Aggrey Msosa

The applicant filed a second application for statutory accident benefits, disputing issues that had been dismissed as abandoned in a prior application after she failed to attend two case conferences.

The respondent raised a preliminary issue, arguing the duplicate claims should be barred by res judicata or abuse of process.

The Tribunal found that while res judicata did not apply because the prior dismissal was not a decision on the merits, the applicant's attempt to re-litigate the dismissed issues constituted an abuse of process under section 23(1) of the Statutory Powers Procedure Act.

The applicant failed to satisfy the Reid factors to set aside the dismissal.

Both parties' requests for costs were denied.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits.

The respondent denied a physiotherapy treatment plan on the basis that the injuries fell within the Minor Injury Guidelines (MIG).

The applicant applied to the Licence Appeal Tribunal.

At a case conference, the applicant withdrew the MIG issue and the claim for the treatment plan, leaving only the issue of entitlement to an award under O. Reg. 664 for unreasonable delay.

The Tribunal found that the respondent did not unreasonably withhold or delay payments, as it was within its rights to request a section 44 examination before approving the plan.

The Tribunal also denied the applicant's request for costs regarding the $100 application filing fee, finding no evidence of unreasonable, frivolous, vexatious, or bad faith conduct by the respondent.

The applicant was involved in a motor vehicle accident and sought statutory accident benefits.

The respondent partially approved a psychological assessment plan, reducing the requested fee of $2,267.80 to $1,389.87 based on an insurer's examination.

The Tribunal found that the respondent's assessor failed to provide a rationale for the reduced fee breakdown and that the applicant's assessor was not required to provide an hourly breakdown under the Schedule.

The Tribunal ordered the respondent to pay the outstanding balance of $877.93 plus interest.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits.

The respondent denied the claims on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG), limiting medical and rehabilitation benefits to $3,500.

The applicant argued that he suffered from psychological impairments and had multiple barriers to recovery that removed him from the MIG.

The Licence Appeal Tribunal found that the applicant failed to provide compelling medical evidence of a psychological injury or a pre-existing condition that would prevent maximal recovery within the MIG limit.

As the applicant's injuries were determined to be minor, the claims for additional treatment plans, assessments, and an award were dismissed.

The applicant was injured in a motor vehicle accident and applied for statutory accident benefits.

The respondent denied the claim on the basis that the application was submitted late without a reasonable explanation, and therefore denied a chiropractic treatment plan.

The Tribunal found that the applicant had a reasonable explanation for the delay, as she had separated from her husband and moved out of the home where the application forms were sent.

The Tribunal also found the chiropractic treatment plan to be reasonable and necessary, and awarded the medical benefit of $3,712.74 along with interest.

The applicant sought income replacement benefits and funding for a psychological treatment plan following a motor vehicle accident.

The Licence Appeal Tribunal dismissed the application, finding the applicant failed to prove on a balance of probabilities that he suffered a substantial inability to perform the essential tasks of his pre-accident employment as a security guard.

The Tribunal preferred the insurer's psychological assessment, which found no ongoing psychological impairment, and concluded the proposed treatment plan was not reasonable and necessary.

The applicant was injured in a motor vehicle accident and sought payment for two orthopaedic assessments under the Statutory Accident Benefits Schedule.

The insurer denied the treatment plans.

The Licence Appeal Tribunal found that the applicant failed to prove the assessments were reasonable and necessary, noting the absence of the actual treatment plans in evidence and preferring the insurer's medical evidence that the applicant suffered only soft tissue injuries.

The appeal was dismissed.