Licence Appeal Tribunal File Number: 17781/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 Minister of Transportation to downgrade a licence pursuant to subsection 32(5)(b)(i) of the Act.

Between:

Daniel Gagnon

Appellant

And

Minister of Transportation

Respondent

AMENDED DECISION

PANEL:

Dr. Peter Savage, Member

Emily Morton, Member

APPEARANCES:

For the Appellant:

Daniel Gagnon, Self-represented

For the Respondent:

Melissa Litrenta, Representative

HEARD: November 20, 2025

OVERVIEW

1Daniel Gagnon (the “appellant”) appeals from the July 18, 2025 decision of the Minister of Transportation (“Minister”) to downgrade his commercial AB licence to a G class licence under s. 32(5)(b)(i) of the Highway Traffic Act, R.S.O. 1990, c. H.8 (the “Act”) due to his cardiovascular disease (specifically, left ventricular dysfunction and left ventricular arrythmias) which have resulted in an implantable cardioverter/defibrillator (“ICD”) following a witnessed cardiac arrest. The Minister reached the decision to downgrade the appellant’s licence after receiving documentation from his treating physicians confirming the appellant’s cardiovascular disease and the ICD.

2Section 14(1)(a) of Ontario Regulation 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 drive a motor vehicle of the applicable class safely. Under s. 14(2)(b) of the Regulation, the Minister may require a driver to provide satisfactory evidence that they are able to drive safely.

3Section 32(5)(b)(i) of the Act states that the Minister may impose the conditions authorized by the regulations, remove any conditions or endorsements, or change the class or classes of a driver’s licence held by the person, in accordance with the results of the examinations and other prescribed requirements.

4The Minister’s position is that the appellant suffers from a medical condition that is likely to significantly interfere with his ability to drive a commercial vehicle safety and that this provides sufficient reason to downgrade his licence under s. 32(5)(b)(i) of the Act.

5The appellant appeals the suspension under s. 50(1) of the Act. He does not deny that he has an ICD but denies that he suffers from a medical condition which interferes with his ability to drive a commercial vehicle safely.

6Pursuant 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.

ISSUE

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 commercial motor vehicle safely. To confirm the downgrade under s. 32(5)(b)(i) of the Act, the Tribunal must be satisfied the Ministry has proven these facts on a balance of probabilities.

8Therefore, the following questions must be addressed:

i. Is it more likely than not that the appellant has a medical condition?

ii. If so, is it more likely than not that this condition likely to significantly interfere with his ability to drive a commercial motor vehicle safely?

RESULT

9After considering all evidence and submissions, we find that the Registrar has met the burden of proof. The appellant suffers from a medical condition likely to significantly impair his ability to drive a motor vehicle of the applicable class safely. Accordingly, we confirm the Registrar’s decision to downgrade the appellant’s driver’s licence.

ANALYSIS

Does the appellant have a medical condition

10The evidence presented at the hearing establishes that the appellant suffers from a medical condition, namely cardiovascular disease including ventricular dysfunction and ventricular arrythmia, and this has required the implantation of the ICD. Though downgrade letter from the Minister dated July 18, 2025 indicated that the licence was downgraded due to a the ICD. The Minister’s representative clarified at the hearing that the ICD is secondary to the appellant’s underlying cardiovascular diseases.

11The Minister presented evidence of a thorough case history of the appellant’s treatment for his cardiovascular disease from 2021 to 2025. There is documentation of coronary artery disease that had been managed with medication and bypass grafting. On October 22, 2021 the appellant had a witnessed cardiac arrest from ventricular fibrillation and severe coronary artery disease, which required the insertion of the ICD. These facts are established through medical reports filed by the Minister at the hearing, including a Cardiovascular Assessment from the appellant’s physician dated March 14, 2022 and a Medical Condition Report dated February 28, 2022. The appellant also confirmed in his evidence that he had a cardiac arrest requiring the implantation of the ICD.

12The Minister filed multiple Cardiovascular Assessments and medical reports related to the appellant’s cardiac disease following the implantation of the ICD. On March 4, 2022 the Registrar of Motor Vehicles informed the appellant his driving privileges had been suspended under the Act because of his reported conditions of heart disease with arrhythmia. The appellant’s physician completed a Cardiovascular Assessment on March 14, 2022, confirming again the October 22, 2021 implantation of the ICD following cardiac arrest. The Cardiovascular Assessment indicates the appellant had not experienced any ischemic symptoms since the cardiovascular interventions and that an ICD check in December of 2021 noted no recorded ventricular fibrillation events. On March 21, 2022 the Registrar informed the appellant it had approved the medical update and informed the appellant it required a further Cardiac Assessment in one year’s time.

