Craig Mazerolle

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that found she was not removed from the Minor Injury Guideline and dismissed her claim for an income replacement benefit.

The applicant argued that new evidence, including catastrophic impairment reports, and errors in weighing expert psychiatric evidence warranted a reconsideration.

The Tribunal dismissed the request, finding the new evidence could have been obtained previously and that the applicant's arguments regarding the expert evidence amounted to a disagreement with the Tribunal's weighing of the evidence rather than an error of law or fact.

The respondent insurer requested a reconsideration of a Licence Appeal Tribunal decision that granted the applicant a 50% award ($1,300) for unreasonably withholding approval of a chiropractic treatment plan.

The insurer argued the Tribunal misapprehended the medical evidence and improperly applied the standard for an award.

The Vice-Chair dismissed the request, finding that the insurer was attempting to re-litigate the weighing of evidence and that the original adjudicator provided adequate reasons and acted within their discretion in granting the maximum award.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that found her injuries remained within the Minor Injury Guideline (MIG) and denied her claims for treatment plans, massage services, an award, and interest.

The applicant argued the Tribunal misapplied the test for causation, erred in its assessment of a chronic pain expert's report, and failed to provide adequate reasons.

The Vice-Chair dismissed the request, finding that the Tribunal properly weighed the evidence regarding pre-existing conditions and functional limitations.

Although the Tribunal made a minor factual error in summarizing the expert's report, the Vice-Chair concluded this error would not likely have changed the outcome, and the original decision met the required standard for sufficiency of reasons.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that denied a treatment plan for physical modalities and an award.

The applicant argued the Tribunal erred in its assessment of medical records from his family physician and a chronic pain physician, and improperly weighed adjuster log notes.

The Vice-Chair dismissed the request, finding that the applicant was attempting to re-litigate the Tribunal's weighing of the evidence and had not established any error of law or fact under Rule 18.2(b) of the Licence Appeal Tribunal Rules.

The applicant requested reconsideration of a Tribunal decision that found it lacked jurisdiction to determine entitlement to a non-earner benefit because the applicant had not submitted a completed disability certificate (OCF-3).

The applicant argued that the respondent's delay in providing the application forms constituted a reasonable explanation for the delay, and that requiring the form years later was futile.

The Tribunal dismissed the reconsideration request, finding that while the delay explained the late filing, it did not excuse the ongoing failure to submit the mandatory OCF-3 once the forms were received.

As there was no completed application or denial, the Tribunal correctly concluded it had no jurisdiction under s. 280 of the Insurance Act.

The applicant requested reconsideration of a Licence Appeal Tribunal decision that denied his claims for an award and interest.

In the initial hearing, the applicant had withdrawn his substantive claim for an attendant care benefit.

The Vice-Chair dismissed the reconsideration request, finding no error of law or fact, as the Tribunal lacked jurisdiction to grant an award or interest when no substantive benefits were found to be payable.

The applicant's attempt to introduce new evidence in the form of attendant care invoices was also rejected, as it would not have affected the outcome given the withdrawal of the underlying benefit claim.

The respondent insurer requested a reconsideration of a Tribunal decision that ordered payment of disputed treatment plans due to defective denial notices under s. 38(8) of the Schedule.

The insurer argued the Tribunal breached procedural fairness by relying on un-cited binding case law, and erred in law by not applying the 260-week limitation period under s. 20(1)(a) to the s. 38(11) remedy.

The Tribunal dismissed the request, finding no breach of procedural fairness as parties are expected to know binding law, and holding that the consumer protection mandate of the Schedule dictates that s. 20(1)(a) does not constrain the specific remedial provisions of s. 38(11).

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that found she was not catastrophically impaired and denied her claims for attendant care benefits.

The applicant argued the Tribunal failed to properly engage with her expert's diagnosis of Somatic Symptom Disorder and improperly relied on surveillance evidence.

The Vice-Chair dismissed the request, finding the applicant was attempting to re-litigate the Tribunal's weighing of the evidence rather than identifying an error of law or fact under Rule 18.2.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that found he was not catastrophically impaired and denied his claims for statutory accident benefits.

The applicant argued that his former counsel withdrew issues without his consent, that the Tribunal erred in its impairment ratings, and that it placed disproportionate weight on surveillance evidence.

The Vice-Chair dismissed the request, finding no breach of procedural fairness, no error of law or fact, and no new evidence that would likely have affected the result.

The applicant requested reconsideration of a Licence Appeal Tribunal decision regarding statutory accident benefits.

The applicant argued the Tribunal erred by failing to award interest for the pre-application period under s. 51(3) of the Schedule and by failing to award interest on the s. 10 special award itself.

The Vice-Chair dismissed the first ground, finding no evidence that the benefits were incurred and therefore overdue.

However, the Vice-Chair granted the second ground, holding that s. 10 of O. Reg. 664 mandates the inclusion of interest on the award amount.

The original decision was varied to include interest payable under s. 10.

The respondent insurer requested a reconsideration of a Licence Appeal Tribunal decision that granted the applicant entitlement to a partially approved psychological treatment plan for observation and monitoring.

The insurer argued the Tribunal breached procedural fairness by admitting a late-served letter from a psychologist and erred in interpreting section 25 of the Statutory Accident Benefits Schedule regarding a $200 fee limit.

