Rebecca Hines

The applicant sought reconsideration of a decision that terminated her income replacement benefit (IRB) at the 104-week mark.

The applicant argued the adjudicator erred in law by failing to apply section 8(2) of the Statutory Accident Benefits Schedule, which provides that an IRB adjusted for a person turning 65 is payable until death without deductions for post-accident income.

The adjudicator agreed, finding that section 8(2) automatically applies and exempts the applicant from the complete inability test under section 6.

The reconsideration was granted, and the applicant was awarded an ongoing IRB of $4.75 per week.

The applicant sought reconsideration of a decision finding that the parties did not reach a binding settlement agreement.

The applicant argued the Tribunal acted outside its jurisdiction, breached procedural fairness, made errors of law and fact, and exhibited a reasonable apprehension of bias.

The adjudicator dismissed the request, finding no jurisdictional error, no breach of procedural fairness, and no errors in interpreting Regulation 664 or applying the legal test for settlement.

The adjudicator also rejected the allegation of bias, noting it was raised after the fact without cogent evidence.

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

The applicant argued for removal from the MIG based on pre-existing shoulder and back pain, as well as chronic pain.

The Tribunal found insufficient evidence that any pre-existing condition would prevent recovery within the MIG and concluded the applicant did not meet the burden of proving chronic pain.

Relying on the insurer's medical examination, the Tribunal held the impairments were predominantly minor.

Consequently, the claims for four physiotherapy treatment plans and interest were dismissed as they exceeded the MIG limit.

The applicant sought statutory accident benefits following a 2019 motor vehicle accident, claiming entitlement to attendant care benefits, various treatment plans, and a special award.

The Licence Appeal Tribunal dismissed the majority of the claims, finding that the applicant failed to prove the expenses were reasonable and necessary or incurred.

The Tribunal preferred the respondent's insurer examination reports, which found the applicant independent in her activities of daily living and lacking neurological impairment.

However, the Tribunal granted the applicant's claim for a driving assessment due to undisputed vehicular anxiety, along with applicable interest.

The applicant sought statutory accident benefits following a motor vehicle accident where he was a passenger in a vehicle that struck a pole, resulting in a traumatic brain injury.

The respondent denied benefits, arguing the applicant was excluded under s. 31(1)(c) of the Schedule because he knew or ought to have known the driver lacked the owner's consent.

The Tribunal found the respondent failed to meet its burden to prove the exclusion applied.

The Tribunal awarded the applicant a non-earner benefit for a closed period, finding he suffered a complete inability to carry on a normal life until October 2020.

Claims for housekeeping benefits, a physiotherapy treatment plan, and a special award were dismissed.

The appellant real estate brokerage brought a motion to stay the Tribunal's prior decision revoking its registration, pending a request for reconsideration and potential appeal.

The Tribunal denied the motion, finding that the appellant failed to address or satisfy the three-part test for a stay set out in RJR-MacDonald.

Specifically, the appellant provided no evidence of irreparable harm and failed to demonstrate that the balance of convenience favoured a stay, instead relying on unsupported allegations of procedural fairness breaches.

The applicant sought statutory accident benefits after allegedly being struck by a vehicle while crossing the street.

The respondent denied benefits, arguing no accident occurred as there was no physical contact.

The Tribunal found the applicant credible and, supported by surveillance video and hospital records, concluded he was struck by the vehicle.

Applying the purpose and causation tests, the Tribunal determined the incident met the definition of an 'accident' under s. 3(1) of the Schedule.

The Tribunal awarded the claimed $2,200 for a psychological assessment, finding the $200 fee for reviewing the treatment plan is separate from the $2,000 assessment cap, and $2,200 for physiotherapy services.

The appellants appealed a Notice of Proposal (NOP) issued by the Registrar to refuse and revoke their registrations as a motor vehicle dealer and salesperson.

The Tribunal found that the individual appellant engaged in a pattern of deceptive business practices, including acting as an unregistered salesperson, falsifying documents, taking out unauthorized repair loans in consumers' names, and responding abusively to consumer complaints.

The Tribunal concluded that the appellants' past conduct afforded reasonable grounds for belief that they would not carry on business in accordance with the law and with integrity and honesty.

Finding that the appellants were ungovernable and had previously breached terms and conditions, the Tribunal directed the Registrar to carry out the NOP to revoke the registrations.

The applicant, who was catastrophically impaired following a motor vehicle accident, sought $27,260.61 for a vehicle chassis upgrade to purchase an SUV, arguing it was necessary for her physical and emotional functioning.

The respondent denied the claim.

The Licence Appeal Tribunal found that the applicant failed to prove the vehicle upgrade was reasonable and necessary, noting inconsistencies between the occupational therapist's recommendation and the driving instructor's positive observations of the applicant driving a sedan.

The Tribunal preferred the respondent's insurer examination reports, which found no accident-related psychological or musculoskeletal impairment necessitating an SUV.

The application was dismissed.

The applicant sought income replacement benefits, medical benefits, interest, and a special award following a motor vehicle accident.

The Licence Appeal Tribunal dismissed all claims.

The Tribunal found the applicant failed to prove a substantial inability to perform the essential tasks of his employment, noting inconsistencies in his medical records, a failure to report pre-accident income, and persuasive insurer examination reports.

The claims for chiropractic, psychological, and occupational therapy treatment plans were also dismissed because the applicant failed to submit the plans into evidence and did not establish that the treatments were reasonable and necessary.

