Jeremy A. Roberts

The applicant requested a reconsideration of a Licence Appeal Tribunal decision denying entitlement to disputed treatment plans under the Statutory Accident Benefits Schedule.

The applicant argued the Tribunal made errors of law and fact, including applying the wrong test and imposing an unduly high threshold, and sought to introduce new evidence.

The Tribunal dismissed the request, finding no errors of law or fact that would have altered the outcome, and concluding that the proposed new evidence could have reasonably been obtained prior to the original hearing.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that found she was not catastrophically impaired under Criterion 8.

The applicant argued the Tribunal made errors of law and fact in assessing her social functioning impairment under the AMA Guides.

The Vice-Chair dismissed the request, finding the Tribunal properly applied the AMA Guides, appropriately weighed the expert medical evidence, and made no error of law or fact that would have led to a different result.

The applicant sought a determination that he sustained a catastrophic impairment as a result of a 2016 motor vehicle accident, claiming marked impairments in social functioning and adaptation, and a whole person impairment (WPI) of 55% or more.

The Tribunal found that the applicant's psychological impairments were largely attributable to pre-existing substance abuse issues rather than the accident.

Preferring the evidence of the respondent's psychiatric assessor, the Tribunal concluded the applicant suffered only mild impairments and a 14% mental/behavioural WPI, falling short of the catastrophic impairment thresholds.

The application for attendant care benefits, assessment costs, and interest was dismissed.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that denied her claims for Income Replacement Benefits and various treatment plans.

The applicant argued the Tribunal made errors of fact by failing to properly consider medical evidence, made errors of law by misapplying the test for post-104-week benefits, and breached procedural fairness by providing insufficient reasons.

The Vice-Chair dismissed the request, finding that the original adjudicator properly weighed the evidence, applied the correct legal tests, and provided sufficient reasons in accordance with the Vavilov standard.

The request for reconsideration was denied.

The applicant sought statutory accident benefits following a 2016 motor vehicle accident, claiming catastrophic impairment under criterion 8 due to mental and behavioural disorders.

The Tribunal found the applicant was not catastrophically impaired, as she failed to establish that her psychological impairments would not have occurred 'but for' the accident, noting a significant time gap and high level of functioning in the intervening years.

The Tribunal granted entitlement to several treatment plans for occupational therapy, assistive devices, and assessments incurred prior to the 260-week mark, but denied plans submitted after that period and denied the claim for living accommodations due to non-compliance with section 38(2) of the Schedule.

The claim for a special award was also dismissed.

Both the applicant and the respondent requested reconsideration of a Tribunal decision regarding entitlement to income replacement benefits (IRBs).

The respondent argued the Tribunal erred in finding the applicant was not barred from proceeding despite missing an insurer's examination, and erred in awarding pre-104-week IRBs.

The applicant argued the Tribunal erred in denying post-104-week IRBs.

The Vice-Chair dismissed both requests, finding neither party met the high threshold of demonstrating an error of law or fact that would likely have changed the result, and that both parties were improperly attempting to re-litigate the original decision.

The applicant sought statutory accident benefits following a motor vehicle accident, specifically claiming entitlement to pre-104 and post-104 income replacement benefits (IRBs).

The Licence Appeal Tribunal found that the applicant failed to provide sufficient medical evidence to demonstrate a substantial inability to perform the essential tasks of his pre-accident employment for the pre-104 period.

Furthermore, the applicant did not provide compelling medical evidence to establish a complete inability to engage in any suitable employment for the post-104 period.

The application for IRBs and interest was dismissed.

The appellants appealed a Tarion Warranty Corporation decision denying warranty coverage for 18 alleged defects in their new home, including cracks on door latches, debris, imperfect studs, a loose kitchen light, door alignment, and paint issues.

The Licence Appeal Tribunal found that the appellants failed to prove on a balance of probabilities that the items fell below industry standards or constituted a breach of the warranty of workmanlike manner under the Ontario New Home Warranties Plan Act.

The Tribunal also denied the builder's request for costs, finding the self-represented appellants' conduct did not meet the high threshold for a costs award.

The appeal was dismissed.

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

The Tribunal first dismissed the insurer's preliminary motion to bar the application for non-attendance at an insurer's examination, finding the request was made years after the application was filed.

On the substantive issues, the Tribunal found the applicant entitled to income replacement benefits for the pre-104-week period due to psychological impairments, but not for the post-104-week period as she did not suffer a complete inability to work.

The Tribunal also approved several treatment plans for occupational therapy, chiropractic, physiotherapy, and massage services, finding them reasonable and necessary.

Claims for a social work treatment plan balance and a special award were dismissed.

The appellant appealed the 45-day impoundment of her motor vehicle after her son was found in the driver's seat with a suspended licence.

The appellant had lent the vehicle to her son's girlfriend, who had a valid licence, with strict instructions that the son was not to drive.

