Driver’s Licence Suspended by Doctor’s Report

Update: see previous post – February 10, 2010 Medical Standards for Canadian Drivers

see source, the Globe and Mail

In most Provinces, doctors have a mandatory obligation to report a patient that he or she feels should not be driving due to a medical condition. This mandatory obligation has been confirmed by the Courts in most cases and doctor’s feel compelled to report a patient who, in their opinion, should not be driving.

The Canadian Medical Association (the “CMA”) has developed the CMA Driver’s Guide for Physicians “Determining Medical Fitness to Operate Motor Vehicles” which doctors in Canada sometimes reference when making a decision to report their patient.

If you are a licenced driver in Ontario and your doctor decides to report you (in accordance with section 203. (1) of the Highway Traffic Act) to the Ministry of Transportation, your driver’s licence could be suspended for quite some time if you suffer from one of the sixteen (16) specific medical conditions that the MOT has defined as “in the opinion of the medical practitioner, is suffering from a condition that may make it dangerous for the person to operate a motor vehicle”.

Out of the nine (9) million driver’s licenced in Ontario, Ontario’s Ministry of Transportation (MTO) suspended 22, 384 driver’s licences in 2009 (the most recent data available) for “medical reasons”. The MTO doesn’t track suspensions by medical condition. These 22, 384 driver licence suspensions do not include those who found their driver licences suspended due to vision-related reasons or the 19,810 driver’s who had their driver licences suspended due to criminal charges impaired driving.

Annually, Ontario issues approximately 17,000 licence suspensions related to driving with a blood alcohol concentration over .08 or for failing/refusing to provide a breath sample. About one-quarter of all fatalities on Ontario roads are alcohol-related.

“Alcohol dependence” is one of sixteen (16) specific medical conditions – including certain heart conditions, unstable mental illness and uncontrolled diabetes – that must be reported in most Canadian provinces if, in a doctor’s opinion, it “may make it dangerous for the person to operate a motor vehicle.”

Only Alberta, Nova Scotia and Quebec leave such reporting to physicians’ discretion.

Once a doctor fills out the report, suspensions may swiftly follow the submission of only the sparsest information – Ontario’s one-page report requires just the date, a signature and a tick in the right box – and may even fly in the face of evidence to the contrary. This report is then forward to the Registrar of Motor Vehicles, Medical Review Section, Ministry of Transportation
2680 Keele St., Downsview ON M3M 3E6

The MOT has a medical advisory committee (also see MTO’s Medical Review Section – Driver Improvement Office), but these experts only review the complex cases when asked by the MOT to do so.

The province’s mandatory reporting requirement under the Highway Traffic Act appears to date back to 1990, but the number of doctors actually doing it began to “steadily increase” only after the province’s health ministry began paying physicians to do it in 2006, Bob Nichols, senior media officer for the transport ministry, told The Globe in an e-mail.

The province pays doctors, who are protected by statute for what otherwise would be a breach of patient confidentiality, $36.25 for each report.

The MOT (the Canadian Council of Motor Transport Administrators (CCMTA) reports about the various medical provisions that would stop a person from driving) relies upon the CCMTA Medical Standards for Drivers. See Medical Standards for Canadian Drivers

Note: On January 1, 2011, section 14 is revoked and the following substituted:

14. (1)  An applicant for or a holder of a driver’s licence must not,

(a) suffer from any mental, emotional, nervous or physical condition or disability likely to significantly interfere with his or her ability to drive a motor vehicle of the applicable class safely; or

(b) be addicted to the use of alcohol or a drug to an extent likely to significantly interfere with his or her ability to drive a motor vehicle safely. O. Reg. 453/10, s. 1.

(2)  In determining whether an applicant for or a holder of a driver’s licence of any class meets the qualifications described in subsection (1), the Minister,

(a) may take into consideration the relevant medical standards for applicants or holders of that class of driver’s licence set out in the CCMTA Medical Standards for Drivers; and

(b) may require the applicant or holder to provide evidence satisfactory to the Minister that he or she is able to drive a motor vehicle of the applicable class safely, including,

(i) any reports of examinations under section 15, and

(ii) any additional medical information. O. Reg. 453/10, s. 1.

(3)  Despite clause (2) (a) and unless otherwise provided in this Regulation, if there is a difference between a medical standard set out in the CCMTA Medical Standards for Drivers and a medical standard set out in this Regulation, the Minister shall take into consideration the standard set out in this Regulation instead of the standard set out in the CCMTA Medical Standards for Drivers. O. Reg. 453/10, s. 1.

(4)  In this section, the CCMTA Medical Standards for Drivers means the document entitled CCMTA Medical Standards for Drivers, published by the Canadian Council of Motor Transport Administrators and dated March 2009, as it may be amended from time to time, that is available on the Internet through the website of the Canadian Council of Motor Transport Administrators. O. Reg. 453/10, s. 1.

