Ernest H. Toomath

The applicant was injured in a motor vehicle accident and sought various medical and rehabilitation benefits, including psychological testing, psychological services, and physiotherapy.

The insurer partially approved the psychological treatment plans based on independent medical examinations and denied the physiotherapy plans.

The Tribunal found the applicant failed to prove the unapproved portions of the psychological plans were reasonable and necessary.

However, the Tribunal approved one of the two identical physiotherapy treatment plans to determine if further passive modalities could provide tangible benefit.

The claim for an award for unreasonable delay was dismissed.

The appellant insurer appealed a Licence Appeal Tribunal (LAT) decision regarding the respondent's entitlement to attendant care benefits under the Statutory Accident Benefits Schedule (SABS).

The LAT had found that the respondent's personal support worker did not need to prove economic loss, as she was providing services in the course of her ordinary employment, even though she was hired after the accident.

The Divisional Court held that the standard of review for the LAT's interpretation of the SABS is reasonableness.

The Court found the LAT's interpretation of s. 3(7)(e)(iii)(A) to be reasonable and consistent with the legislative intent to prevent abuse by unqualified family members, rather than to bar legitimate services.

The appeal was dismissed.

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

The respondent initially denied catastrophic designation, income replacement benefits, and attendant care benefits, but conceded the catastrophic designation and income replacement benefits shortly before the hearing.

The Tribunal found that the applicant's attendant care benefits were incurred because the service provider was working as a personal support worker at the time the services were rendered.

The Tribunal also awarded the applicant 30% of the income replacement benefits owed due to the respondent's unreasonable delay and excessive documentation requests.

The respondents issued a notice of action against the appellant within the two-year limitation period under the Warsaw Convention but failed to serve it within the six-month period under the Rules of Civil Procedure.

The master granted an extension of time for service, which was affirmed by the Divisional Court.

The appellant appealed, arguing the claim was extinguished under Article 29 of the Convention.

The Court of Appeal dismissed the appeal, holding that once a claim is issued within the two-year period, the Convention is satisfied and subsequent procedural requirements, including time for service, are governed by the Ontario Rules.

The applicant, an assembly line worker, was struck by a van while crossing the street, sustaining a severe left knee injury.

The insurer paid income replacement benefits until July 1995, when it terminated them based on medical assessments suggesting she could return to work.

The applicant sought ongoing benefits up to the 104-week mark.

The arbitrator found that the applicant's job required prolonged sitting with her knee bent, which caused disabling pain and reduced concentration.

Preferring the evidence of the treating specialists over the insurer's assessor, the arbitrator concluded the applicant suffered a substantial inability to perform the essential tasks of her employment.

The claim for ongoing income replacement benefits was allowed, but the request for a special award was dismissed as the insurer's initial termination was based on medical reports available at the time.