Carmine Tiano

The applicant sought a determination of catastrophic impairment following a motor vehicle accident that caused chronic regional pain syndrome, requiring a surgically implanted spinal cord stimulator.

The central issue was whether the applicant's gait derangement should be assessed with the stimulator turned on or off under the AMA Guides.

The Tribunal held that because the stimulator's use could be easily eliminated by turning it off, the assessment must be conducted with it off.

Preferring the applicant's expert evidence, the Tribunal found the applicant required more than one cane when the device was off, resulting in a 40% whole person impairment for gait derangement.

Combined with other ratings, the applicant met the 55% threshold and was deemed catastrophically impaired.

The applicant filed a human rights application alleging failure to accommodate her work-related back injury and discriminatory termination.

The respondents sought to defer the application because the applicant had an ongoing claim before the Workplace Safety and Insurance Board (WSIB) Appeals Resolution Officer regarding the same injury and return-to-work issues.

The Tribunal found a substantial overlap between the issues in the two proceedings, particularly regarding the nature of the disability and accommodation.

The Tribunal ordered the application deferred until the WSIB Appeals Resolution Officer issues a final decision.

Following the dismissal of the insurer's appeal, the parties disputed the quantum of appeal expenses payable to the insured.

The insurer challenged the claimed hourly rate of $150 and the total hours docketed by the insured's counsel.

The Director's Delegate found the $150 hourly rate justified given counsel's experience and the relative complexity of the issues raised by the insurer on appeal.

Rejecting a strict line-by-line assessment or a fixed ratio of preparation to hearing time, the Delegate assessed a global figure of $5,000 for legal fees, disbursements, and GST.

The insurer appealed an arbitrator's decision finding that the claimant was involved in a motor vehicle accident, arguing that the accident was staged and that the arbitrator failed to provide sufficient reasons for rejecting its expert and circumstantial evidence.

The Director's Delegate dismissed the appeal, holding that the arbitrator's reasons were adequate, that she properly assessed the claimant's credibility, and that her factual findings were entitled to deference.

The arbitrator was not required to engage in a detailed analysis of every piece of evidence, and there was no error of law in her preference for the claimant's direct evidence over the insurer's expert theories.

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

She claimed to be completely disabled by chronic pain and psychological distress.

The insurer denied the claims, arguing the applicant was not credible and was malingering.

The arbitrator dismissed the applicant's claims, finding her evidence riddled with inconsistencies, including a failure to report pre-existing medical conditions and psychometric test results indicating a lack of effort or intentional poor performance.

The arbitrator preferred the evidence of the insurer's experts and concluded the applicant failed to prove she suffered a complete inability to engage in employment as a result of the accident.

The Applicant applied for statutory accident benefits following an alleged motor vehicle accident.

The Insurer denied the benefits, alleging that the accident was staged and that the Applicant's vehicle was struck while stationary.

The Insurer relied on the reports of an investigator and two accident reconstruction experts who concluded the collision did not occur as described.

The Arbitrator found the Applicant to be a credible witness and accepted her version of events.

The Arbitrator gave little weight to the Insurer's expert reports because the experts did not examine the vehicles or interview the drivers, and relied on inaccurate information.

The Arbitrator concluded that the Applicant was involved in an accident as defined in section 2 of the Schedule.

The insurer brought a motion to stay an upcoming arbitration proceeding until the applicant attended two insurer's examinations (physiatrist and psychiatrist).

The applicant had previously failed to attend scheduled examinations.

The arbitrator found the requested examinations were reasonably necessary and the applicant had no reasonable excuse for non-attendance.

The arbitration was stayed until the applicant made himself available for the examinations.

The insurer was also ordered to produce its accident benefits file to the applicant.

The applicant was injured in a motor vehicle accident and claimed an income replacement benefit based on self-employment as an Amway distributor.

The insurer paid an other disability benefit.

The arbitrator found that the applicant was not self-employed at the time of the accident but qualified for an income replacement benefit because she had been employed as a child care worker within the 156 weeks before the accident.

The arbitrator concluded that the applicant's physical and psychological impairments, including an inability to control her anger, rendered her substantially disabled from working as a child care worker.

The applicant was awarded income replacement benefits, with a credit to the insurer for other disability benefits paid.

The claim for a special award was dismissed.