See: O. Reg. 453/10, ss. 1, 9.

Report of medical practitioner

203. (1) Every legally qualified medical practitioner shall report to the Registrar the name, address and clinical condition of every person sixteen years of age or over attending upon the medical practitioner for medical services who, in the opinion of the medical practitioner, is suffering from a condition that may make it dangerous for the person to operate a motor vehicle. R.S.O. 1990, c. H.8, s. 203 (1).

No action for complying with subs. (1)

(2) No action shall be brought against a qualified medical practitioner for complying with this section. R.S.O. 1990, c. H.8, s. 203 (2).

Reports privileged

(3) The report referred to in subsection (1) is privileged for the information of the Registrar only and shall not be open for public inspection, and the report is inadmissible in evidence for any purpose in any trial except to prove compliance with subsection (1). R.S.O. 1990, c. H.8, s. 203 (3).

17. (1)  Qualifications required by an applicant for or a holder of a Class A, B, C, D, E or F driver’s licence are that the applicant or holder,

(a) has no history or clinical diagnosis of diabetes that requires insulin for control;

(b) is not taking any drug that could, in the dosage prescribed or in the dosage recommended by the manufacturer, impair his or her ability to drive a motor vehicle of the applicable class safely;

(c) has no established medical history of myocardial infarction, angina pectoris, coronary insufficiency or thrombosis;

(d) has no established medical history of heart disease including arrhythmia or of respiratory dysfunction likely to interfere with the safe driving of a motor vehicle of the applicable class;

(e) is not suffering from an aortic aneurysm, whether resected or not;

(f) is not suffering from hypertension accompanied by postural hypotension resulting in giddiness when under treatment;

(g) has no established medical history of loss of consciousness or awareness due to a chronic or recurring condition;

(h) has no established medical history of a disorder of the musculoskeletal or nervous system that may interfere with the safe driving of a motor vehicle of the applicable class;

(i) has no established medical history of an intractable psychotic or psychoneurotic disorder, having particular regard for sustained hostile, aggressive, paranoid, suicidal or other destructive tendencies or depression unless it is medically determined that the condition from which the person has suffered is corrected or controlled;

(j) has a visual acuity as measured by Snellen Rating that is not poorer than 20/30 with both eyes open and examined together and not poorer than 20/100 in the weaker eye, with or without the aid of corrective lenses; and

(k) has a horizontal visual field of at least 150 continuous degrees along the horizontal meridian and at least 20 continuous degrees above and below fixation, with both eyes open and examined together. O. Reg. 340/94, s. 17 (1); O. Reg. 83/05, s. 9.

(2)  An applicant for or a holder of a Class A, B, C, D, E or F driver’s licence who fails to meet the qualifications referred to in clauses (1) (a) to (i) may, despite the failure, qualify for the class of licence applied for or held if he or she demonstrates the ability to drive a motor vehicle in the applicable class as safely as any person who meets those qualifications. O. Reg. 340/94, s. 17 (2).

(3)  An applicant for or a holder of a Class D driver’s licence who fails to meet the qualification referred to in clause (1) (c) may, despite the failure, qualify for that class of licence if it is medically determined that he or she has made a full recovery and there is no established history of a second occurrence of myocardial infarction, thrombosis or recurring angina pectoris. O. Reg. 340/94, s. 17 (3).

(4)  An applicant for or a holder of a Class B, C, E or F driver’s licence whose hearing in one ear is better than in the other must be able to perceive in the better ear, with or without a hearing aid, a forced whisper at a distance of 1.5 metres or, if an audiometer is used to test the person’s hearing, must not have a loss in the better ear of more than 40 decibels at 500, 1,000 and 2,000 hertz. O. Reg. 340/94, s. 17 (4).

Report of Optometrist

204. (1) Every member of the College of Optometrists of Ontario shall report to the Registrar the name, address and clinical condition of every person sixteen years of age or over attending upon the optometrist for optometric services who, in the opinion of the optometrist, is suffering from an eye condition that may make it dangerous for the person to operate a motor vehicle. R.S.O. 1990, c. H.8, s. 204 (1); 1998, c. 18, Sched. G, s. 56.

No action for compliance with subs. (1)

(2) No action shall be brought against a qualified optometrist for complying with this section. R.S.O. 1990, c. H.8, s. 204 (2).

Reports privileged

(3) The report referred to in subsection (1) is privileged for the information of the Registrar only and shall not be open for public inspection, and the report is inadmissible in evidence for any purpose in any trial except to prove compliance with subsection (1). R.S.O. 1990, c. H.8, s. 204 (3).

Update: January 27, 2011 – Motion detectors in the brain, rather than poor vision or scrambled thinking, may be making it difficult for the elderly to drive, research has found.

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