Harry Adamidis

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

The applicant failed to attend the videoconference hearing and did not file any evidence or submissions.

Although the applicant had emailed the Tribunal requesting an adjournment because he would be in the Philippines, he failed to submit the prescribed adjournment form despite being instructed to do so.

The Tribunal proceeded in the applicant's absence pursuant to s. 7(1) of the Statutory Powers Procedure Act.

As the applicant bore the burden of proof and provided no evidence, the application was dismissed.

The applicant sought a determination that she sustained a catastrophic impairment as a result of a motor vehicle accident, along with entitlement to various accident benefits, an award, and interest.

The Tribunal evaluated the medical evidence under Criterion 7 and Criterion 8 of the Statutory Accident Benefits Schedule.

The Tribunal preferred the respondent's expert evidence, finding the applicant did not have Complex Regional Pain Syndrome and that her physical and psychological impairments did not meet the catastrophic impairment thresholds.

As the applicant's non-catastrophic medical rehabilitation limits were exhausted, the claims for attendant care and treatment plans were dismissed.

The claims for an award and interest were also dismissed.

The applicant sought entitlement to statutory accident benefits for an endocrinology CAT assessment and various other CAT assessments following a motor vehicle accident.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to establish on a balance of probabilities that the proposed assessments were reasonable and necessary.

The Tribunal noted that the applicant's diabetes and pancreatitis pre-dated the accident and lacked a causal connection to it.

Furthermore, the applicant failed to justify the need for multiple psychiatric and occupational therapy assessments beyond the statutory caps.

Claims for interest and an award for unreasonable delay were also dismissed.

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

The adjudicator found the applicant was barred from proceeding with her claim for an income replacement benefit because she failed to dispute the denial within the two-year limitation period under section 56 of the Schedule.

Regarding medical and rehabilitation benefits, the adjudicator approved a treatment plan for Botox injections and a cold cap to treat post-traumatic headaches, finding them reasonable and necessary.

The remaining claims for various treatment plans, including occupational therapy, social work services, and delivery fees, were dismissed due to insufficient evidence, failure to prove the expenses were not administrative fees, or failure to comply with a section 33 request for information.

The applicant sought statutory accident benefits following a motor vehicle accident, including an income replacement benefit (IRB) and several treatment plans.

The Licence Appeal Tribunal found the applicant was barred from proceeding to a hearing on the treatment plans because she failed to dispute the denials within the two-year limitation period and failed to attend a section 44 insurer's examination without a reasonable explanation.

However, the Tribunal found the respondent improperly stopped the applicant's IRB payments without providing proper notice under section 37(4) of the Schedule.

The applicant was awarded IRB payments for a brief period in January 2023, plus interest, but her claim for a section 10 award was dismissed.

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

The insurer denied a $1,997.00 physiotherapy treatment plan, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) and the $3,500 limit was exhausted.

The Tribunal found the applicant failed to prove chronic pain with functional impairment warranting removal from the MIG.

The application was dismissed, and the applicant was not entitled to the treatment plan or interest.

The applicant sought statutory accident benefits following a 2021 motor vehicle accident.

The Tribunal found the applicant sustained a catastrophic impairment under Criterion 8 due to marked impairments in all four areas of function (activities of daily living, social functioning, concentration, persistence and pace, and adaptation) stemming from accident-related mental and behavioural disorders, including somatic symptom disorder and exacerbated PTSD.

However, the Tribunal dismissed the claims for a non-earner benefit, attendant care benefits, and various treatment plans, finding the applicant did not suffer a complete inability to carry on a normal life and failed to prove the treatment plans were reasonable and necessary.

The applicant sought accident benefits following a 2018 motor vehicle accident.

The insurer denied three treatment plans.

The Tribunal found the applicant was barred from proceeding to a hearing for one treatment plan submitted more than 260 weeks after the accident, as there was insufficient evidence of optional benefits or catastrophic impairment.

However, the Tribunal found the applicant was entitled to the other two treatment plans for chiropractic treatment, as the medical evidence established they were reasonable and necessary to address ongoing pain and functional limitations caused by the accident.

The applicant was also awarded interest on the overdue benefits.

The applicant sought statutory accident benefits following a motor vehicle accident, disputing the insurer's determination that her injuries fell within the Minor Injury Guideline (MIG).

The applicant argued she suffered from chronic pain and a psychological disorder warranting removal from the MIG.

The Tribunal found the applicant's evidence of pain insufficient to establish functional impairment, preferring the respondent's physiatry assessment.

The Tribunal also accepted the respondent's psychological assessment, which found evidence of malingering and no diagnosable psychological injury.

As the injuries were predominantly minor and the MIG limits were exhausted, the claims for treatment plans, an award, interest, and costs were dismissed.

The applicant sought statutory accident benefits following a 2018 motor vehicle accident, claiming catastrophic impairment under Criteria 6, 7, and 8 of the Schedule.

The Tribunal gave no weight to the applicant's key expert witness, who failed to attend the hearing for cross-examination, citing procedural fairness.

Relying on surveillance evidence that contradicted the applicant's claims of severe impairment and social isolation, the Tribunal found the applicant did not meet the threshold for catastrophic impairment.

Consequently, claims for medication expenses beyond the non-catastrophic limit, a special award, and interest were dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming she sustained a catastrophic impairment.

The Licence Appeal Tribunal assessed her physical and psychological impairments under Criteria 7 and 8 of the Schedule.