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

The insurer denied the claim, arguing the applicant failed to report the accident within the prescribed 7-day timeline.

The Tribunal found the applicant was not barred from proceeding, as the insurer failed to produce complete log notes and had misled the applicant about settling the claim.

On the substantive issues, the Tribunal found the applicant's injuries fell within the Minor Injury Guideline (MIG) and denied the claim for a non-earner benefit.

The Tribunal ordered the insurer to pay a $2,200 treatment plan because the applicant was entitled to treatment within the MIG limit, but denied a $1,302.49 treatment plan that proposed treatment outside the MIG.

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

The respondent denied the benefits and sought repayment of past IRBs, alleging wilful misrepresentation regarding the applicant's receipt of long-term disability benefits.

The Tribunal found that the applicant failed to prove entitlement to the IRB and chiropractic treatment, as the medical evidence did not establish a substantial inability to perform the essential tasks of his employment or that the treatment was reasonable and necessary.

However, the Tribunal dismissed the respondent's claim for repayment, finding that the overpayment was due to an adjuster error rather than wilful misrepresentation, and the notice of repayment was provided outside the 12-month limitation period.

Claims for interest and a special award were also dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to income replacement benefits (IRBs) and a neurological assessment.

The Tribunal found that the applicant failed to prove she met the disability test for IRBs, as the medical evidence did not establish a substantial inability to perform the essential tasks of her self-employment.

However, because the respondent insurer issued deficient notices suspending and terminating the IRBs, the Tribunal ordered the respondent to pay IRBs totaling $9,783.83 for the period before a compliant notice was issued.

The claim for a neurological assessment was dismissed as not reasonable and necessary.

The Tribunal denied a special award but granted $500 in costs to the applicant due to the respondent's late service of an accounting report.

The applicant sought accident benefits following a motor vehicle accident, claiming entitlement to income replacement benefits, medical benefits for physiotherapy, and an accounting report.

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

The Tribunal found that the applicant failed to prove she suffered from chronic pain or a psychological impairment warranting removal from the MIG.

The Tribunal also dismissed the claim for income replacement benefits, finding insufficient medical evidence of an accident-related impairment causing a substantial inability to perform the essential tasks of her employment.

The claims for the accounting report and interest were also dismissed.

The appellant appealed the 45-day impoundment of his vehicle under the Highway Traffic Act, which occurred after his employee was caught driving it with a suspended licence.

The appellant argued the impoundment caused exceptional hardship to his construction business.

The Tribunal dismissed the appeal, finding that the appellant had alternative means of transportation, including four other vehicles, and therefore failed to meet the test for exceptional hardship.

The appellant appealed a decision by Tarion Warranty Corporation denying her claim for compensation exceeding the statutory maximum under the Ontario New Home Warranties Plan Act.

After multiple adjournment requests were denied, the appellant failed to attend the scheduled videoconference hearing.

The Tribunal proceeded in her absence under Rule 3.7.1 of the Licence Appeal Tribunal Rules.

As the appellant provided no evidence or submissions, she failed to meet her onus of proof, and the appeal was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, specifically claiming income replacement benefits (IRBs) and a treatment plan for physiotherapy.

The Tribunal found the applicant met the pre-104 test for IRBs, as her accident-related physical and psychological impairments, combined with her age and pre-existing conditions, resulted in a substantial inability to perform her essential tasks as a cleaner.

However, the IRB amount was adjusted to $4.75 per week due to the age 65 ramp-down provision.

The applicant failed to prove entitlement to post-104 IRBs, as she did not establish a complete inability to engage in suitable employment.

Claims for an award and costs were dismissed, and the treatment plan was found to be no longer in dispute.

The appellant appealed the Minister of Transportation's decision to downgrade his commercial Class B driver's licence to a Class G licence due to a medical condition.

The appellant had an implantable cardioverter defibrillator (ICD) inserted following a history of cardiovascular disease.

The Licence Appeal Tribunal applied the CCMTA Medical Standards, which generally disqualify commercial drivers with an ICD unless a cardiologist assesses their annual risk of sudden incapacitation at 1% or less.

Finding insufficient expert cardiological evidence to establish a risk of 1% or less, the Tribunal concluded the appellant's condition was likely to significantly interfere with his ability to safely operate a commercial vehicle.

The decision to downgrade the licence was confirmed.

The applicant sought to enforce a settlement agreement allegedly reached with the respondent insurer regarding her statutory accident benefits claim.

The parties had negotiated an agreement in principle via email, but the applicant refused to sign a release that included the tortfeasor (Ryder).

The Tribunal found that a mutually agreeable release was an essential term of the settlement.

Because the applicant amended the settlement disclosure notice without agreement and did not execute the required release, no binding and enforceable settlement agreement was reached.

The application to enforce the settlement was dismissed.

The applicant was injured while riding her bicycle when she veered off the road to avoid an oncoming, unidentified vehicle driving erratically.

The respondent denied her claim for statutory accident benefits, arguing the incident did not meet the definition of an 'accident' under the Schedule because no vehicle was involved.

The Tribunal found the applicant credible and concluded that a vehicle was involved, satisfying both the purpose and causation tests.

The Tribunal determined the applicant's impairments fell outside the Minor Injury Guideline and ordered the respondent to pay the disputed medical and examination expenses up to the Guideline limits.

The Tribunal dismissed the claim for a special award but ordered the respondent to pay $500 in costs for unreasonable conduct during the proceeding.