Daniel Lee

The applicant sought entitlement to statutory accident benefits for physiotherapy, massage therapy, a psychological assessment, and a chronic pain assessment following a November 2020 motor vehicle accident.

The Licence Appeal Tribunal dismissed all claims, finding that the applicant failed to provide corroborating medical evidence to establish that the treatment plans were reasonable and necessary.

The Tribunal preferred the evidence of the insurer's medical examiners, who found no objective evidence of ongoing physical or psychological impairment related to the accident.

Claims for an award under s. 10 of Regulation 664 and interest were also dismissed.

The applicant requested a reconsideration of a decision that dismissed his claims for catastrophic impairment, attendant care benefits, and medical and rehabilitation benefits following a motor vehicle accident.

The applicant argued the adjudicator erred by allowing the respondent's psychiatric expert to testify outside the scope of her report, by limiting the evidence of the applicant's chiropractor regarding psychological impairments, and by failing to properly consider the meaning of 'useful function'.

The adjudicator dismissed the reconsideration request, finding no errors of law or fact.

The adjudicator held that the respondent's expert evidence was latent in her report, the chiropractor was not qualified to opine on psychological impairments, and the applicant was improperly attempting to relitigate findings of fact.

The applicant sought statutory accident benefits after witnessing a fatal bus accident, claiming it caused a catastrophic impairment (schizophrenia).

The respondent denied the benefits, arguing the applicant's condition was pre-existing or prodromal.

The Tribunal found that while the accident may have triggered an acute psychotic episode, the applicant was likely prodromal for years prior and failed to prove he sustained a Class 4 marked or Class 5 extreme impairment in the required spheres of function.

The Tribunal also dismissed claims for attendant care, rehabilitation support worker services, and other expenses, as the applicant's non-catastrophic policy limits were exhausted and the expenses were either not incurred or not reasonable and necessary.

The respondent requested an adjournment of the hearing due to a cyber attack that prevented access to its internal systems and files.

The applicant opposed the adjournment and brought a motion to exclude surveillance video and a report that were disclosed past the deadlines set in the case conference order.

The Tribunal granted the adjournment, finding it reasonable to allow the respondent time to prepare once systems were restored.

The Tribunal also granted the applicant's motion to exclude the surveillance evidence, finding it had little probative value, was not used by assessors, and its late disclosure caused prejudice that outweighed any relevance.

The Applicant sought non-earner benefits following a 2013 motor vehicle accident where he was struck as a pedestrian, aggravating a severe pre-existing right knee injury from a 2012 accident.

The insurer denied the claim based on independent medical assessments.

The arbitrator rejected the insurer's medical assessments as flawed for failing to properly consider the pre-existing injury.

However, the arbitrator dismissed the application because the Applicant failed to provide sufficient corroborating evidence of his pre- and post-accident activities of daily living, complicated by his post-accident cocaine addiction and inconsistent living arrangements, to prove he suffered a complete inability to carry on a normal life.