Licence Appeal Tribunal File Number: 18402/MED

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 the class of licence pursuant to Section 32(5)(b)(i) of the Act.

Between:

Shahid Afzal

Appellant

and

Minister of Transportation

Respondent

DECISION

ADJUDICATOR:

Dr. Kailey Minnings

APPEARANCES:

For the Appellant:

Shahid Afzal, self represented

For the Respondent:

Melissa Litrenta, Representative

HEARD: April 21, 2026

OVERVIEW

1Shahid Afzal (the “appellant”) appeals from the decision of Minister of Transportation (the “Minister” or the “respondent”) to downgrade his driver’s licence from a commercial Class “AZ” to a “G” licence pursuant to s. 32(5)(b)(i) of the Highway Traffic Act, R.S.O. 1990, c. H.8 (the “Act”), after the respondent received a report from a health care provider that the appellant suffers from a medical condition that may affect his ability to drive a commercial vehicle safely.

2The Minister has the authority under s. 32(5)(b)(i) of the Act to impose the conditions authorized by the regulations, remove any conditions or endorsements or change the class or classes of driver’s licence held by the person, in accordance with the results of the examinations and other prescribed requirements.

3Section 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.

4The Minister takes the position that the appellant suffers from a medical condition, namely syncope/loss of consciousness and respiratory disease, that is likely to significantly interfere with his ability to drive a commercial vehicle safely 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 denies that he suffers from a respiratory disease but acknowledges that he suffered from syncope/loss of consciousness. He 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 Minister.

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 commercial motor vehicle safely.

8To resolve that issue, I will address the following questions:

i. Does the appellant suffer from a medical condition?

i. Does the appellant suffer from syncope/loss of consciousness?

ii. Does the appellant suffer from a respiratory disease?

ii. If so, is this likely to significantly interfere with his ability to drive a commercial motor vehicle safely?

9The Minister bears the burden of proving on a balance of probabilities that the answer to each of the above questions is “yes”. The Minister 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 commercial driving will be sufficient to meet the Minister’s burden.

RESULT

10Having considered all the evidence and submissions and for the reasons that follow, I find that the Minister has satisfied its burden to establish that the appellant suffers from syncope/loss of consciousness and that is likely to significantly interfere with his ability to drive a commercial motor vehicle safely. I confirm the Minister’s decision to downgrade the appellant’s driver’s licence.

11As the Minister’s decision to downgrade the appellant’s driver’s licence has been confirmed for one of the medical conditions, it is unnecessary to determine a decision on the remaining medical condition.

ANALYSIS

Does the appellant suffer from syncope/loss of consciousness?

12The evidence presented at the hearing establishes that the appellant suffers from a medical condition, namely syncope/loss of consciousness.

13The Minister’s position is supported by the following medical reports:

i. A January 10, 2026 Medical Condition Report (“MCR”) from family doctor Dr. Abidi. It indicates that the appellant suffered from syncope, single episode not yet diagnosed, and it states, “Patient is a [heavy goods vehicle] driver, reports loss of consciousness when parked for a service break. No cause found yet. Is under investigation.”

ii. A February 7, 2026 Seizures and Loss of Consciousness (“SLOC”) form, dated completed by Dr. Abidi. It indicates that the appellant had one episode of unexplained syncope, and the doctor wrote, “Patient had unexplained loss of consciousness start of January 2026. CT head and ECG in ED were normal. He is awaiting further cardiology and neurology investigation.”

iii. A March 2, 2026 consultation note from neurologist Dr. Bhaskar. The note indicates:

