Epilepsy Ontario :: Epilepsy & Driving in Ontario

Epilepsy & Driving

In accord with the Ontario Highway Traffic Act, the Ministry of Transportation makes all decisions about driver's licences in Ontario.

Persons with a Seizure Disorder May Drive in Ontario, if

febrile convulsions were limited to early childhood
seizures were a result of a toxic illness which is now completely cured
seizures are prevented by medication,
the person has been free of seizures for 12 months, and
medication does not cause drowsiness or poor co-ordination
the person has had a solitary seizure which cannot be related to a toxic illness and
has provided a full neurologic examination revealing no epileptiform activity
the person has had seizures only during sleep or immediately upon awakening (nocturnal seizures) for at least 5 years
the person has been seizure free on medication for 1 year and seizures recur because of cessation or alteration of medication on their physician's instructions.

Who May Not Drive in Ontario

any person with uncontrolled seizures
any person who has had seizures in the past 12 months
any person who is presently taking anticonvulsant medications that cause drowsiness or poor muscle control
any person who requires medication to prevent seizures but persistently drinks alcohol to excess, or does not comply with their physician's recommendations about prescribed antiepileptic drugs.

Like most jurisdictions, the Province of Ontario has strictly enforced driving regulations. Ontario's Highway Traffic Act makes the Ministry of Transportation responsible for the maintenance of a medical review programme. Under the Act, the Registrar of Motor Vehicles has authority to collect/request and review medical information as required, and to make decisions about the suspension of driver licences for an assortment of medical conditions, including epilepsy.

On the back of an Ontario driver's licence is printed: "If you become physically or mentally disabled to an extent that might affect your safe operation of a motor vehicle notify the Ministry immediately." This is not an option: it is a legal obligation to the Ministry of Transportation.

Further, if you have a seizure, your physician must report it to the Ministry. The Highway Traffic Act (Section 203) states: "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 such medical practitioner is suffering from a condition that may make it dangerous for such person to operate a motor vehicle."

While you are not officially suspended from driving until you receive a "Notice of Suspension" from the Ministry, you are better to find other methods of transportation. If you drive after your physician has advised you to refrain from driving (while waiting for official notification from the Ministry), should you have an accident, you can be held liable in civil court. You should also check with your insurance company about your coverage: you may not be covered in such an event. (In Ontario, you must have insurance before you can drive on any public road.)

Seizures, Truth and Change

When discussing your seizure history with your neurologist, it is in your best interest to be accurate and honest. Your neurologist relies on you to get a complete and truthful picture of your seizure activity. Your treatment is based on this information. If your disclosure is inaccurate, your treatment cannot be the best possible.

Reporting your seizures to your physician may result in a change of lifestyle. Your health is precious: in order to obtain the best health care and to maintain optimum health, some lifestyle changes may be necessary.

After your physician files a report with the Ministry of Transportation, one of two options will happen. You will either

Often, the purpose of the Ministry's request for information is to confirm that a suspension is warranted. Many reports based on a physician's initial observation (as in an hospital emergency unit) are rejected after a thorough investigation, if the findings do not justify a licence suspension.

Don't be tempted go to one physician for your primary health care and another for supporting documentation for your licence. Any inconsistencies in reports to the Ministry must be explained or justified before the Ministry will reinstate your licence.

Appeal

If your licence is suspended, you have several options to appeal the decision of the Ministry.

Similarly, you may write a detailed outline of your case and submit it to the Ministry in lieu of your attendance at an Administrative Review. Be sure to indicate that your letter is being submitted in lieu of your personal attendance at the Review and ask for a reply.

Should these steps fail, you may proceed to a hearing before the Licence Suspension Appeal Board. You may present your case at a hearing in writing, in person or with legal representation. To arrange for an appeal, contact the Ministry of Transportation and ask for an appeals application form. There is a fee for this service, payable to the Treasurer of Ontario.

If you disagree with the decision of the Licence Suspension Appeal Board, you may further appeal your case to the Judge of the County or District Court of the area of your residence.

Exceptions to Disclosure

You must report a medical condition only if it interferes with your driving. You must inform the Ministry only if your condition is not fully controlled. Generally, if you have been seizure-free for one year, your control is considered good enough to permit the operation of a vehicle. If you are unsure of the definition of "control" in your particular case, consult your physician or neurologist.

Commercial Driver's Licences

In applying for a commercial licence, you are required to complete a medical examination form. If you have epilepsy, have had epilepsy in the past or your epilepsy is fully controlled at present, you can also expect to receive a supplementary request for a detailed neurological assessment. This information is essential as the Ministry must review each application on its own merits. Specific details regarding your history, treatment and current control are critical in coming to a decision about your application.

If you have a commercial driver's licence and subsequently develop epilepsy, your condition must be reported to the Ministry when diagnosed. If not reported at that time, your physician will, as a matter of course, include this information in the Report of Medical Examination required of all commercial drivers every three years. Again, the Ministry will request a supplementary detailed neurological assessment. Under some circumstances you may need a waiver.

Since March 1999, Canadian commercial drivers with epilepsy cannot drive in the United States of America. [In the USA, drivers are not allowed to hold a commercial licence if they have insulin-dependent diabetes, monocular vision, hearing impairment, or epilepsy – even if seizures are successfully controlled with anti-convulsant medication. Under a reciprocal agreement, Canadian drivers with these conditions are not permitted to drive a commercial motor vehicle in the USA. Drivers with any of these conditions will have a code displayed on their licence and driving record to indicate that they are not eligible to drive a commercial motor vehicle in the USA.]

