Avril A. Farlam

The applicant sought statutory accident benefits following a motor vehicle accident.

The respondent denied funding for physiotherapy and a psychological assessment on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and the $3,500 funding limit had been exhausted.

The Licence Appeal Tribunal found that the applicant's physical injuries were predominantly minor and that she failed to provide compelling evidence of a pre-existing condition or psychological impairment that would remove her from the MIG.

As the funding limit was exhausted, the claims for medical benefits, interest, and a special award were dismissed.

The applicant sought statutory accident benefits for two treatment plans following a 2016 motor vehicle accident.

The Licence Appeal Tribunal dismissed the claims, finding the applicant failed to meet the onus of proving the treatment plans were reasonable and necessary.

The medical evidence provided by the applicant did not include recommendations for the disputed physical therapy, and the treatment plans themselves were either not filed or improperly submitted.

As no benefits were payable, the claim for interest was also dismissed.

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

The respondent insurer determined the applicant's injuries fell within the Minor Injury Guideline (MIG) and denied a $2,260.00 treatment plan for a chronic pain assessment.

The Tribunal found that the applicant's injuries fell outside the MIG, preferring the evidence of the applicant's specialist who diagnosed chronic pain syndrome over the respondent's general practitioner.

The Tribunal held that the chronic pain assessment was reasonable and necessary, rejecting the respondent's argument that the cost should be covered by OHIP under s. 47(2) of the Schedule due to a lack of evidence.

The applicant was awarded the cost of the assessment and interest.

The applicant sought non-earner benefits following a motor vehicle accident.

The respondent requested a preliminary issue hearing to determine whether the applicant was precluded from proceeding with her application because she failed to attend a section 44 insurer's examination.

The Tribunal found that the applicant failed to attend the examination without a reasonable explanation and that the respondent's notices met the requirements of the Schedule.

The application was dismissed, and no costs were awarded to the respondent.

The applicant was injured in a rear-end motor vehicle accident and sought medical benefits for psychological services.

The respondent denied the treatment plans, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) and the $3,500 funding limit had been exhausted.

The Tribunal found that the applicant failed to provide sufficient medical evidence, such as corroboration from her family physician, to prove she suffered from a pre-existing condition, psychological impairment, or chronic pain that would remove her from the MIG.

As the injuries were deemed minor and the funding limit was exhausted, the claims for medical benefits, interest, and a special award were dismissed.

The applicant sought statutory accident benefits for chiropractic treatment following a motor vehicle accident.

The respondent denied the treatment plans on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and the $3,500 funding limit had been exhausted.

The Licence Appeal Tribunal found that the applicant failed to prove on a balance of probabilities that her injuries were not predominantly minor or that she had a pre-existing condition preventing maximal recovery within the MIG limits.

The application was dismissed.

The applicant sought statutory accident benefits for assistive devices, including an orthopedic mattress and an ergonomic chair, following a 2014 motor vehicle accident.

The respondent denied the treatment plans on the basis that they were not reasonable and necessary.

The Licence Appeal Tribunal found that the applicant failed to provide sufficient medical evidence linking her health complaints to the accident or demonstrating how the proposed devices would achieve the treatment goals.

The application was dismissed, and claims for an award and interest were denied.

The applicant sought statutory accident benefits following a motor vehicle accident.

The respondent insurer requested two s. 44 insurer's examinations to address the applicability of the Minor Injury Guideline and the need for attendant care benefits.

The applicant refused to attend, arguing the examinations were not legally permitted.

The respondent raised a preliminary issue that the applicant was barred from proceeding with her application under s. 55 of the Schedule.

The Tribunal found that the respondent was entitled to request the examinations to respond to new medical documentation and that the applicant's erroneous legal position was not a reasonable explanation for non-attendance.

The applicant was barred from proceeding with her application, save for her income replacement benefit claim.

The applicant sought entitlement to statutory accident benefits following a motor vehicle accident, including three treatment plans for chiropractic services, the cost of an attendant care assessment, and the cost of an orthopaedic assessment.

The Tribunal found the chiropractic treatment plans to be reasonable and necessary, preferring the evidence of the applicant's orthopaedic surgeon over the respondent's assessors.

However, the claims for the attendant care and orthopaedic assessments were dismissed due to insufficient evidence and flawed factual foundations, particularly given surveillance showing the applicant's physical capabilities.

The claim for a special award was also dismissed, but interest was awarded on the payable benefits.

The applicant sought statutory accident benefits following a motor vehicle accident, specifically claiming the cost of two treatment plans for assistive devices, an award, and interest.

The Licence Appeal Tribunal found that the applicant failed to prove on a balance of probabilities that the proposed treatment plans, which included an orthopedic mattress and a specialized chair, were reasonable and necessary.

The Tribunal also declined to admit late evidence submitted by the applicant.

The application was dismissed in its entirety.