[The appellant] was in the USA for work and was driving his truck. He had usual amount of sleep night before. Had his breakfast and started to drive. He can’t recall the details and it was an unwitnessed event. Essentially there was a 10-minute window wherein he was not able to give any details. There was an unwitnessed [loss of consciousness] (likely not driving as there were no accidents noted). He remembers sitting up from the driver seat and looking to see if any clues. He drove for about another 3-4 hours before he felt his head was sore on the right posterior scalp. When he put his hand there, there was blood… he pulled into a rest stop and assessed his injury. ED note mentioned some bruising in left wrist and elbow as well. Post ictal – reports no disorientation or fatigue; but he is amnestic of events… Impression: ... single unwitnessed transient loss of consciousness on January 4, 2026 while working. The episode was characterized by an approximately 10-minute period of amnesia with subsequent discovery of a scalp laceration and minor extremity bruising, suggesting a fall… Neurological exam is normal. CT head and routine EEG are both normal. Based on the available history and investigation, this event is best characterized at this time as an unwitnessed syncopal episode of unclear etiology… Driving – from a neurological standpoint, no restrictions required on licensure. Given the nature of the event, best to complete cardiological studies before considering reinstatement.”

iv. A March 6, 2026 cardiology consultation note from Dr. Chahal. The cardiologist wrote, “…while sitting in his truck, had an episode of passing out, but he was sitting up right and stopped at the rest stop. He did not slump over, but noticed some bleeding on the back of the head. He did not have confusion afterwards, and did not have loss of bowel or bladder function. He did mention chest tightness followed by coughing up bloody sputum.” Under Assessment and Plan, the cardiologist indicates that a stress echocardiogram from June 7, 2025 was normal and that an undated echocardiogram and undated 72 hour Holter monitor were normal. The cardiologist writes, “With respect to his chest pain/coughing up blood, I recommend referral to a respirologist for a comprehensive workup.”

14The appellant indicated that he works as a truck driver, driving a 65-foot semi-trailer truck since 2006. He generally drives long distances to the United States and spends up to 5-7 days per trip, driving approximately 55 hours per week.

15The appellant acknowledges that he experienced an episode of loss of consciousness on January 4, 2026. He testified that he was working in the United States on a several days long trip. He had parked his truck to sleep overnight. In the morning, he woke up and drove a few minutes to a rest station. He set a 15-minute timer for his break, got out of his truck to go to the washroom. He came back to his truck and recalls looking at the timer, which was at 5 minutes. The next thing he remembers is that he was sitting in the seat of his truck, and the timer was at 15 minutes. He testified that he passed out and that approximately 10 minutes had passed. He denies any symptoms or warning signs leading up to this episode.

16The appellant testified that he felt okay immediately after this occurred, and so he resumed driving. After three hours of driving, he noticed pain on his head and realized that he was bleeding from the back of his head. He pulled over and called his daughter to explain the situation. She advised him to call 911. However, he felt fine aside from some pain, so he did not call 911 or seek medical attention and he continued driving his route for three days as scheduled.

17The appellant testified that on his return to Canada on January 7, 2026, he presented to the emergency room “because of the hit on my head I was concerned there may be bleeding inside”. He testified that in the ER, he underwent a CT scan of the head which was normal and that the ER physician “cleared him” to drive.

18He testified that in the subsequent days, he had additional visits to doctors for various symptoms. On January 10, 2026, he presented to his family doctor for abdominal pain, and he was advised to return to the emergency department for investigations. He underwent an abdominal ultrasound which was reportedly normal. He testified that around the same time, he visited a walk-in clinic and was diagnosed with and treated for vertigo. He also visited his family doctor regarding concerns about the vertebrae in his neck to request an MRI scan. He testified that at that point, his family doctor completed the MCR.

19I find that the appellant and the respondent are in agreement that on January 4, 2026, there was an episode of syncope/loss of consciousness. The medical evidence including the MCR, neurology and cardiology consultation notes also support this. I accept the family physician’s and neurologist’s opinion that this episode represented “unexplained syncope”.

20I find that the Minister has established on a balance of probabilities that the appellant suffers from syncope/loss of consciousness.

Is the appellant’s medical condition of syncope/loss of consciousness likely to significantly interfere with his ability to drive a commercial vehicle safely?

21I find that the Minister has proven on a balance of probabilities that the appellant’s medical condition is likely to significantly interfere with his ability to drive a commercial vehicle safely.

