driver’s licensing purposes; rather, s. 39(1) of PHIPA outlines the disclosure by a “health information custodian” of personal health information for health or other programs such as a person’s eligibility to receive health care.

36Instead, and although not raised by the appellant, I take notice that s. 29(b) of PHIPA authorizes a health information custodian to disclose the person’s personal health information without their consent if “permitted or required” by the PHIPA. Section 43(1)(h) of PHIPA authorizes the disclosure of a person’s personal health information “if permitted or required by law,” and s. 43(2) of PHIPA permits the disclosure of a person’s personal health information if another law exempts the personal health information from being confidential or secret.

37This brings me to the present context. I take notice that physicians have a statutory duty under s. 203 of the Act to report to the Registrar of Motor Vehicles any patient aged 16 years or older who, in their opinion, suffers from a medical condition that may make it dangerous for the person to operate a motor vehicle. Section 14.1(1) and 14.1(3) of Ontario Regulation 340/94 under the Act required Dr. G. to report to the Registrar any person with a cognitive impairment that affects attention, judgment and problem solving, planning and sequencing, memory, insight, reaction time or visuo-spatial perception, and results in substantial limitation of the person’s ability to perform activities of daily living. Even if I were to consider that Dr. G’s report was discretionary, s. 203(3) of the Act relieves Dr. G of their duty of confidentiality. Accordingly, whether mandatory or discretionary, when I consider s. 203 of the Act, I am satisfied that ss. 29(b), 43(1)(h) and 43(2) of PHIPA properly authorized Dr. G’s disclosure of the appellant’s results to the Registrar. I therefore disagree the appellant’s PHIPA argument.

38In terms of the ACA, I find that it is also not relevant to the case before me. While the ACA promotes the removal of barriers to accessibility for people living with disabilities such as being hard of hearing, the appellant does not argue how the ACA invalidates the results of either the MoCA or the functional tests conducted on the appellant.

39In review of the extensive documentation submitted by the appellant in support of his position, it is evident that the appellant relies on academic literature and legal authorities to argue that standard verbally administered cognitive screening tools, including the MoCA, may underestimate ability in individuals with hearing impairment or language barriers, and that failure to provide appropriate accommodation may render such testing unreliable or discriminatory. The materials submitted emphasize that auditory-based testing can be affected by unaddressed sensory impairment, that accommodations such amplification or adapted test formats maybe required in some contexts, and that courts have scrutinized cognitive testing where accessibility concerns were not considered.

40I accept that hearing impairment and language barriers can affect performance on verbally administered cognitive screening tools if appropriate accommodations are not provided. However, the materials filed by the appellant are general in nature and do not constitute expert evidence addressing the validity of the appellant’s own assessment. There is no medical or expert opinion before the Tribunal establishing that the testing conducted in this case was invalid, improperly administered, or discriminatory in its application to the appellant. Nor is there evidence that the diagnosis of dementia was based solely on an unaccommodated screening score.

41There is similarly no evidence before the Tribunal regarding the specific circumstances of Dr. G’s assessment, including what accommodations, if any, were provided or how the clinical findings were interpreted. The appellant did not testify about the assessment, and his representative was not present during the cognitive evaluation in Dr. G’s office. Given these circumstances, I am not prepared to infer that the assessment was conducted without regard to the appellant’s hearing or language considerations. As a geriatrician, Dr. G will have specialized training in cognitive disorders and would reasonably be expected to understand the potential impact of sensory or language barriers on testing and to interpret any screening results within an appropriate context. Furthermore, a diagnosis of dementia is not made on the basis of a single screening instrument such as the MoCA alone, but on clinical judgment informed by a broader assessment.

42The medical record further demonstrates that concerns regarding the appellant’s cognition predated the geriatric assessment. Approximately six months earlier, Dr. K, the appellant’s family physician and the referring physician, ordered a CT scan of the appellant’s head with the stated indication of, “cognitive function decline, reduced memory”. This documentation strongly suggests that cognitive concerns were identified prior to the referral to the geriatrician. Furthermore, there is no medical opinion before the Tribunal contradicting or questioning the diagnosis made by Dr. G.

43With respect to the MoCA administered during the functional driving assessment, the appellant’s representative testified that she was present, provided translation assistance, and requested the OT speak loudly to accommodate the appellant’s hearing impairment. She further testified that the OT had received training to administer the MoCA. This evidence indicates, that in that setting, the appellant’s hearing and language concerns were recognized, and that the test was administered by a qualified healthcare provider.

44In the absence of competing medical evidence, and considering the longitudinal documentation of cognitive concerns, the specialist qualifications of the diagnosing physician, and the principle that dementia is diagnosed through clinical judgment informed by multiple sources rather than a single cognitive screening score, I assign significant weight to Dr. G’s opinion. On the balance of probabilities, I find that the Registrar has established 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?

45I 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.

46The Registrar’s position is supported by:

i. The Functional Driving Assessment completed December 3, 2025, and

ii. The Canadian Council of Motor Transport Administrators Medical Standards for Drivers [2025] (the “CCMTA Standards”).