The applicant sought income replacement benefits (IRBs) following a motor vehicle accident.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to provide reliable and consistent evidence regarding both the injuries sustained in the accident and the essential tasks of his pre-accident employment.

Due to this evidentiary deficit, the applicant could not establish a substantial inability to perform his essential employment tasks for the pre-104 week period, nor a complete inability to engage in any employment for the post-104 week period.

The claim for IRBs and interest was dismissed.

The applicant sought income replacement benefits (IRB) following a motor vehicle accident.

The respondent agreed the applicant qualified for IRB but disputed the quantum.

The applicant, who was self-employed, argued his IRB should be calculated based on his earnings in the 52 weeks prior to the accident.

The Tribunal found that under section 4(3) of the Schedule, a self-employed person's IRB must be calculated based on their income from the last completed taxation year.

Since the applicant declared no self-employment income in 2016, the last completed taxation year before the 2017 accident, his IRB entitlement was calculated at nil.

The application was dismissed.

The appellant appealed the 45-day impoundment of her vehicle under the Highway Traffic Act, arguing it would cause exceptional hardship for her transportation needs and finances.

The Licence Appeal Tribunal found that the appellant had alternatives to the impounded vehicle, such as rides from her husband and taxis.

Furthermore, because the appellant was driving while her licence was suspended, the Tribunal was precluded by regulation from considering her financial losses.

The appeal was dismissed and the impoundment was confirmed.

The applicant sought accident benefits following a motor vehicle collision.

The respondent denied a chiropractic treatment plan and a chronic pain assessment on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and the $3,500 funding limit had been exhausted.

The applicant argued that pre-existing low back pain, psychological impairments, and chronic pain removed him from the MIG.

The Tribunal found that the applicant failed to provide compelling medical evidence of a pre-existing condition that would prevent maximal recovery within the MIG limits.

Furthermore, the Tribunal gave little weight to the orthopaedic surgeon's recording of self-reported psychological symptoms and found insufficient evidence to establish chronic pain.

As the injuries were predominantly minor and the funding limit was exhausted, the application was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident.

The respondent denied certain treatment plans, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) and the $3,500 funding limit had been exhausted.

The applicant argued that pre-existing back pain, chronic pain, and psychological impairments removed him from the MIG.

The Tribunal found insufficient medical evidence to support the applicant's claims, noting that his family physician did not diagnose chronic pain or psychological impairment, and preferred the respondent's psychological assessment.

The Tribunal concluded the applicant sustained minor injuries subject to the MIG limit, dismissing the claims for additional medical benefits and examination expenses.

The appellant appealed the Registrar of Motor Vehicles' decision to suspend his commercial driver's licence due to an alcohol use disorder.

The Registrar suspended the licence under section 47(1) of the Highway Traffic Act after receiving a medical report from the appellant's family physician.

The Licence Appeal Tribunal found that the appellant suffers from an alcohol use disorder that is likely to significantly interfere with his ability to drive safely, noting that he had not abstained from alcohol for the 12-month period recommended by the CCMTA Medical Standards for Drivers.

The Tribunal confirmed the Registrar's decision to suspend the licence.

The applicant sought a rehabilitation benefit of $4,534.35 for chiropractic services following a motor vehicle accident.

The respondent denied the claim on the basis that the treatment was not reasonable and necessary.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to prove the treatment was reasonable and necessary given her extensive pre-existing back issues, lack of documented accident-related complaints for a two-year period, and insufficient medical evidence linking the proposed treatment to the accident.

The applicant's claim for costs was also dismissed.

The applicant sought a non-earner benefit following a motor vehicle accident, claiming a complete inability to carry on a normal life due to physical and psychological injuries.

The Licence Appeal Tribunal dismissed the application, finding the applicant's evidence lacked specificity and was contradicted by inconsistent self-reporting and surveillance evidence showing him jet skiing and lifting weights.

The Tribunal preferred the respondent's assessments, concluding the applicant failed to meet the stringent threshold for the benefit.

The applicant sought a non-earner benefit under the Statutory Accident Benefits Schedule following a motor vehicle accident.

The Licence Appeal Tribunal dismissed the application, finding the applicant failed to prove a complete inability to carry on a normal life.

Medical evidence and surveillance demonstrated that the applicant had substantially returned to his pre-accident routine, including working as a plumber and engaging in social and leisure activities.

Claims for interest and a special award were consequently dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident.

The respondent denied various medical benefits and examination costs on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and the $3,500 limit had been exhausted.

The Licence Appeal Tribunal found that the applicant sustained predominantly minor physical injuries, such as uncomplicated myofascial strains and contusions.

The applicant failed to prove on a balance of probabilities that he suffered from a concussion, chronic pain, or psychological impairments that would remove him from the MIG.

As the MIG limit was already exhausted, the claims for additional medical benefits and examination costs were dismissed.