Waiver Process for Commercial Drivers

Regulation 462 of the Highway Traffic Act describes medical qualifications for anyone wanting to apply for or retain a commercial licence. Regarding epilepsy, the regulation states that a holder or applicant of a classified licence must not have an established medical history of loss of consciousness or awareness due to a chronic or recurring condition. People with uncontrolled epilepsy are prohibited from holding classified licences.

There is an option for the Minister of Transportation to waive this requirement if applicant submits a waiver certificate from an appropriate medical specialist indicating that in the specialist's opinion, the applicant is medically fit and able to function normally.

The regulation states that the Minister must consider:

Every driver with epilepsy who wants to obtain or hold a classified licence must apply for a waiver of medical standards. In deciding to waive, the Minister and the Ministry's Medical Advisory Committee – a panel of specialists from the fields of neurology, psychiatry, cardiology and endocrinology – may refer to the Canadian Medical Association's (CMA) publication Physicians' Guide to Driver Examination. It recommends that commercial drivers be seizure-free and free of medication for five years before being granted a commercial licence. The Ministry strictly adheres to the CMA's guidelines, considering the long shifts that commercial drivers drive, the additional responsibilities of carrying dangerous goods or passengers, and the host of stressful traffic, road and weather situations they encounter daily.

Sick Leave

You may consider taking Sick Leave if your licence has been suspended and your job requires a driver's licence. Discuss this with your physician. If s/he agrees, short term leave might provide a solution while investigating the cause of new seizures. However, short term leave will not ensure that your licence will be reinstated. Also, it might raise unnecessary concerns with your employer about your ability to do your job.

Being unable to drive does not prevent your fulfilling other functions of your job. A change in job duties is another option. The Ontario Human Rights Code requires employers to accommodate employees who are unable to fulfill an essential duty due to disability. The Ontario Human Rights Commission's "Guidelines for Assessing Accommodation Requirements for Persons with Disabilities" states that the employee should continue to be employed in equivalent responsibilities (with equivalent pay). If driving is an essential duty and your licence has been suspended due to disability, your employer is obligated to assign you alternate tasks, unless "undue hardship" can be proven.

Long-term Leave

Most physicians would be unlikely to sign forms stating that you are not well enough to work simply because you cannot drive. Being unable to drive is not the same as being unable to work. Again, it is the employer's obligation to allow you to return to your regular job or to accommodate by assigning alternate duties. Employers may try to use the issue of not driving to excluding people from the workforce. Placing you on long term leave could allow them to avoid having to legally accommodate. However, once on long term sick leave, it may be very difficult to convince employers that you can return to work, especially if your medical condition remains unchanged since long term leave was approved.

Car Insurance

A health condition does not change your car insurance rates. Your car insurance company cannot question your health status as long as you have a valid driver's licence.

You have no legal obligation to inform them of your health status. Insurance rates can be based only on the car you drive and your driving record. According to the Ontario Human Rights Code, an increase in car insurance rates based on a health condition is discriminatory.

Should your licence be suspended, you may want to change the type of coverage for your car. If you were the sole driver, you might cancel your "collision" coverage, paying only basic fire and theft coverage for the vehicle while in storage. No medical reason is required to remove personal coverage or to have it reinstated.

Driving with a Suspended Licence

If you drive while your driver's licence is suspended for "medical reasons" and are stopped by the police, you will be charged with driving while under suspension. This can lead to a fine of up to $2,000, an extension of the suspension and a jail sentence.

If you have an accident, regardless of whether your condition precipitated the accident, you will probably find that your insurance has also been revoked. This could easily end in civil court and financial ruin. Check with your insurance company for details.

Licence Expiration & Renewal Notice

If your licence expires while under suspension, wait until you receive a notice of reinstatement. Then, renew your licence. If you do not seek reinstatement after your one-year suspension and decide to delay for a few years because you don't need a licence right away, you may have to undergo a driver examination. Any driver who is unlicenced/suspended in excess of three years must re-enter the system as a new driver and complete a road, written, and vision test.

Change of Address

If you change your address while your licence is under suspension, you should report your move to the Ministry within the required six days to ensure that information about your suspension will be sent to the correct location.

Doctor's Fees for Completing a Report

Your doctor can charge for filling out any reports on your behalf even when these forms are required by law. These procedures are no longer covered by OHIP and are now considered to be a chargeable procedure by the Ministry of Health.

Help in Getting Back your Licence

Your local epilepsy organization may be able to help you to understand the process of licence review. If your job security depends upon keeping or getting back your licence, they may be able to assist in getting details of Ministry of Transportation decisions. If you have difficulty arranging accommodation with your employer or need to explore a career change because of the suspension of your driver's licence, your local chapter may be able to direct you to useful resources in your community.

Contact your nearest Driver Examination Office or the Ministry of Transportation for further information about

applying for a "beginner" licence
applying for a commercial licence
suspension of a driver's licence
appealing a licence suspension
any other driver-related issue.

Contacts

Ontario Ministry of Health
416-314-5518
800-268-1154
email infomoh@gov.on.ca info about ministry programs and services
http://www.health.gov.on.ca/

Ontario Ministry of Transportation
800-268-4686
416-235-2999
http://www.mto.gov.on.ca/english/index.html

Ontario Human Rights Commission
416-314-4500
800-387-9080
email info@ohrc.on.ca
http://www.ohrc.on.ca/

Advocacy Resource Centre for the Handicapped (ARCH)
416-482-8255
email arch@indie.ca
http://indie.ca/arch/

Law Society of Upper Canada - Lawyer Referral Service
416-947-3330
800-268-8326
http://www.lsuc.on.ca

Law Society of Upper Canada - Ontario Legal Aid
416-598-0200
http://www.lsuc.on.ca

Ontario Insurance Commission
416-250-7250
800-668-0128
http://www.ontarioinsurance.com/