E. Louise Logan

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that denied his entitlement to an income replacement benefit (IRB), interest, and an award.

The applicant argued that the Tribunal breached procedural fairness and made errors of law in assessing the validity of the insurer's notices under section 36(4) of the Statutory Accident Benefits Schedule.

The Vice-Chair dismissed the reconsideration request, finding no breach of procedural fairness and concluding that the rehearing adjudicator correctly applied the law in determining that the insurer's requests for information were compliant, thereby not triggering the mandatory payment provisions of section 36(6).

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that denied him substantive benefits after he failed to file written submissions.

Two days before the submission deadline, the applicant's counsel removed himself from the record.

A family member contacted the Tribunal requesting an extension of time to obtain new counsel due to the applicant's language barrier and inability to navigate the process.

The hearing adjudicator was seemingly unaware of this request and proceeded to dismiss the claims.

The Vice-Chair found that proceeding with the hearing under these circumstances constituted a material breach of procedural fairness.

The reconsideration request was granted, the original decision was cancelled, and a rehearing before a different adjudicator was ordered.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that denied entitlement to physiotherapy and psychological treatment plans, interest, and an award.

The Vice-Chair found that the original adjudicator erred in law and fact by requiring a diagnosis of chronic pain syndrome and relying on maximum medical recovery and a return to modified work to deny the physiotherapy plans, without linking these factors to the legal test for reasonableness and necessity.

These errors were material and likely affected the outcome.

However, the request regarding the psychological services plan was dismissed because the applicant had not addressed the applicable hourly rate in her initial submissions.

The decision regarding physiotherapy, interest, and an award was cancelled, and a rehearing before a new adjudicator was ordered.

The applicant requested a reconsideration of a Tribunal decision that barred him from proceeding to a hearing for non-earner benefits due to a material misrepresentation and found him subject to the Minor Injury Guideline (MIG).

The applicant argued the Tribunal failed to properly consider medical evidence, erred in its treatment of an investigation report, and demonstrated bias.

The Tribunal dismissed the request, finding that the applicant was attempting to re-litigate issues and advance new arguments not raised at the initial hearing.

The Tribunal concluded it had properly weighed the evidence, including surveillance and medical reports, and found no evidence to support the allegations of bias.

The applicant requested reconsideration of a Tribunal decision that dismissed his application for failing to file submissions.

The applicant provided evidence that he had, in fact, filed and served his submissions by the deadline set in the Case Conference Report and Order.

The Tribunal found that it had erred in fact by determining the applicant had not made submissions, and that this error likely affected the outcome.

The request for reconsideration was granted, the original decision was cancelled, and a rehearing before a new adjudicator was ordered.

The respondent insurer requested reconsideration of a Tribunal decision that found the applicant catastrophically impaired and entitled to a post-104 week income replacement benefit (IRB) as of September 1, 2024.

The Tribunal denied the reconsideration request regarding catastrophic impairment, finding that the original adjudicator provided adequate reasons and properly weighed the psychiatric and surveillance evidence.

However, the Tribunal granted the reconsideration request regarding the IRB.

Relying on the Divisional Court's recent decision in Paesano, the Tribunal found that the original adjudicator erred in law by awarding a post-104 week IRB without considering the impact of her findings that the applicant was not entitled to a pre-104 week IRB or a post-104 week IRB for the three years prior.

The IRB decision was cancelled and remitted for a rehearing before a new adjudicator.

The applicant requested a reconsideration of a Tribunal decision that awarded her income replacement benefits (IRBs) for a specific period ending on her intended retirement date.

She argued the Tribunal erred in law by relying on her former counsel's closing submissions and her testimony regarding her retirement, rather than applying the statutory disability test for ongoing entitlement.

The Tribunal denied the request, finding no error of law or fact.

The original decision correctly granted the exact relief sought by the applicant's counsel at the hearing, and it was not an error to rely on the applicant's sworn testimony and unambiguous submissions of her counsel.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that denied an extension of time to pursue claims for income replacement benefits and various treatment plans, and denied entitlement to attendant care benefits and other medical benefits.

The Vice-Chair found that the Tribunal had correctly applied the Manuel factors in refusing the extension of time and had not breached procedural fairness.

The Vice-Chair also upheld the Tribunal's findings that the applicant failed to meet his burden of proving the requested attendant care benefits and treatment plans were reasonable and necessary.

The request for reconsideration was denied.

The applicant requested reconsideration of a Tribunal decision that found her claim for an income replacement benefit (IRB) was statute-barred due to the expiry of the two-year limitation period.

The applicant argued the Tribunal erred in law by misinterpreting a tolling agreement, violating the parol evidence rule, failing to consider an extension of time under section 7 of the Licence Appeal Tribunal Act, and improperly awarding costs against her.

The Tribunal denied the request, finding that the applicant was attempting to relitigate issues and raise new arguments not presented at the initial hearing.

The Tribunal concluded there was no error of law or fact in its interpretation of the tolling agreement, its refusal to grant an extension of time, or its costs award.

The applicant requested a reconsideration of a decision dismissing their application for accident benefits.

The applicant argued the Tribunal breached procedural fairness by denying an oral adjournment request made after their former representative was suddenly hospitalized.

The Vice-Chair found that the adjudicator misconstrued Rule 16.2 of the Licence Appeal Tribunal Rules by focusing on what the applicant should have known rather than what they actually knew.

The denial of the adjournment resulted in the application being dismissed without evidence, constituting a material breach of procedural fairness.

