Lyndra Griffith

The applicant sought reconsideration of a Licence Appeal Tribunal decision regarding his entitlement to attendant care benefits.

He argued the Tribunal violated procedural fairness and erred in law by denying an adjournment, refusing to admit new evidence after the hearing, misinterpreting section 42(12) of the Statutory Accident Benefits Schedule regarding the submission of a new Form 1, and failing to address arguments raised in his reply submissions.

The adjudicator dismissed the request, finding no violation of procedural fairness or errors of law that would have changed the outcome of the original decision.

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

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

The Tribunal found the applicant had a pre-existing high-grade ankle sprain that prevented maximal recovery within the MIG, thereby removing him from its limits.

The Tribunal awarded the claimed physiotherapy treatment plan as reasonable and necessary, but denied the psychological assessment due to a lack of compelling contemporaneous evidence.

The claim for non-earner benefits was dismissed for lack of jurisdiction, as the applicant had not yet made the required election between income replacement and non-earner benefits.

The applicant was involved in a motor vehicle accident and sought a determination of catastrophic impairment (CAT) due to psychological injuries, including PTSD and a relapse of Major Depressive Disorder.

The respondent denied the CAT designation based on its assessors' conclusions that the applicant suffered only moderate impairments.

The Tribunal preferred the evidence of the applicant's assessors, finding that the respondent's psychiatric assessment lacked thoroughness and failed to properly consider the applicant's reduced functioning in activities of daily living.

The Tribunal concluded that the applicant sustained a Class 4 (marked) impairment in at least one area of functioning and therefore met the definition of catastrophic impairment under the Schedule.

The Tribunal also granted the applicant's request to anonymize her name and limit public access to the adjudicative records due to the sensitive nature of her mental health information.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that included income/losses from one of his properties in the calculation of his Income Replacement Benefits.

The applicant argued the adjudicator erred in law by classifying the property as employment income rather than investment income and by focusing on his level of activity.

The adjudicator dismissed the request, finding that the applicant was attempting to relitigate the original hearing and had failed to identify a significant error of fact or law.

The applicant failed to attend a scheduled hearing for statutory accident benefits after previously requesting multiple adjournments.

The respondent sought costs under Rule 19 of the Licence Appeal Tribunal Rules, arguing the applicant acted unreasonably and caused unnecessary preparation and disbursement expenses.

The Tribunal found the applicant's conduct unreasonable and ordered him to pay $409.06 in costs to the respondent for court reporting services.

The applicant insurer sought repayment of $11,954.22 in income replacement benefits (IRBs) paid to the respondent, alleging the respondent wilfully misrepresented information on his Employer's Confirmation Form (OCF-2).

The Licence Appeal Tribunal found that the respondent forged the OCF-2 to obtain benefits while on an unpaid leave of absence out of the country.

The Tribunal ordered the respondent to repay the full amount of the IRBs plus interest.

The applicant was injured in a motor vehicle accident when a car ran over his foot, causing a crush injury.

He sought post-104 week income replacement benefits, attendant care benefits, and various medical and rehabilitation benefits.

The Tribunal found the applicant was not entitled to post-104 week IRBs as he failed to prove a complete inability to engage in suitable employment.

Claims for attendant care benefits were dismissed because the applicant was largely independent and failed to prove his mother sustained an economic loss.

The Tribunal approved some treatment plans for assistive devices and physiotherapy, finding them reasonable and necessary, but denied others due to lack of contemporaneous medical evidence or failure to submit prior approval.

The claim for a special award was dismissed.

The applicant was involved in a motor vehicle accident and applied for accident benefits 14 months later.

The respondent denied the claim, arguing the applicant was precluded from bringing a claim due to the delay.

The Tribunal found that the applicant had a reasonable explanation for the delay under section 34 of the Statutory Accident Benefits Schedule, as the respondent failed to provide the applicant with an application for benefits (OCF-1) and there was confusion regarding the applicable policy and coverage.

The applicant is not precluded from bringing a claim.

The applicant sought attendant care benefits following a motor vehicle accident.

The Licence Appeal Tribunal dismissed the application, finding it lacked jurisdiction over the first claim because the applicant had previously withdrawn it and failed to notify the insurer of a renewed dispute.

The Tribunal also found the second claim was not properly submitted.

In the alternative, the Tribunal held the applicant failed to prove the attendant care expenses were 'incurred' under the Schedule, as the care was provided by his wife, a retired personal support worker who was not employed at the time of the accident and did not sustain an economic loss.

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

A videoconference hearing was scheduled, but the self-represented applicant failed to attend.

The Tribunal proceeded in her absence under the Statutory Powers Procedure Act.

Because the applicant provided no submissions or evidence, she failed to meet her burden of proof.

The application for non-earner benefits, medical benefits, and interest was dismissed.

The applicant was catastrophically injured in a motor vehicle accident and sought statutory accident benefits, including custom orthotics and attendant care benefits (ACBs).

The respondent denied the orthotics and partially denied the ACBs.

