Trina Morissette

The applicant sought a determination that she sustained a catastrophic impairment (CAT) under Criterion 7 of the Statutory Accident Benefits Schedule following a motor vehicle accident.

The applicant relied on expert assessments suggesting a combined whole person impairment (WPI) of 63%, while the respondent's experts assessed her at 38%.

The Tribunal preferred the respondent's experts, finding the applicant's neurological and psychological ratings were largely unsupported by medical evidence and heavily influenced by pre-existing conditions.

The Tribunal concluded the applicant's combined WPI was 41%, falling short of the 55% threshold, and dismissed the application.

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

The insurer partially denied two treatment plans in early 2020.

The applicant filed an application with the Licence Appeal Tribunal in April 2025, well beyond the two-year limitation period under section 56 of the Schedule.

The applicant argued the denial notices were non-compliant and sought an extension under section 7 of the LAT Act.

The Tribunal found the denial notices were clear and unequivocal, triggering the limitation period.

Applying the Manuel factors, the Tribunal declined to extend the limitation period, finding no bona fide intention to appeal, significant delay, prejudice to the respondent, and lack of demonstrated merit.

The application was dismissed as statute-barred.

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

The respondent denied or partially denied three treatment plans, citing the Minor Injury Guideline.

The applicant filed an application with the Licence Appeal Tribunal more than four years after the denials.

The Tribunal found that the denial letters were clear and unequivocal, triggering the two-year limitation period under section 56 of the Schedule.

The Tribunal declined to extend the limitation period under section 7 of the Licence Appeal Tribunal Act, finding that the applicant failed to demonstrate a bona fide intention to appeal, the delay was significant, the respondent would be prejudiced, and there was no evidence of merit.

The application was dismissed as statute-barred.

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

The respondent denied three treatment plans, citing the Minor Injury Guideline.

The applicant filed an application with the Tribunal more than four years after the denials.

The Tribunal found that the denial letters were clear and unequivocal, triggering the two-year limitation period under section 56 of the Schedule.

The Tribunal declined to extend the limitation period under section 7 of the Licence Appeal Tribunal Act, finding the applicant failed to establish a bona fide intention to appeal, the delay was significant, the respondent would be prejudiced, and the applicant failed to demonstrate the merits of the appeal.

The application was dismissed.

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

In a prior application, the Tribunal found the applicant was not entitled to the IRB.

The applicant subsequently filed a new application claiming an IRB and a catastrophic impairment determination.

The respondent argued the IRB claim was barred by res judicata.

The Tribunal agreed, finding the preconditions for res judicata were met and the applicant failed to establish that the doctrine should be waived based on fresh evidence or fairness.

The applicant was barred from proceeding with the IRB claim.

The applicant sought statutory accident benefits after being assaulted by another passenger while riding in an Uber.

The respondent denied benefits, arguing the incident was not an 'accident' under the Statutory Accident Benefits Schedule.

The Tribunal found that while the purpose test was met, the causation test was not.

The assault was an intervening act that broke the chain of causation, and the use or operation of the vehicle was not the direct cause or dominant feature of the applicant's psychological injuries.

The application was dismissed.

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

The respondent scheduled multiple insurer's examinations (IEs) under section 44 of the Statutory Accident Benefits Schedule, which the applicant failed to attend.

The respondent brought a preliminary issue hearing arguing the application should be dismissed under section 55(1)2 of the Schedule.

The Tribunal found that the respondent provided valid notices of examination and made reasonable accommodation efforts.

The applicant failed to provide a reasonable explanation for her non-attendance, as her family physician's notes stating she was unfit to attend were contradicted by her attendance at other medical appointments.

The Tribunal held the applicant was statute-barred from proceeding and dismissed the application.

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

The respondent denied benefits, arguing the applicant failed to submit the OCF-1 application within the 30-day prescribed time limit.

The Tribunal found that the applicant notified the respondent of the accident within the required seven days.

Furthermore, the Tribunal held that the applicant had a reasonable explanation for the delayed submission of the OCF-1, as the respondent had granted extensions and continued to process the claim without clearly communicating that the file was closed.

The applicant was permitted to proceed with his application.

The applicant was involved in a motor vehicle accident while driving his employer's vehicle and sought statutory accident benefits.

The respondent insurer argued the applicant was barred from proceeding because he failed to notify them within seven days and failed to submit his application within 30 days.

The Tribunal found the applicant had a reasonable explanation for the delay, as he reasonably believed his employer had notified the insurer, and the insurer never provided the required application forms to trigger the 30-day timeline.

The applicant was permitted to proceed with his claim.

The applicant was struck by an ION light rail train and sought statutory accident benefits.

The respondent denied benefits, arguing the train was 'railway rolling stock' and not an 'automobile' under the legislation.

The Tribunal applied consumer protection principles of statutory interpretation and found that the ION train operates similarly to a streetcar, which is expressly exempted from the railway exclusion.

The Tribunal concluded the ION train is an 'automobile' and the incident qualifies as an 'accident', allowing the application to proceed.

The applicant was a passenger in an Uber involved in a motor vehicle accident and sought statutory accident benefits.