47The Registrar relied on the Functional Driving Assessment that concluded the appellant was “not fit to drive based on his medical condition”. The Registrar commented that in addition to the failed scores on the Road Sign Quiz and MoCA test, the on-road assessment recorded the appellant “lacked awareness - left signal on, slow to execute maneuvers”. The appellant did not use compensatory strategies, “No blind spot checks or scanning, does not leave a safe gap”. The OT’s on road score was 27/39 and comments included, “Slow Turns, forgets instructions, difft’y [difficulty] deciphering street”. The driving instructor’s on-road score was 14/33 noting the appellant “lacks awareness, dangerous action”. The result was that the appellant was determined to have deficits in functional driving skills and driving was not recommended. Additional comments provided were that the appellant, “is not fit to drive based on his medical condition…He lacks insight into his condition. He lacked spatial awareness, observation skills and overall memory and judgment. He drove 20 km/hr below the speed limit and he confused instructions turning left when he should have turned right. He does not meet MTO standards”.

48The Registrar stated their position is further supported by the Canadian Council of Motor Transport Administrators (“CCMTA Standards”). The CCMTA Standards are written by physicians and experts across the country to assist Ontario and other jurisdictions in assessing medical fitness to drive.

49Chapter 6 describes cognitive impairment in general and the concerns that result regarding driving safety, noting that cognitive problems often have a direct effect upon fitness to drive.

50Specifically, 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 condition does not affect ability to drive; and

iii. Conditions for maintaining a licence are met.

51This Standard acknowledges that judgement and insight are important for driving, yet the usual battery of tests to assess the extent of cognitive limitations do not evaluate these functions. For these reasons, this Standard concludes that a Functional Driving Assessment is usually the most appropriate means of assessing the effects of the cognitive limitations upon driving unless severe dementia has been demonstrated.

52The Registrar stated that as of their January 2, 2026, letter, the appellant’s licence will remain under suspension until which time as they receive confirmation that there has been a significant improvement in the appellant’s medical condition. The Registrar has received no further information confirming an improvement in the medical condition. The Registrar submits that the law and the Standards are being applied correctly and the medical evidence supports the appellant does have a medical condition that is likely to significantly interfere with his ability to drive safely.

53Section 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.

54Under cross-examination from the appellant’s representative regarding the typical process of a Functional Driving Assessment, the Registrar responded that it was his understanding that it was common practice for both the OT and the driving instructor to be present in the vehicle, but he is not qualified to answer questions on how the instructor and therapist would communicate in the vehicle during the assessment. The Registrar was further questioned about the provincial driving screening that occurs in any driver over the age of 80 years. When asked further as to who was in the vehicle during the provincial screening assessment, he indicated he did not believe an OT would not be present, but he is not familiar with the specifics of this process.

55The appellant’s representative argued that the appellant successfully completed two annual renewals of his driver’s licence since turning 80 years old that included the standard provincial cognitive screening. She argued the appellant had no history of motor vehicle collisions, complaints or other driving concerns.

56The appellant’s representative testified that the driving component of the Functional Driving Assessment was discriminatory and unconstitutional because it requires an OT to be present and the OT guides the driving instructor as to the impairment. She further stated that the functional driving assessment is inadmissible and constitutes a violation of equality rights. She shared her observations during the driving assessment that the driving instructor was speaking quietly, and she was having difficulty hearing from her position in the backseat and had to request they speak loudly. The appellant’s representative further argued that the driving test the appellant underwent is different from the test required to issue a G licence, and that those with cognitive or sensory disabilities should not be held to a higher standard of driver testing.

57While I have considered the testimony of the appellant’s representative and the appellant’s position that he drives safely, these submissions are not supported by medical or expert evidence. The appellant’s position is weighed against:

i. the scientific research that cognitive problems often have a direct effect upon fitness to drive as outlined in the CCMTA Standards,

ii. that the appellant’s geriatrician recommended a Functional Driving Assessment due to concerns about the safety of driving with cognitive impairment,

iii. that the result of the Functional Driving Assessment was a conclusion that the appellant is not fit to drive based on his medical condition,

iv. that the on-road assessment documented functional deficits directly relevant to safe vehicle operation, including reduced situational awareness, failure to scan or check blind spots, impaired judgment, and slowed execution of driving maneuvers, and

v. 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.

58I have also considered the appellant’s representative’s concerns regarding the process in which the functional driving assessment was conducted, the concern that the driving instructor spoke quietly, and that the driving assessment should not have been different than a standard Class G licence driving assessment. While I acknowledge the concerns of the appellant’s representative, there is no evidence before the Tribunal that the communication between the OT and driving instructor was improper or that it deviated from accepted practice. While the appellant’s representative perceived the instructor to be speaking quietly from the back seat, there is no evidence that the appellant indicated he could not hear instructions, requested clarification, or that the assessment findings were attributable to the inability to hear directions, rather than the functional deficits documented. There are deficits listed in the assessment that extend beyond verbal instruction, including failures of observation, situational awareness and judgment. Accordingly, I am not persuaded that the structure or conduct of the Functional Driving Assessment renders its conclusions unreliable or discriminatory. I also accept that a Functional Driving Assessment required for medical fitness-to-drive purposes is distinct from a routine licencing test for the reasons that it is designed to assess the impact of a medical condition on functional driving capacity.

59Although 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. The Functional Driving Assessment is particularly persuasive because it evaluates real-world driving performance rather than theoretical capacity.

60I acknowledge the burden that the lack of a driver’s licence is having on the appellant. However, the medical and functional evidence is significant and compelling. As 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

61I 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

62For 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.