MTO Reporting Requirements Task Force 

The OPA has continued advocating regarding the Ministry of Transportation of Ontario (MTO)’s medical condition reporting requirements since the 2018 MTO updates.

Over the last 2 years, we brought several concerns to an MTO Program advisor regarding (but not limited to) the following:

• the presence of certain psychiatric diagnoses being identified on the reporting form – concern regarding patient privacy, stigma against psychiatric conditions, lack of evidence-base, and lack of qualifiers to prevent over-reporting
• variable interpretations of the “uncontrolled substance use disorder” language, also with no qualifiers provided
• lack of clarity regarding the reporting of transient episodes in the context of a chronic illness

In early 2020, the OPA was able to offer advice on an “Interpretive Guide” drafted by the MTO to assist with understanding nuances of reporting requirements. Unfortunately, the OPA has not received updates regarding the status of this guide, nor has there been information about ability to change specific language in the Highway Traffic Act Ontario Regulation 360/94.

As of October 2020, the MTO released a modified Medical Condition Report with changes relevant to our physician members:

• All medical information is now listed on the 2^nd page, reserving the 1^st page for patient identifying information
• Under “Psychiatric Illness” section: the checkboxes identifying specific diagnoses have been removed

The OPA will provide further communications if there is further progress. 

Update as of Dec 8, 2020

MTO MEDICAL CONDITION REPORTING RESOURCES

GENERAL REPORTING GUIDANCE

• Ontario Regulation 340/94 describes those conditions/impairments that are mandatory for a physician, optometrist or nurse practitioner to report.  When a report of a mandatory condition is made it will result in a licence suspension.
• Other conditions or impairments that may impair an individual’s ability to drive safely may be reported as a discretionary report.
• The law applies to any patient, age 16 or older, regardless of whether they hold a driver’s licence.
• Conditions that are transient or non-recurrent are not required to be reported

REPORTING:

MTO: Medical Condition Report form

MTO: Reporting a medically unfit driver: healthcare practitioners

MTO: Fact Sheet on the Medical Review Process

ASSESSING FITNESS:

Canadian Medical Association Driver’s Guide: Determining Medical Fitness to Operate Motor Vehicles, 9^th ed

Canadian Council of Motor Transport Administrators, Medical Standards

MEDICOLEGAL CONSIDERATIONS

The OPA approached the Canadian Medical Protective Association (CMPA) for guidance and input on common case scenarios. While the CMPA was unable to provide commentary on such cases, the CMPA provided general guidance on medico-legal risks. The guidelines are available upon request to members only by emailing: opa@eopa.ca.