Daniel Hynes

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

The Licence Appeal Tribunal considered whether treatment plans for injections, an adjustable mattress, and a pillow were reasonable and necessary.

The Tribunal found the injections and adjustable mattress were reasonable and necessary to treat the applicant's chronic pain and sleep disturbances resulting from the accident.

The claim for the pillow was denied as the applicant failed to justify an excessive documentation fee.

The respondent was ordered to pay for the injections and mattress, plus interest.

The applicant sought a reconsideration of a Licence Appeal Tribunal decision that denied entitlement to a treatment plan for psychological services.

The applicant argued under Rule 18.2(b) that the Tribunal made an error of fact by referring to the treatment plan as proposing psychological treatment rather than a psychological assessment.

The Vice-Chair dismissed the request, finding that the applicant had failed to provide the OCF-18 or any supporting submissions at the original hearing.

The Tribunal held that the applicant's failure to meet his evidentiary burden at first instance did not constitute an error of fact by the Tribunal, and the reconsideration request was an improper attempt to re-litigate the case.

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 that the applicant's psychological impairments, including driving-related anxiety and depression, warranted removal from the MIG, preferring the applicant's psychological expert over the respondent's.

However, the Tribunal dismissed the claims for the specific disputed treatment plans because the applicant failed to provide the actual treatment plans (OCF-18s) or make submissions demonstrating that the proposed treatments were reasonable and necessary.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that denied her entitlement to income replacement benefits (IRBs) beyond 104 weeks post-accident.

The applicant argued the Tribunal made errors of fact and law by disregarding the expert evidence of a psychologist and ignoring the clinical notes of her treating psychologist and optometrist.

The adjudicator dismissed the request, finding that the Tribunal correctly weighed the expert evidence, which failed to provide an analysis of the applicant's ability to work.

The adjudicator also held that the Tribunal's failure to explicitly refer to certain clinical notes did not constitute an error, and that the omitted evidence would not have changed the outcome regarding the applicant's entitlement to IRBs.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits from the respondent insurer.

The Tribunal found the applicant was entitled to income replacement benefits for the first 104 weeks post-accident, as she suffered a substantial inability to perform the essential tasks of her pre-accident employment as a personal support worker.

However, she was not entitled to income replacement benefits beyond 104 weeks, as she failed to prove a complete inability to engage in any employment for which she was reasonably suited.

The Tribunal also partially approved a treatment plan for assistive devices, but denied other treatment plans for occupational therapy, rehabilitative therapy, and a massage therapy assessment.

The applicant's request for costs was denied.

The applicant, injured in a motor vehicle accident, sought statutory accident benefits and filed a motion for the production of the respondent's adjuster log notes from the date of the OCF-1 to the date of the application to the Tribunal.

The respondent argued that notes created after the initial FSCO application were protected by litigation privilege.

The Tribunal granted the motion in part, ordering the production of the log notes subject to redactions for relevance, reserves, and privilege, noting that litigation privilege attached to the issue of catastrophic impairment only upon its denial on December 5, 2016.

The applicant was injured in a motor vehicle accident and applied for a catastrophic impairment determination approximately 15 months post-accident.

Because the application was submitted prior to the two-year mark, the applicant was required to satisfy the additional criteria under s. 3.1(2)(b) of the Statutory Accident Benefits Schedule.

The Tribunal found that the applicant's medical experts provided projections of future impairment rather than a present determination that the applicant had a 55% whole person impairment.

Furthermore, the evidence did not establish that the applicant's condition was unlikely to improve to less than 55% impairment.

The application was dismissed as premature.