The Tribunal found the applicant's Whole Person Impairment rating was 41%, falling short of the 55% threshold, and that she suffered only moderate, not marked or extreme, psychological impairments.

Claims for a non-earner benefit, attendant care benefits, and various treatment plans were also dismissed due to insufficient evidence and failure to meet the respective legal tests.

The application was dismissed in its entirety.

The applicant sought a determination of catastrophic impairment under Criterion 8 of the SABS following a motor vehicle accident, along with a treatment plan for CAT assessments and an award.

The Tribunal found that the applicant suffered from moderate impairments in activities of daily living and social functioning, but did not meet the threshold of three marked impairments or one extreme impairment required for a catastrophic designation.

The Tribunal noted that the applicant's physical limitations, rather than her psychological symptoms, primarily restricted her activities of daily living.

The claims for the treatment plan, interest, and an award were dismissed.

The applicant sought income replacement benefits (IRBs) and a treatment plan following a motor vehicle accident that exacerbated her pre-existing migraines.

The Tribunal found the applicant was entitled to a pre-104 IRB, as her migraines prevented her from performing the essential tasks of her employment as a restaurant manager.

The Tribunal also awarded a post-104 IRB for a limited period, terminating when medical evidence showed her headaches had significantly improved with prophylaxis, enabling her to engage in part-time employment.

The treatment plan and a claim for a special award were denied, but interest on overdue benefits was granted.

The applicant sought a determination that he sustained a catastrophic impairment as a result of a motor vehicle accident, along with entitlement to various attendant care benefits and treatment plans.

The Licence Appeal Tribunal evaluated the applicant's impairments under Criterion 7 (Whole Person Impairment) and Criterion 8 (mental and behavioural disorders).

The Tribunal rejected several of the applicant's physical impairment ratings due to a lack of causal evidence and methodological flaws, concluding the applicant did not meet the 55% WPI threshold.

Under Criterion 8, the Tribunal found the applicant had only mild impairments in activities of daily living and social functioning, failing to meet the threshold of three marked or one extreme impairment.

As the applicant was not catastrophically impaired and had exhausted his non-CAT limits, the claims for attendant care and treatment plans were dismissed.

The applicant sought statutory accident benefits following a 2015 motor vehicle accident, claiming catastrophic impairment due to mental and behavioural disorders and entitlement to income replacement benefits (IRB).

The Licence Appeal Tribunal found that the applicant did not meet the threshold for catastrophic impairment under Criterion 8, as he sustained only moderate, rather than marked, impairments in activities of daily living and adaptation.

The Tribunal preferred the respondent's psychiatric assessment, noting the applicant maintained useful functioning such as driving, going to the gym, and caring for his parents.

The Tribunal also dismissed the claim for IRB, finding insufficient objective medical evidence that the applicant suffered a substantial inability to perform the essential tasks of his pre-accident employment as an IT technician.

Claims for an award and interest were consequently dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming catastrophic impairment under Criterion 7.

The respondent denied the benefits.

The Tribunal found the applicant was not catastrophically impaired, as her Whole Person Impairment rating was 48%, falling short of the 55% threshold.

The Tribunal rejected the WPI ratings for incontinence and headaches provided by the respondent's own expert, finding the incontinence was pre-existing and did not worsen post-accident.

Claims for psychological services, case management, interest, and a section 10 award were also dismissed.

The applicant sought interest on allegedly overdue Income Replacement Benefits (IRB) and an award for unreasonable delay under s. 10 of O. Reg. 664 following a motor vehicle accident.

The Tribunal found that the applicant failed to provide the necessary financial documentation requested by the insurer to calculate the IRB quantum, triggering s. 33(6) of the Schedule, which suspends the insurer's liability to pay.

Consequently, no benefits were overdue, and no interest was payable.

The Tribunal also dismissed the claim for an award, finding the insurer's requests for documentation were reasonable and supported by legitimate accounting reasons.

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

At the scheduled videoconference hearing, the applicant failed to appear and had not filed a document brief or witness list.

Applicant's counsel made an oral request for an adjournment, citing the sudden hospitalization of the applicant's paralegal representative.

The Tribunal denied the adjournment request under Rule 16.2, finding insufficient evidence to establish compelling circumstances or explain why a written request could not have been made prior to the hearing.

As the applicant filed no evidence and made no submissions, the application for benefits was dismissed.

The applicant sought statutory accident benefits following a 2018 motor vehicle accident, claiming she sustained a catastrophic impairment.

The Licence Appeal Tribunal evaluated her impairments under Criterion 7 (Whole Person Impairment) and Criterion 8 (mental and behavioural disorders) of the Schedule.

The Tribunal rejected several of the applicant's expert ratings due to methodological flaws and inconsistencies with surveillance footage, which showed the applicant performing strenuous tasks like shovelling snow and shopping independently.

The Tribunal concluded the applicant did not meet the threshold for catastrophic impairment and dismissed her claims for attendant care, treatment plans, and a special award.

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

The respondent denied the benefits on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant argued for removal from the MIG due to chronic pain and psychological impairments.

The Tribunal found the applicant's medical evidence, including clinical notes and OCF forms, insufficient to establish chronic pain or psychological injury caused by the accident.

The Tribunal concluded the injuries were predominantly minor and subject to the MIG limit, which had been exhausted.

The claims for treatment plans, an award, and interest were dismissed.