The respondent denied the claim because the applicant failed to notify it within seven days and submitted her OCF-1 application one and a half years late.

The Tribunal found that the applicant's ignorance of the law did not constitute a reasonable explanation for the delay.

As a result, the applicant is barred from proceeding with her application before the Tribunal.

The applicant sought income replacement benefits (IRBs) following a motor vehicle accident.

The insurer paid IRBs initially but ceased payments after the applicant returned to work, issuing a notice of stoppage.

Over three years later, the applicant applied to the Tribunal to dispute the denial.

The Tribunal found the insurer's notice was valid under the Smith criteria, triggering the two-year limitation period.

Applying the Manuel factors, the Tribunal declined to extend the limitation period, finding no bona fide intention to appeal in time, significant delay, prejudice to the insurer, and lack of merit.

The application was dismissed as statute-barred.

The applicant, injured in a pedestrian-vehicle collision, sought an award under section 10 of Regulation 664, alleging the respondent insurer unreasonably withheld or delayed payment of attendant care benefits and a treatment plan.

The Licence Appeal Tribunal found that the respondent's denial of the treatment plan was valid and compliant with section 38(8) of the Schedule, as the requested benefits exceeded the non-catastrophic limit.

The Tribunal also found insufficient evidence that attendant care benefits were unreasonably delayed.

The respondent's request for costs was denied, as the applicant's decision to proceed with the hearing was not unreasonable.

The application was dismissed.

The applicant sought a determination that he sustained a catastrophic impairment (CAT) following a 2020 motor vehicle accident, claiming entitlement to extended medical benefits.

The Tribunal assessed the applicant's physical and psychological impairments under Criteria 6, 7, and 8 of the Statutory Accident Benefits Schedule.

The Tribunal found insufficient evidence of radiculopathy and rejected several of the applicant's expert ratings, ultimately determining a 25% physical whole person impairment (WPI).

Combined with psychological impairments, the applicant did not meet the 55% WPI threshold.

The Tribunal also found the applicant did not suffer three marked impairments in his spheres of functioning.

As the applicant did not meet the CAT threshold and the non-CAT limits were exhausted, the application for medical benefits, an award, and interest was dismissed.

The applicant sought removal from the Minor Injury Guideline (MIG) and payment for various psychological and physiotherapy treatment plans following a motor vehicle accident.

The applicant relied on psychological assessments diagnosing trauma-related disorders.

The Tribunal gave little weight to the psychological reports as they relied entirely on uncorroborated self-reporting and lacked contemporaneous medical documentation.

The Tribunal found the applicant failed to prove his injuries fell outside the MIG.

As the MIG limits were exhausted, all claims for treatment plans, interest, and an award were dismissed.

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

The respondent denied four treatment plans for chiropractic services on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and the $3,500 limit was exhausted.

The applicant argued the denial notices were non-compliant with section 38 of the Schedule.

The Tribunal found the applicant failed to prove his injuries warranted removal from the MIG.

Furthermore, the Tribunal held the respondent's denial notices were compliant, as they clearly identified the benefits, provided valid medical reasons, and invited further documentation.

The application was dismissed.

The applicant sought a determination of catastrophic impairment and entitlement to various statutory accident benefits following a 2018 motor vehicle accident.

The Licence Appeal Tribunal found that the applicant sustained a catastrophic impairment under Criterion 7, accepting a combined Whole Person Impairment rating of 55% based on musculoskeletal, headache, medication, and psychological impairments.

While the Tribunal found the applicant was entitled to attendant care and housekeeping benefits in principle, it held that no benefits were payable because the applicant failed to prove the expenses had been incurred.

The claims for medical benefits, an award, and interest were dismissed.

The applicant was injured in a motor vehicle accident during the course of his employment and initially received WSIB benefits.

He subsequently sought statutory accident benefits from the respondent insurer, claiming he had elected to withdraw his WSIB claim to pursue a tort action.

The Tribunal found that the applicant failed to provide persuasive evidence that he had properly withdrawn his WSIB claim or obtained the required consent from the WSIB.

Furthermore, the applicant did not demonstrate a bona fide intention to pursue a tort claim, as his Statement of Claim was filed after the limitation period and not served.

Consequently, the applicant was barred under section 61 of the Schedule from pursuing accident benefits, and the application was dismissed.

The applicant sought a non-earner benefit, interest, and an award under s. 10 of Reg. 664 following a motor vehicle accident.

The Tribunal applied the Heath test and found the applicant failed to prove a complete inability to carry on a normal life, noting his pre-accident baseline involved minimal activity due to prior health issues and there was substantially little change post-accident.

The Tribunal placed little weight on the applicant's physiotherapist certificate as it lacked detail and included psychological diagnoses outside the practitioner's scope.

The application was dismissed in its entirety.

The applicant requested a reconsideration of a decision denying him a non-earner benefit and interest.

The adjudicator found that the initial decision's failure to mention or weigh the applicant's medical evidence constituted a material breach of procedural fairness.

However, upon reconsidering the medical evidence, including reports from a pain specialist and clinical notes, the adjudicator concluded that the evidence did not establish that the applicant suffered a complete inability to carry on a normal life as a result of the accident.

The initial decision dismissing the application was confirmed.