13On March 13, 2025 the Ministry wrote to the applicant advising that based on a review of medical reports filed for his commercial driver’s licence, a further Cardiovascular Assessment was required. Following receipt of the assessment, the Ministry communicated on May 15, 2025 its decision to downgrade the appellant’s commercial licence to a class G licence. The May 15, 2025 decision letter advises the applicant that if he wished to regain his commercial licence, a further report with specific information regarding his cardiac disease is required. Following the exchange of further information and a Medical Assessment Committee opinion dated July 16, 2025, the Minister confirmed its decision that the appellant is eligible for a Class G licence only on July 18, 2025.

14The Minister filed a great deal of further information regarding the appellant’s treatment for his cardiac disease between 2021 and 2025. This case history documents excellent medical and cardiovascular care from the appellant’s team. It further documents that the appellant continues to follow all medical advice given by his team. The evidence is that the appellant is compliant with medications and treatment follow up.

15We find the medical evidence in this case is clear and that the medical condition is not under dispute. Based on all of the information available, we find the Minister has established on a balance of probabilities that the appellant has an ICD that was implanted as a result of his cardiovascular disease.

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

16We 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.

17The Minister submits that the appellant’s medical condition of having an ICD interferes with his ability to drive a commercial vehicle safely. The Minister relies on the Canadian Council of Motor Transport Administrators Medical Standards for Drivers [2025 update] (the “CCMTA Standards”). The evidence before the Tribunal is that the CCMTA Standards are written by physicians and experts across the country and used in Ontario and other jurisdictions to assess driver fitness in the setting of certain medical conditions.

18The Minister relies on Chapter 3 of the CCMTA Standards to support its position the appellant’s medical condition is likely to interfere with his ability to drive a commercial vehicle safely. Chapter 3 indicates that drivers with cardiovascular disease have a higher risk of adverse driving outcomes than those without cardiovascular disease. The Minister highlighted that the CCMTA Standards were updated in the spring of 2025 to reflect the latest Guidelines given by the Canadian Cardiovascular Society. Standard 3.6.24, which is a Standard recently revised in the spring of 2025, applies to commercial drivers who have an ICD implanted. The revised Standard states that drivers are not eligible for a commercial licence, except in exceptional circumstances involving mild disease and an annual risk of less than 1% of sudden incapacitation.

19The Minister also relies on its own experts: Medical Assessment Committee (“MAC”). The MAC submitted a report July 16, 2025, authored by Dr. Chris T Simpson, a Quens university professor and a cardiologist. The MAC Summary summarizes the medical history leading to the implantation of the ICD. It states that a 2024 device check of the ICD reported “numerous episodes of non-sustained VT (asymptomatic) lasting up to 3 min at 150 bpm). The MAC Summary states that because of the implantation of the ICD and the documented VT of up to three minutes in 2024, the appellant cannot be reasonably assigned an annual risk of sudden incapacitation of less than 1%, and that the risk is “considerably higher than that.” The Medical Assessment Committee thus recommended that the applicant is ineligible for a commercial class licence.

20Section 14(2)(a) of the Regulation allows the Minister 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 it is not bound by them. There is also no regulatory obligation on the Tribunal to consider the Canadian Cardiovascular Society’s Guidelines, though they too may be considered by the Tribunal along with all of the other relevant evidence.

21The appellant gave evidence that he had been driving safely with the ICD implant for years without incident. He states that since the time the ICD was implanted, his medical condition has not deteriorated or worsened. He has been compliant with medication and follows the advice of his treatment team. The appellant points to a letter from his cardiologist, Dr. Ravi, dated June 11, 2025 that confirms the appellant is compliant with medication, does not report any unusual chest discomfort and, in general has been “holding his own” in terms of his cardiac care. The appellant also submitted an October 2, 2025 letter from Dr. Ravi which states that “as per current rules” patients with ICDs are not allowed to have a commercial driver’s licence. This letter again confirms the appellant needs the ICD for secondary prevention.

