E. Louise Logan

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that found her injuries were predominantly minor and subject to the Minor Injury Guideline.

The applicant argued the Tribunal violated procedural fairness by assigning the same adjudicator to the reconsideration, made errors of fact and law in weighing the evidence, and sought to introduce new medical evidence.

The Tribunal dismissed the request, finding no procedural unfairness in its assignment practices, no errors in the original weighing of evidence, and that the applicant failed to demonstrate why the new evidence could not have been obtained prior to the original hearing.

The applicant requested a reconsideration of a previous Tribunal decision which found his injuries were predominantly minor, denied his claim for non-earner benefits (NEBs) and treatment plans, and ordered him to repay $6,105.00 in NEBs.

The applicant argued the Tribunal erred in weighing the medical evidence regarding his pre-existing conditions and relied on an incomplete OCF-3 form.

The Tribunal denied the reconsideration request, finding that the applicant was attempting to re-litigate his case and re-weigh the evidence, which are not valid grounds for reconsideration under Rule 18.2.

The Tribunal confirmed that the original decision properly considered the totality of the evidence.

The applicant requested a reconsideration of a previous Tribunal decision which found her injuries fell within the Minor Injury Guideline (MIG) and denied her medical benefits.

The applicant argued the Tribunal failed to consider her case law and erred in interpreting the notice requirements under sections 38 and 54 of the Schedule.

The Tribunal dismissed the request, finding that it had adequately addressed the evidence, authorities, and the adequacy of the denial letters in its original decision, and that the applicant was improperly attempting to re-litigate her case.

The applicant requested a reconsideration of a Tribunal decision that dismissed their application for accident benefits due to a failure to attend insurer's examinations.

The applicant argued the Tribunal violated procedural fairness, failed to remain impartial, and made errors of fact and law.

The Vice-Chair dismissed the procedural fairness and bias arguments, finding no reasonable apprehension of bias.

However, the Vice-Chair found the Tribunal erred by dismissing the application in its entirety, as the preliminary issue hearing only addressed attendant care, housekeeping, and caregiver benefits.

The reconsideration was granted in part, allowing the applicant to proceed with the remaining benefit claims.

The applicant sought a reconsideration of a Licence Appeal Tribunal decision that denied her claim for an income replacement benefit (IRB), interest, and an award under Regulation 664.

The applicant argued the Tribunal acted outside its jurisdiction, violated procedural fairness, and made errors of fact and law by conducting its own assessment of the medical evidence rather than deferring to the disability certificate or insurer's examination.

The Vice-Chair dismissed the request, finding that the Tribunal has the statutory jurisdiction to determine benefit entitlement and did not err in its weighing of the evidence.

The reconsideration request was deemed an attempt to re-litigate the original case.

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

The respondent denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant failed to demonstrate that her post-accident diagnosis of dural AV fistula, alleged psychological condition, or pre-existing conditions warranted removal from the MIG.

Furthermore, the Tribunal held that the applicant was not entitled to a non-earner benefit, as she had resumed most of her normal activities of daily living and did not suffer a complete inability to carry on a normal life.

The application was dismissed.

The applicant sought reconsideration of a Case Conference Report and Order that closed his file after he allegedly withdrew his application for accident benefits.

The applicant argued he was compelled to withdraw by the adjudicator when he attempted to add new issues.

The Vice-Chair found that the Tribunal violated procedural fairness by advising the applicant to withdraw and then issuing an order indicating he had done so, as it is solely the applicant's choice to pursue an application.

The request for reconsideration was granted, and the original application was allowed to proceed to prevent an abuse of process.

The applicant was injured in a motor vehicle accident and sought medical benefits for chiropractic treatment, an orthopaedic assessment, and a psychological assessment.

The respondent denied the benefits on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and the monetary limits had been exhausted.

The Tribunal found that the applicant failed to prove that his pre-existing shoulder injury, left knee injury, or alleged psychological condition warranted removal from the MIG.

As the MIG limits were exhausted, the claims for treatment and assessments were dismissed, along with the claim for interest.

The applicant sought a reconsideration of a Licence Appeal Tribunal decision that denied her claims for an income replacement benefit (IRB), attendant care benefits, and various treatment plans following a motor vehicle accident.

The applicant argued the Tribunal made errors of fact and law regarding her concussion diagnosis, surveillance evidence, and the medical assessments of several experts.

The Vice-Chair dismissed the request for reconsideration, finding that while there were minor factual inaccuracies in the original decision, they were not significant enough to have likely changed the result.

The Tribunal's original weighing of the medical evidence and surveillance footage was upheld.

The applicant sought reconsideration of a Licence Appeal Tribunal decision that denied his claims for a non-earner benefit and medical and rehabilitation benefits (treatment plans).

The applicant argued the Tribunal erred in its assessment of the evidence and failed to consider the totality of the medical reports.

The Vice-Chair dismissed the request, finding that the applicant was attempting to re-litigate his case and had failed to meet the high threshold for reconsideration under Rule 18.2(b).

The original decision was confirmed.

The applicant and respondent both sought reconsideration of a Licence Appeal Tribunal decision that found the applicant was not catastrophically impaired and awarded the applicant $2,000 in costs.

The applicant argued the Tribunal erred in its assessment of her activities of daily living and sought to introduce new evidence regarding her relationship breakdown.

The respondent argued the Tribunal erred in awarding costs based on its counsel's conduct.