The Tribunal dismissed the reconsideration request, finding no error in its procedural fairness analysis under Rule 9.3 and confirming that the $200 limit applies to the review and approval of an OCF-18, not to the assessments proposed within it.

The applicant requested reconsideration of a Licence Appeal Tribunal decision that found she was subject to the Minor Injury Guideline (MIG) and not entitled to a non-earner benefit or disputed treatment plans.

The applicant argued the Tribunal made errors of law and fact, breached procedural fairness, and that new evidence was available.

The Vice-Chair dismissed the arguments regarding errors of law and procedural fairness, finding the original adjudicator properly applied the test for removal from the MIG and correctly assessed the evidence.

However, the Vice-Chair granted the reconsideration request in part based on new evidence—a section 44 physiatry report and an Explanation of Benefits—that the applicant received after the original decision was released.

The Vice-Chair ordered a written rehearing before a different adjudicator limited to the issues of the MIG, disputed treatment plans, and interest.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that denied entitlement to three treatment plans for massage, chiropractic, and physiotherapy treatments.

The applicant argued the Tribunal breached procedural fairness by failing to address his key argument that the physical treatments would help him cope with his somatic pain disorder.

The Vice-Chair agreed, finding the original decision lacked sufficient reasons on this central issue, thereby breaching procedural fairness under Rule 18.2(a).

The reconsideration was granted, and the disputed treatment plans and interest issues were remitted to a new adjudicator for a rehearing based on the existing written record.

The appellant requested a reconsideration of a Tribunal decision confirming the impoundment of her vehicle under the Highway Traffic Act.

She sought to introduce new evidence that the charge against her son, which led to the impoundment, had been withdrawn.

The Tribunal found that while the evidence was new and could not have been obtained previously, it would not likely have affected the result.

The original decision was based on the appellant's failure to demonstrate that no alternative vehicles were available, a requirement for proving exceptional hardship.

As the new evidence did not impact this central finding, the request for reconsideration was dismissed.

Both the applicant and the respondent requested reconsideration of a Licence Appeal Tribunal decision.

The applicant argued the Tribunal erred by excluding a late-filed occupational therapy report and by misapplying the Criterion 8 catastrophic impairment analysis.

The respondent argued the Tribunal erred by extending the limitation period under s. 7 of the LAT Act and by granting an award.

The Vice-Chair dismissed both requests, finding that the parties were attempting to re-litigate issues and disagreeing with the Tribunal's weighing of the evidence, which does not meet the high threshold for reconsideration under Rule 18.2.

The applicant requested a reconsideration of a preliminary issue decision which found she was barred from proceeding with her accident benefits claim due to a seven-month delay in notifying the insurer.

The applicant argued the Tribunal failed to meaningfully apply the consumer protection mandate of the Schedule and overly focused on the length of delay and lack of medical documentation.

The Tribunal dismissed the request, finding the applicant was attempting to re-litigate her case and had not established any error of law or fact that would warrant a reconsideration under Rule 18.2(b).

The respondent insurer requested a reconsideration of a Licence Appeal Tribunal decision that granted the applicant entitlement to a physiotherapy treatment plan.

The respondent argued that the Tribunal committed a material breach of procedural fairness by failing to address its core defense that the treatment plan was properly denied under s. 38(5) and s. 38(6) of the Statutory Accident Benefits Schedule, as it was submitted during a period when the applicant was subject to the Minor Injury Guideline.

The Vice-Chair agreed, finding that the original decision misstated the respondent's position and failed to expressly engage with the statutory defense.

The request for reconsideration was granted, and a written rehearing before a different adjudicator was ordered solely on the issue of the physiotherapy treatment plan.

The respondent insurer requested a reconsideration of a Licence Appeal Tribunal decision that removed the applicant from the Minor Injury Guideline (MIG) and approved treatment plans.

The respondent argued that the Tribunal failed to consider its submissions regarding the MIG and left templated placeholders in its reasons for approving the treatment plans.

The Vice-Chair granted the reconsideration, finding that the original decision lacked sufficient reasons and failed to address the respondent's key arguments, thereby breaching procedural fairness.

The original decision was cancelled and the matter was remitted to a different adjudicator for a rehearing based on the written record.

The respondent insurer requested a reconsideration of a decision awarding the applicant an income replacement benefit and treatment plans.

The insurer argued the Tribunal confused the dates of two accidents, misapprehended surveillance evidence, and applied an incorrect causation test.

The Vice-Chair dismissed the request, finding that while there were typographical errors regarding the accident dates, the Tribunal clearly understood the correct timeline and the errors did not impact the outcome.

Furthermore, the Tribunal correctly applied the 'but for' test for causation.

The request for reconsideration was dismissed.

The applicant requested reconsideration of a decision denying her claim for catastrophic impairment and various medical benefits following a motor vehicle accident.

She also filed a Notice of Constitutional Question, arguing the Tribunal's assessment of her psychiatric impairments violated s. 15(1) of the Charter.

The Vice-Chair granted the reconsideration in part, finding the Tribunal erred in denying six treatment plans based on the 260-week limit, as the respondent had previously admitted the policy allowed for 10 years of benefits.

A written rehearing was ordered for those six plans.

The reconsideration was otherwise dismissed, as the Tribunal made no error in its causation analysis for catastrophic impairment or its strict application of s. 38(2) for living accommodations.

The Charter challenge was also dismissed, as the Tribunal's causation analysis did not constitute adverse-effect discrimination against individuals with mental disabilities.