The Tribunal found that the son was not the 'driver' under the Highway Traffic Act as he was not on a highway, and that the appellant exercised reasonable due diligence by verifying the girlfriend's licence and instructing her not to let the son drive.

The appeal was allowed and the vehicle ordered released.

The appellant appealed the 45-day impoundment of his motor vehicle under the Highway Traffic Act, arguing that the impoundment would cause exceptional hardship to his family, including a medically fragile child.

The Tribunal found that the appellant had access to reliable alternative transportation, such as walking, assistance from family members, and a company van.

As the appellant failed to demonstrate that no alternatives were available, the Tribunal concluded that the exceptional hardship criteria were not met and confirmed the impoundment.

The applicant sought statutory accident benefits following a motor vehicle accident, including a non-earner benefit and several treatment plans.

The Licence Appeal Tribunal dismissed the application.

The Tribunal found the applicant was excluded from receiving a non-earner benefit under s. 31(1)(a)(ii) of the Schedule because she was driving with a suspended licence at the time of the accident.

The claims for treatment plans were also dismissed as the applicant failed to provide sufficient medical evidence to prove they were reasonable and necessary.

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

Prior to the scheduled three-day hearing, the parties informed the Tribunal they had entered into a tolling agreement and would not proceed, but failed to file a formal Notice of Withdrawal.

When neither party attended the hearing, the Vice-Chair accepted their prior email as confirmation of withdrawal and closed the Tribunal file.

The applicant sought statutory accident benefits following a motor vehicle accident but failed to attend the scheduled videoconference hearing.

The Tribunal proceeded in his absence pursuant to the Statutory Powers Procedure Act and the Licence Appeal Tribunal Rules.

Because the applicant presented no evidence or submissions, he failed to meet his burden of proving entitlement to the disputed benefits, including income replacement benefits and various treatment plans.

The application was dismissed.

The respondent's request for costs was also denied, as the applicant's non-attendance did not meet the high threshold of unreasonable, frivolous, or vexatious conduct.

The applicant requested a reconsideration of a decision that found she was not catastrophically impaired under criterion 8.

The applicant argued the Tribunal acted outside its jurisdiction, breached procedural fairness by limiting her testimony and allegedly diagnosing malingering, and erred in law by failing to follow the Pastore framework.

The Vice-Chair dismissed the request, finding that the original decision correctly applied the 'but for' test for causation, offered reasonable accommodations during testimony, and properly followed the legal tests without making an unauthorized medical diagnosis.

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

The respondent insurer denied benefits and scheduled insurer examinations under section 44 of the Schedule.

The applicant failed to attend the scheduled assessments and did not provide a reasonable explanation.

The Tribunal found that the notices of assessment were proper and provided sufficient medical reasons.

Consequently, the applicant was barred from proceeding with his claim under section 55 of the Schedule.

The application was dismissed, and the respondent's request for costs was denied.

The applicant, who had pre-existing autism, was involved in a motor vehicle accident while riding her bike.

She sought a determination of catastrophic impairment and various statutory accident benefits.

The respondent denied the benefits, arguing her impairments were solely related to her pre-existing autism.

The Tribunal found that the accident was a necessary cause of her worsened psychological condition, leading to an extreme impairment in adaptation.

The applicant was deemed catastrophically impaired and awarded ongoing attendant care benefits and partial occupational therapy costs, but denied past attendant care benefits and other treatment plans.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming she sustained a catastrophic impairment and was entitled to post-104 income replacement benefits, attendant care, and various medical benefits.

The Licence Appeal Tribunal dismissed the application.

The Tribunal gave no weight to the applicant's key expert psychiatrist, who recanted his findings during cross-examination when confronted with evidence of the applicant's actual functional capabilities, including international travel and childcare.

Consequently, the applicant failed to prove she met the criteria for catastrophic impairment or that she suffered a complete inability to engage in suitable employment.

As the non-catastrophic benefit limits were exhausted, all claims were dismissed.

The applicant sought a determination of catastrophic impairment and entitlement to attendant care benefits and assessment costs following a motorcycle accident.

The Licence Appeal Tribunal found that the applicant did not meet the threshold for catastrophic impairment under either criterion 7 or 8, preferring the evidence of the respondent's experts over the applicant's expert, whose conclusions relied heavily on inconsistent self-reporting.

The Tribunal also dismissed the claims for attendant care benefits and assessment costs due to a lack of evidence demonstrating incurred expenses or reasonable necessity.

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

Prior to the hearing, the applicant passed away, and no litigation guardian was formally appointed.

At the hearing, the applicant's representative requested an adjournment, arguing he lacked authority to proceed.

The Tribunal denied the oral adjournment request because it was not submitted on the proper form and the representative had six months to do so.

As the applicant presented no evidence or submissions on the substantive issues, the Tribunal found the applicant failed to meet the burden of proof and dismissed the application.