22The appellant also provided two support letters from the owner and president of two different transport truck businesses who had employed the appellant as a driver very recently. The letters state that the applicant has had a perfect safety record and exhibits exceptional driving skills and professionalism in his very recent performance as a truck driver. The appellant testified at his hearing that he had been advised by his cardiologist who advised him he would likely be ineligible to continue to hold a commercial class licence as a result of the ICD implantation. Since the downgrade, the appellant has sold his commercial vehicle. The appellant testified that he enjoys work very much and has found work as a driver that does not require a commercial class licence.

23The appellant testified that he has not felt the physical effects of a defibrillation arising from the ICD, and in particular the 2024 event noted in the MAC Summary. The appellant also gave evidence that he is aware of other holders of commercial class licences in his vocational community that have an ICD but have not been subject to a downgrade of their licence.

24We acknowledge the appellant’s position that he has driven a commercial vehicle safely for years. We also acknowledge that his performance as a commercial truck driver is reported by supervisors to be impeccable in recent years, since the implant of the ICD. We further acknowledge the reports from the appellant’s dedicated medical care team that he is a patient who has diligently followed treatment advice.

25However, we find that the Minister has met the burden of proving it is more likely than not that the appellant’s medical condition significantly interferes with his ability to drive a commercial class vehicle safely. While we are not bound by the CCMTA Standards, they were updated very recently in the spring of 2025 to reflect the recently updated Canadian Cardiovascular Society Guidelines, which are produced by cardiovascular researchers and clinicians. The Guidelines are updated periodically in response to the best available evidence regarding advances in investigation and management of cardiovascular diseases. The most current CCMTA Standard with respect to drivers with ICDs are not eligible for a commercial licence, except in exceptional circumstances of mild disease and an annual risk of less than 1% of sudden incapacitation. The MAC opinion in the appellant’s case is that because of the implantation of the ICD and the documented VT of up to three minutes in 2024, the appellant cannot be reasonably assigned an annual risk of sudden incapacitation of less than 1%, and that the risk is “considerably higher than that.”

26We appreciate that the appellant’s evidence is that he has not personally experienced the physical effect of the ICD since its implantation. However, we give weight to the recently revised standard that commercial drivers with an annual risk of sudden incapacitation or in the exceptional circumstance of mild disease are not eligible for commercial drivers’ licences. The Minister’s representative emphasized in her submissions there is a heightened risk when a commercial driver experiences a period of incapacity while given the size and weight of the class of vehicles they are licenced to drive. The CCMTA Standards require a higher level of fitness for commercial drivers than those that operate class G vehicles. We find there is an additional risk to road safety when operating a commercial vehicle. Should the commercial driver suffer a collision the consequences are much more likely to be serious. We therefore accept and apply the revised CCMTA Standard 3.6.24 for commercial drivers with an ICD.

27We find that the evidence of the MAC that the applicant has a considerably higher risk of sudden incapacitation than less than 1 % is reliable and convincing. The MAC summary refers to the documented VT of up to three minutes in 2024. The appellant did not provide any evidence that would detract from the weight we give to the July 16, 2025 MAC opinion regarding the applicant’s risk as a commercial driver with an ICD. Indeed, the most recent correspondence from the appellant’s cardiologist is simply that the current standards are that people with ICDs are not allowed to have a commercial driver’s licence, and that the appellant is in need of his ICD for secondary prevention. Dr. Ravi did not provide a recommendation the commercial licence should be reinstated.

28We recognize the appellant’s frustration that he states he has heard of other commercial drivers in his community who have ICDs but have not received a downgrade. There was no evidence with respect to this at the hearing, beyond the appellant’s own observation, and we must decide this appeal on its merits, on the evidence before us. The evidence is that the most up to date medical guidance is that drivers with ICDs should not operate commercial vehicles, with very limited exceptions.

CONCLUSION

29We find that the Minister has discharged the onus of establishing on a balance of probabilities that the appellant suffers from a medical condition that is likely to significantly interfere with his ability to drive a motor vehicle of the applicable class safely.

ORDER

30For the reasons set out above, pursuant to s. 50(2) of the Act, we confirm the Minister’s decision to downgrade the appellant’s commercial class driver’s licence.

Released: January 16, 2026

__________________________

Dr. Peter Savage

Adjudicator

__________________________

Emily Morton

Adjudicator