Darrell P. March

The applicant sought various statutory accident benefits following a 2014 motor vehicle accident.

The Tribunal found that the doctrine of res judicata applied to a previous 2020 decision, which determined the applicant suffered only uncomplicated soft tissue injuries and that his shoulder condition was due to natural degeneration and prior trauma.

The applicant failed to establish that his chronic pain and other physical complaints were caused by the accident.

The Tribunal dismissed the claims for attendant care benefits above the agreed amount, as well as claims for physiotherapy, housing assessments, dental services, and assistive devices.

However, because both parties' assessors agreed the applicant met the catastrophic impairment threshold under Criterion 8 (mental/behavioural), the Tribunal awarded $4,400 for the assessments related to that determination.

The claim for a special award for unreasonable delay was dismissed.

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

Prior to the hearing, the applicant withdrew all substantive issues, leaving only a preliminary issue regarding whether he was barred from benefits under section 31(1)(a)(i) of the Schedule for operating an uninsured vehicle.

The Tribunal held that it lacked jurisdiction to hear the preliminary issue as a stand-alone matter because the underlying benefits were no longer in dispute.

The respondent's request for costs was dismissed, as the applicant's conduct in withdrawing the issues and arguing the jurisdictional point was not unreasonable, frivolous, vexatious, or in bad faith.

The applicant, who suffered catastrophic psychological injuries after a vehicle struck and killed her friend while they were walking, sought various statutory accident benefits.

The Licence Appeal Tribunal found the applicant was entitled to treatment plans for nutritional counselling (including produce boxes), drum lessons, and OCF-18 completion fees, but denied the enhanced hourly rate for a psychotherapist.

The Tribunal also granted a section 10 award of $2,585.20 against the respondent for egregiously proceeding with an in-home attendant care assessment despite the applicant's explicit refusal to consent.

The Tribunal initiated a review of its initial and reconsideration decisions under Rule 18.5 of the Licence Appeal Tribunal Rules, 2023.

The review focused on whether the Tribunal committed a material breach of procedural fairness by relying on the respondent's expert reports when the respondent did not call those experts for cross-examination.

The Vice-Chair found that admitting and relying upon the untested expert evidence, which was pivotal in denying the applicant's claim of catastrophic impairment, constituted a material breach of procedural fairness.

The initial and reconsideration decisions were cancelled in part, and a rehearing was ordered for the determination of catastrophic impairment under Criterion 7 and the claim for attendant care benefits.

The applicants sought statutory accident benefits for psychological injuries sustained after their family member witnessed a fatal motor vehicle accident.

In a previous preliminary issue decision, the Tribunal found the applicants were not 'insured persons' under the Schedule because the family member did not sustain a physical injury.

The applicants brought a new application raising a constitutional challenge to the Schedule and tendering new medical reports.

The Tribunal dismissed the application, holding it was barred by res judicata.

The Tribunal found the constitutional issue could have been raised previously, and the new medical reports did not conclusively impeach the original finding that no physical injury was sustained.

The applicant sought statutory accident benefits, claiming catastrophic impairment under Criteria 7 and 8 following a 2006 motor vehicle accident.

The Licence Appeal Tribunal found that the applicant failed to prove catastrophic impairment, noting pre-existing depression and degenerative disc disease, as well as multiple subsequent accidents.

The Tribunal excluded several of the applicant's expert reports because the experts were not called to testify, denying the respondent the right to cross-examine.

As the applicant was not catastrophically impaired, all claims for treatment plans, assessments, and attendant care incurred more than 10 years post-accident were dismissed.

Claims for a section 10 award and interest were also dismissed, and no costs were awarded to the respondent.

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

The respondent denied various treatment plans for chiropractic and massage services.

As preliminary issues, the respondent argued the applicant was barred from proceeding due to non-attendance at insurer's examinations and an examination under oath.

The adjudicator found the applicant was barred from proceeding with one treatment plan due to an unexcused failure to attend a properly noticed insurer's examination, but not barred for the others.

The adjudicator also held that failure to attend an examination under oath is not a bar to proceeding to a hearing.

On the substantive issues, the adjudicator dismissed the claims for the remaining treatment plans, finding the applicant failed to establish they were reasonable and necessary.

Claims for interest and an award were also dismissed.

The applicant requested a reconsideration of a decision finding she was not catastrophically impaired.

She argued the Tribunal breached procedural fairness by failing to assess two spheres of Criterion 8, and made errors of law and fact in assessing her visual and psychiatric impairments.

The Tribunal dismissed the request, finding no breach of procedural fairness as the statute did not require further analysis.

The Tribunal also found no errors of law or fact, noting that the applicant's experts failed to follow the AMA Guides' methodology for rating impairments.

The request for reconsideration was dismissed.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision which found she was not catastrophically impaired and denied her claims for attendant care, treatment plans, housekeeping, and costs.

The applicant argued the Tribunal breached procedural fairness and made errors of fact and law in assessing various Whole Person Impairment (WPI) ratings, including those for upper extremity, mental status, diplopia, medications, and social functioning.

The Adjudicator dismissed the request, finding no material breach of procedural fairness as the applicant had ample opportunity to present her case during the 11-day hearing.

Furthermore, the Adjudicator concluded that no errors of fact or law were made that would have resulted in a different outcome.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that found he did not sustain a catastrophic impairment.

The applicant argued that the Tribunal breached procedural fairness and made errors of law by excluding his written submissions, relying on the respondent's section 44 assessment reports without the assessors testifying, and ignoring his expert evidence.

The Tribunal dismissed the reconsideration request, finding that case law is not new evidence under Rule 18.2(c), the exclusion of written submissions in a videoconference hearing was proper, the applicant had the opportunity to summons the section 44 assessors but failed to do so, and the Tribunal is not required to comment on every piece of evidence in its decision.