The reconsideration was granted, the original decision cancelled, and a rehearing ordered before a new adjudicator.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision denying his claim for statutory accident benefits.

The applicant argued the Tribunal erred in fact by finding he had not filed any evidence.

The Vice-Chair granted the reconsideration request, finding that the applicant had indeed filed a 1008-page document brief prior to the deadline.

However, upon reconsidering the matter, the Vice-Chair confirmed the original decision.

Because the applicant had only filed a document brief without any accompanying written submissions to explain how the evidence supported his claim, he failed to meet his evidentiary burden.

The Tribunal declined to sift through the voluminous record to make the applicant's case for him.

The respondent insurer requested a reconsideration of a Tribunal decision granting the applicant entitlement to a chronic pain assessment.

The insurer argued the Tribunal erred by finding that only psychologists and psychiatrists could provide expert opinion evidence on chronic pain, thereby improperly discounting the evidence of its general practitioner and orthopaedic surgeon.

The Vice-Chair granted the reconsideration, finding the Tribunal erred in its treatment of the medical experts.

Upon rehearing the issue, the Vice-Chair weighed the competing medical evidence and concluded that the applicant's ongoing reports of pain and diagnosis of somatic symptom disorder provided reasonable grounds to warrant a chronic pain assessment.

The treatment plan was deemed reasonable and necessary.

The applicant sought reconsideration of a Tribunal order that dismissed his application for accident benefits as abandoned.

The applicant argued the Tribunal erred in fact and that new evidence regarding his mental capacity should be considered.

The Tribunal found no error of fact or law in the original decision based on the evidence available at the time.

However, the Tribunal granted the reconsideration based on new evidence—a capacity assessment and the appointment of a litigation guardian—which demonstrated the applicant lacked capacity to instruct counsel when the application was dismissed.

The Tribunal varied the original order and reinstated the application to proceed to a hearing.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that dismissed his application for statutory accident benefits due to his non-attendance at the hearing.

The applicant sought reconsideration under Rule 18.2(c) of the Licence Appeal Tribunal Rules, 2023, submitting two new operative summaries.

The Tribunal dismissed the request, finding that the applicant failed to provide any submissions explaining how the new medical reports met the high threshold for reconsideration or would have affected the original decision.

Both parties requested reconsideration of a Tribunal decision awarding the applicant non-earner benefits, attendant care benefits, and a section 10 award.

The applicant sought to increase the attendant care benefits to $6,000 per month, arguing the Tribunal erred in fact and law.

The Tribunal dismissed the applicant's request, finding no jurisdictional error, breach of procedural fairness, or error of fact that would change the outcome.

The respondent sought to deny the benefits and the award.

The Tribunal granted the respondent's request in part, finding it had mistakenly included $362,880 in family member invoices as incurred attendant care expenses.

The Tribunal also found it erred in concluding that none of the respondent's section 44 reports addressed the non-earner benefit test.

Consequently, the Tribunal ordered a rehearing on the issues of non-earner benefits and the section 10 award.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that found he did not sustain a catastrophic impairment and denied his claims for various benefits.

The applicant argued the Tribunal erred in its assessment of the medical evidence and application of the law regarding treatment plans.

The Vice-Chair dismissed the request, finding that the applicant was attempting to re-litigate his case and failed to establish any error of fact or law under Rule 18.2(b) of the Licence Appeal Tribunal Rules, 2023.

The applicant requested a reconsideration of a preliminary issue decision which found he was barred from proceeding with his claim for accident benefits under section 55 of the Statutory Accident Benefits Schedule due to a failure to notify the insurer of his intention to apply within the timeframe set out in section 32(1).

The applicant argued the Tribunal erred in law and fact, and sought to introduce new evidence, including a Social Benefits Tribunal decision, surveillance footage, and medical forms.

The Licence Appeal Tribunal dismissed the request for reconsideration, finding no error of law or fact in the initial decision's interpretation of section 32(1).

The Tribunal also denied the motion to admit new evidence, concluding that evidence regarding the extent of the applicant's injuries was not relevant to the preliminary issue of whether he was barred from pursuing his claim.

The applicant requested reconsideration of a decision dismissing his application for accident benefits after he failed to file submissions.

The applicant argued that the missed deadline was due to the inadvertence of his former representative, who experienced two family deaths.

The Tribunal found that dismissing the application without submissions, after denying a motion for an extension of time, resulted in a material breach of procedural fairness.

The reconsideration was granted in part, and a new written hearing was ordered for the non-earner benefits and other issues, while the request regarding catastrophic impairment was dismissed as it had been previously withdrawn.

The respondent insurer requested a reconsideration of a Tribunal decision awarding the applicant attendant care benefits.

The insurer argued the Tribunal erred in finding it had not properly denied the benefits and in awarding benefits despite finding no functional limitations caused by the accident.

The Vice-Chair dismissed these grounds, finding no error of fact or law.

However, the Vice-Chair granted the reconsideration in part, finding the Tribunal erred by failing to apply section 42(5) of the Schedule, which governs retroactive attendant care benefits before a Form 1 is submitted.

The decision was varied to award attendant care benefits only from the date the Form 1 was received.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision which found her psychological injuries did not meet the definition of an accident and were subject to the Minor Injury Guideline.

The applicant argued that her psychological trauma was triggered by viewing a dashcam video of the motor vehicle accident.

The Vice-Chair granted the reconsideration, finding that the initial adjudicator erred in law by applying the test for whether an accident occurred rather than the test for whether the accident caused the psychological impairment.

A rehearing of all issues by a different adjudicator was ordered.