22The Minister argues that syncope/loss of consciousness interferes with the appellant’s ability to drive a commercial vehicle and relies on the Canadian Council of Motor Transport Administrators Medical Standards for Drivers [April 2025] (the “CCMTA Standards”). Chapter 19 of the CCMTA Standards indicates that syncope causes an episodic impairment of all the functions necessary for driving and, as such, the driver cannot compensate in case of an episode. Chapter 19.6.8 states that commercial drivers with single unexplained syncope are eligible for a commercial licence if it has been 12 months since the last episode of syncope.

23Section 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 are not bound by them.

24The respondent explained that the CCMTA Standards are more stringent for commercial driving compared to non-commercial driving. Commercial drivers spend more time driving and drive longer distances than drivers of non-commercial vehicles and should a crash occur, the consequences of a crash are more likely to be serious given the size and/or gross weight of a commercial vehicle.

25The appellant argues that the episode of syncope/loss of consciousness he experienced on January 4, 2026 does not impact his ability to drive a commercial vehicle safely. His position is that he has been a truck driver since 2006; he has not had any previous issues; he follows safety procedures and laws diligently; he is an honest person and would not place other road users at risk. Further, he indicated that the licence suspension is causing significant stress and loss of income.

26Further, the appellant testified that he has undergone a thorough and extensive medical workup for this issue. He pointed to the medical consultation notes from the neurologist and cardiologist, indicating that his tests and investigations have been normal. He also referred to a March 12, 2026 narrative letter from his family physician, Dr. Abidi, further confirming that the workup is complete and has been normal.

27Finally, to support his position, the appellant pointed out that the Minister has reinstated his G level licence. He indicated that he does not see the logic behind why his G licence would be reinstated, if he were unsafe to drive. It is his position that he should be allowed regain his commercial licence.

28I acknowledge that the licence downgrade has had a significant impact on the appellant. However, I am concerned by his decision to continue driving his commercial vehicle despite experiencing an unexplained syncopal episode and possible head injury. The appellant testified that he was concerned about bleeding in the brain, yet he waited 3 days before seeking medical attention and continued to drive during that time. Given these decisions, I am concerned about his judgement and insight into how medical conditions may affect safety to drive.

29Further, the appellant testified that he does not understand why his family doctor reported this condition after he had been cleared by the ER physician. Additionally, he indicated does not see the logic as to why he is allowed to drive a personal vehicle and not a commercial vehicle. These statements suggest that the appellant lacks awareness or appreciation for the heightened risks and responsibility associated with operating a large, heavy commercial vehicle.

30I acknowledge and have considered that the appellant has had an extensive workup for syncope/loss of consciousness, including consultation with a neurologist and a cardiologist, two ER visits and several investigations including CT head, abdominal ultrasound, EEG, ECHO and Holter monitor and that the investigations did not show any concerning underlying abnormality. However, I am concerned that the appellant lost consciousness for approximately 10 minutes, experienced amnesia in that he doesn’t remember the circumstances of the event and that he suffered a hit to his head. There was no prodrome or warning signs which would allow him to compensate if this were to recur while driving. This is a significant event. Should it recur while he is driving a commercial vehicle the outcome could be catastrophic.

31Although I am not bound by the CCMTA Standards, I find them reasonable, and I have considered them here. The CCMTA 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. At the time of the hearing, only 3.5 months had passed since the unexplained syncopal episode which is significantly shorter than the 12-month syncope-free period recommended in the CCMTA Standards. I find that a longer waiting time to ensure stability and no recurrence of syncope is both reasonable and prudent for road safety.

32I am satisfied on a balance of probabilities that the appellant’s medical condition of syncope/loss of consciousness is likely to significantly interfere with his ability to drive a commercial vehicle safely.

Conclusion

33I find that the Minister has discharged the onus of establishing on a balance of probabilities that the appellant suffers from a medical condition, namely syncope/loss of consciousness, that is likely to significantly interfere with his ability to drive a commercial vehicle safely.

34As the Minister’s decision to downgrade the appellant’s driver’s licence has been confirmed for syncope/loss of consciousness, it is unnecessary to determine a decision on the remaining medical condition of respiratory disease.

ORDER

35For the reasons set out above, pursuant to subsection 50(2) of the Act, I confirm the Minister’s decision to downgrade the appellant’s driver’s licence.