The Vice-Chair dismissed both requests, finding no errors of law or fact in the original decision and concluding the new evidence would not have affected the result.

The applicant sought non-earner benefits following a motor vehicle accident, which were denied by the insurer.

The applicant filed an application with the Licence Appeal Tribunal 59 days after the expiry of the two-year limitation period, accounting for the COVID-19 suspension period.

The Tribunal applied the four-factor test under section 7 of the Licence Appeal Tribunal Act and found that the applicant had a bona fide intention to appeal, the delay was not significant, the respondent would not suffer prejudice, and there was some merit to the claim.

The Tribunal exercised its discretion to extend the limitation period and allowed the application to proceed.

The applicant was injured in a rear-end motor vehicle accident and sought statutory accident benefits, including income replacement benefits (IRBs) and medical benefits.

The Licence Appeal Tribunal found that the applicant's accident-related psychological condition and pain caused a substantial inability to perform the essential tasks of her pre-accident employment as a student placement coordinator, entitling her to IRBs for the pre-104 week period.

However, the Tribunal dismissed her claim for post-104 week IRBs, finding she did not suffer a complete inability to engage in suitable employment.

The Tribunal also denied the claimed medical benefits for physiotherapy, an attendant care assessment, and assistive devices, preferring the insurer's medical evidence that the physical injuries did not warrant the disputed treatment plans.

The applicant sought statutory accident benefits, including income replacement benefits (IRBs) and medical benefits for physiotherapy, following a motor vehicle accident.

The Tribunal found that while the insurer failed to comply with the procedural timelines under section 36(4) of the Schedule, creating a period of statutory entitlement to IRBs, the quantum payable was nil because the applicant had returned to work and earned income that offset the benefit.

For the subsequent period, the applicant failed to prove a substantial inability to perform the essential tasks of her employment.

The claims for medical benefits were also dismissed as the applicant did not provide medical evidence to prove the treatments were reasonable and necessary, whereas the insurer's examination reports indicated only minor injuries.

The applicant sought a determination of catastrophic impairment following a motor vehicle accident.

The respondent scheduled psychological and occupational therapy insurer's examinations (IEs).

The applicant attended both, but the psychologist passed away before finalizing his report, and the applicant declined to participate in the situational portion of the occupational therapy IE.

The respondent scheduled a second set of IEs, which the applicant refused to attend.

The Tribunal found that a second in-person psychological IE was not reasonably necessary, as the respondent possessed the draft report and raw data.

However, the Tribunal found the situational occupational therapy assessment was reasonably necessary.

The Tribunal stayed the proceeding until the applicant complied with the situational assessment requirement.

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

The respondent determined the applicant's injuries fell within the Minor Injury Guideline (MIG) and capped medical and rehabilitation benefits at $3,500.

The applicant applied to the Licence Appeal Tribunal, arguing that pre-existing conditions, chronic pain, and psychological impairments warranted removal from the MIG.

The Tribunal found insufficient evidence to support the applicant's claims, preferring the respondent's independent medical examination reports over the applicant's orthopaedic expert.

The Tribunal concluded the applicant sustained minor injuries, and having exhausted the $3,500 limit, was not entitled to further chiropractic benefits, interest, or an award.

The applicant was involved in a rear-end motor vehicle accident and sought statutory accident benefits, including a non-earner benefit and a medical benefit for a concussion assessment.

The adjudicator found that the applicant failed to demonstrate a complete inability to carry on a normal life, noting inconsistent reporting of post-accident functional deficits and a lack of evidence regarding pre-accident activities.

The adjudicator also denied the concussion assessment, drawing a negative inference from the applicant's failure to produce records from a prior OHIP-funded neurological assessment.

The application was dismissed in its entirety, with no entitlement to a section 10 award or interest.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that partially denied her claims for treatment plans under the Statutory Accident Benefits Schedule.

The applicant argued that the Tribunal violated procedural fairness by refusing to consider her late reply submissions and by asking factual questions after the hearing.

She also alleged errors of law regarding the application of the Minor Injury Guideline and claimed there was new evidence.

The Vice-Chair dismissed the request, finding no procedural unfairness as the applicant missed the mandated deadline for reply submissions.

The Vice-Chair also found no error of law, noting the applicant was attempting to reargue her case, and concluded that the applicant failed to identify any new evidence that met the test for reconsideration.

The applicant sought statutory accident benefits following a motor vehicle accident, arguing her injuries fell outside the Minor Injury Guideline (MIG) due to a pre-existing psychological condition and accident-related driving anxiety.

The Licence Appeal Tribunal found the applicant failed to provide compelling evidence that a pre-existing condition prevented her from achieving maximal medical recovery within the MIG limit.

The Tribunal preferred the respondent's psychological assessment, which concluded the applicant's injuries were minor and not a barrier to recovery.

The application for additional medical benefits and interest was dismissed.

The applicant requested a reconsideration of a Tribunal decision which found that he was not involved in an 'accident' as defined by the Statutory Accident Benefits Schedule because the incident was staged.

The applicant argued the Tribunal violated procedural fairness and made errors of fact and law by excluding certain evidence, drawing an adverse inference from a lack of evidence, and relying on pleadings from a civil proceeding.

The Vice-Chair dismissed the request, finding that the Tribunal properly excluded evidence that was not properly before it, correctly drew an adverse inference, and appropriately used the civil pleadings to assess credibility rather than as statements of fact.