The Tribunal found the orthotics were reasonable and necessary, noting the respondent's notice was proper but the medical evidence supported the claim.

Regarding ACBs, the Tribunal weighed competing Form 1 assessments, finding the applicant's assessor recommended excessive hours while the respondent's assessor failed to account for the applicant's psychological impairments and lack of motivation.

The Tribunal awarded ACBs at $3,121.57 per month.

Claims for a Regulation 664 award were dismissed, but interest was awarded on overdue payments.

The applicant was involved in a motor vehicle accident and sought an income replacement benefit (IRB) from the respondent insurer.

The central issue was whether the applicant's income and losses from various rental and development properties should be classified as self-employment income or passive investment income for the purpose of calculating the IRB.

The Tribunal determined that three of the properties generated passive rental income, while the development of a fourth property constituted self-employment.

The Tribunal concluded the applicant was entitled to an IRB of $325.00 per week, less applicable deductions, plus interest on overdue payments.

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

The respondent denied claims for chiropractic services and income replacement benefits, asserting the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Licence Appeal Tribunal found that the applicant failed to prove his injuries warranted removal from the MIG based on pre-existing conditions, chronic pain, or psychological impairment.

As the $3,500 MIG limit was exhausted, the claims for chiropractic services were dismissed.

The claim for income replacement benefits was also dismissed due to a lack of evidence.

Consequently, claims for an award and interest were denied.

The applicant sought statutory accident benefits following two motor vehicle accidents.

After multiple adjournments, the applicant failed to attend the scheduled video hearing.

The applicant's daughter attended to advise he could not attend due to unforeseen circumstances, but the applicant could not be reached.

The adjudicator proceeded in the applicant's absence pursuant to s. 7(3) of the Statutory Powers Procedure Act.

As the applicant provided no submissions or evidence, he failed to meet his burden of proof.

The claims for benefits were dismissed, and the respondent's request for costs was directed to proceed in writing.

The applicant was injured in a motor vehicle accident and sought a non-earner benefit (NEB) under the Statutory Accident Benefits Schedule.

The respondent denied the claim, and the applicant applied to the Licence Appeal Tribunal.

Applying the Heath framework, the adjudicator compared the applicant's pre- and post-accident activities.

The adjudicator found that the applicant's subjective complaints were inconsistent with surveillance evidence and medical assessments, which showed she remained physically active, socialized, and performed various activities of daily living.

The application was dismissed, as the applicant failed to prove a complete inability to carry on a normal life.

The applicant sought various statutory accident benefits following a motor vehicle accident, including income replacement benefits (IRBs), attendant care benefits (ACBs), transportation costs, and a chronic pain assessment.

The Licence Appeal Tribunal dismissed the application in its entirety.

The Tribunal found the applicant failed to prove a substantial or complete inability to work to qualify for IRBs, noting she had returned to work and later received CERB due to pandemic-related job loss.

Claims for ACBs, transportation costs, and the chronic pain assessment were also dismissed for lack of supporting evidence and failure to meet the respective legal thresholds.

Consequently, claims for interest and a Regulation 664 award were denied.

The applicant sought income replacement benefits and medical benefits following a motor vehicle accident.

The applicant failed to properly serve summonses on his intended witnesses, resulting in the respondent's motion to quash the summonses being granted.

At the hearing, the applicant chose not to give oral evidence and provided no substantive documentary evidence to support his claims.

The Tribunal dismissed the application, finding the applicant failed to meet his burden of proving entitlement to the claimed benefits on a balance of probabilities.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits.

The respondent insurer denied several treatment plans, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The adjudicator found that the applicant's psychological symptoms, documented by her family physician shortly after the accident, warranted removal from the MIG.

The adjudicator approved the disputed psychological assessment and chiropractic treatment plans, finding them reasonable and necessary based on contemporaneous medical records.

The adjudicator also rejected the respondent's argument that one of the treatment plans was time-barred, noting that the limitation period was suspended by COVID-19 regulations.

The applicant was awarded the disputed benefits with interest.

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

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

The applicant argued he should be removed from the MIG due to pre-existing conditions, chronic pain, and psychological impairments.

The Tribunal found the applicant's evidence, including expert reports, unreliable and inconsistent with his family doctor's clinical notes.

The Tribunal preferred the respondent's insurer examination reports, concluding the applicant failed to prove his injuries warranted treatment beyond the MIG.

As the MIG limits were nearly exhausted, the disputed treatment plans were denied and the application was dismissed.

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

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

The Tribunal found the applicant's injuries, specifically fragmentation of the lateral distal tibia, warranted removal from the MIG.

The Tribunal granted the claim for an orthopaedic assessment, finding it reasonable and necessary based on objective evidence of physical complaints and a pre-existing knee injury.

However, claims for physiotherapy were dismissed due to a lack of evidentiary submissions, and a psychological assessment was denied after the applicant's psychological report was excluded for late production.

Interest was awarded on the approved orthopaedic assessment.