The applicant requested a reconsideration of a Tribunal decision denying her entitlement to a post-104 income replacement benefit (IRB).

The applicant argued the adjudicator erred in law and breached procedural fairness by failing to determine substantive entitlement to the IRB, even if the quantum was zero.

The adjudicator agreed it was an error not to address the substantive threshold but found this was not a material breach or an error that would have changed the outcome.

The adjudicator reviewed the medical and vocational evidence, preferring the respondent's multidisciplinary assessments which concluded the applicant did not suffer a complete inability to engage in suitable employment.

The request for reconsideration was dismissed, and the respondent's request for costs was denied.

The applicant sought a determination that she was catastrophically impaired under Criterions 7 and 8 of the Statutory Accident Benefits Schedule following a 2017 motor vehicle accident, along with payment for disputed treatment and assessment plans.

The Tribunal found that the applicant's expert on visual impairment failed to follow the AMA Guides' testing methods, resulting in the rejection of the 24% WPI rating for diplopia.

The Tribunal also adjusted the applicant's psychological impairment ratings, finding them inconsistent with her demonstrated functional abilities.

Consequently, the applicant did not meet the threshold for catastrophic impairment under either criterion.

The claims for psychological services and catastrophic impairment assessments were dismissed for lack of evidence demonstrating they were reasonable and necessary.

The respondent's request for costs due to the applicant's late withdrawal of Criterion 4 was also dismissed.

The applicant sought statutory accident benefits following a 2016 motor vehicle accident, claiming catastrophic impairment under Criteria 7 (55% whole person impairment) and Criteria 8 (marked impairment in three of four domains).

The Licence Appeal Tribunal found the applicant's whole person impairment was 47%, falling short of the 55% threshold, and that he did not suffer marked impairment in social functioning.

The Tribunal denied most of the disputed treatment and assessment plans, finding them not reasonable and necessary, but approved a $2,665.50 chronic pain assessment.

Claims for attendant care benefits, an award for unreasonable delay, and costs were dismissed.

The applicant, a pedestrian struck by a vehicle, sought statutory accident benefits including a catastrophic impairment designation under Criterion 4, income replacement benefits, and various treatment plans.

The adjudicator found the applicant did not meet the test for catastrophic impairment, preferring the respondent's neurologist who concluded there was no diagnostic evidence of brain trauma from the accident.

Claims for income replacement benefits and a central vacuum system were dismissed, while treatment plans for physiotherapy and occupational therapy were approved as reasonable and necessary.

Requests for costs by both parties were denied.

The respondent insurer requested a reconsideration of a Tribunal decision that ordered it to pay for a catastrophic impairment determination assessment.

The insurer argued the Tribunal erred in law by strictly interpreting s. 38(8) of the Schedule to require a medical reason for denying the treatment plan, and by ordering payment of the full proposed amount rather than only the incurred costs under s. 38(11)2.

The Tribunal dismissed the first ground, affirming that s. 38(8) requires insurers to provide a medical reason in addition to any other reasons for denial.

However, the Tribunal granted the reconsideration in part on the second ground, varying the original order to clarify that the insurer's liability under s. 38(11)2 is limited to the $6,780.00 actually incurred by the applicant.

The applicant was injured in a motor vehicle accident and sought income replacement benefits (IRBs) from the respondent insurer.

The respondent stopped IRB payments in August 2022 due to a potential overpayment related to the applicant's receipt of long-term disability benefits.

The parties resolved the quantum of IRBs prior to the hearing.

The Tribunal found that the respondent unreasonably delayed the payment of IRBs by failing to reinstate payments despite having sufficient information and previously agreeing to do so.

The Tribunal ordered the respondent to pay a special award of 20% on the IRB payments withheld between August 2022 and January 2024, plus interest.

The applicant sought statutory accident benefits, claiming a catastrophic impairment due to mental and behavioural disorders following a motor vehicle accident.

The Licence Appeal Tribunal found that the applicant did not sustain a marked impairment in social functioning, as his self-reports were inconsistent with direct observations by psychiatrists, family testimony, and surveillance evidence.

Because the applicant could not establish a marked impairment in at least three areas of function, the application was dismissed.

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

The Licence Appeal Tribunal found the applicant was entitled to the balance of treatment hours for equine-assisted psychotherapy at an hourly rate of $99.75, but denied claims for form completion fees, travel time, and chiropractic services.

The Tribunal also ordered the respondent to pay for a catastrophic impairment determination examination because its denial notice failed to provide medical reasons, violating section 38(8) of the Schedule.

The applicant's claim for an award under section 10 of Regulation 664 was dismissed.

The applicants, the spouse and dependents of a victim of an impaired driving accident, sought reconsideration of a preliminary issue decision that found they were not insured persons under the Statutory Accident Benefits Schedule (SABS).

The applicants argued the Tribunal erred in its interpretation of section 3(1)(a)(ii) by requiring a physical injury and misapprehended medical evidence.

The Tribunal dismissed the request for reconsideration, finding no errors of law or fact that would have changed the outcome, and declined to hear constitutional arguments because the Notice of Constitutional Question was not filed in compliance with the Rules.

Following the dismissal of the plaintiff's action for failing to attend an examination for discovery, the defendant sought costs on a substantial indemnity basis.

The self-represented plaintiff made unsubstantiated allegations of fraud against the defendant's counsel and filed a complaint against the judge.

The court found the plaintiff's conduct since August 2021 to be reprehensible, vexatious, and unnecessarily lengthening the proceeding.

The court awarded the defendant costs of $47,000, reflecting substantial indemnity costs for the period after August 2021 and partial indemnity costs prior to that date.