Atila Balaban

The applicant sought statutory accident benefits following a 2019 motor vehicle accident, specifically a $19,097.00 treatment plan for a catastrophic impairment (CAT) assessment and an award for unreasonable delay.

The Tribunal found the applicant was entitled to $9,266.00 for the CAT assessment, approving the physiatry, psychiatry, and occupational therapy components, but denying duplicative or premature elements like the intake assessment and OCF-19 completion.

The Tribunal admitted several late or disputed medical reports, finding them relevant and not prejudicial.

The claim for a special award was dismissed as the insurer's denial was not unreasonable, though interest was awarded on the overdue assessment costs.

The applicant was injured in a motor vehicle accident and sought post-104 weeks income replacement benefits (IRBs), arguing she suffered a complete inability to engage in suitable employment.

The Tribunal preferred the respondent's expert evidence, finding the applicant retained the functional capacity for sedentary work and did not meet the complete inability test.

The Tribunal also held that the respondent correctly deducted the applicant's maternity leave Employment Insurance benefits from her pre-104 weeks IRBs, as they constitute gross employment income under the Schedule.

Finally, the Tribunal dismissed the claim for a special award, finding the respondent's handling of the claim and temporary stoppages of benefits pending further medical information were not unreasonable.

Following the settlement of a motor vehicle accident tort claim, the plaintiffs brought a motion for costs and an increase in the pre-judgment interest rate.

The court assessed the costs of the civil action, reducing the amount claimed to account for expenses incurred due to a trial adjournment requested by the plaintiffs.

The court also considered whether the tort defendant should contribute to the costs the plaintiffs incurred in parallel statutory accident benefits (SABs) proceedings, ultimately ordering a $20,000 contribution because the SABs settlements significantly reduced the defendant's tort exposure.

The plaintiffs' request to increase the pre-judgment interest rate to offset statutory deductible increases was dismissed.

The applicant sought income replacement benefits and the cost of vocational and functional abilities assessments following a motor vehicle accident.

The adjudicator found that the applicant failed to prove on a balance of probabilities that she suffered a substantial inability to perform the essential tasks of her pre-accident employment as a kitchen assistant.

The medical evidence submitted by the applicant lacked sufficient detail regarding her job duties and how her limitations impeded her capacity to work.

The claims for the cost of examinations were also dismissed as the applicant failed to prove they were reasonable and necessary.

Consequently, claims for interest and an award for unreasonable delay were denied.

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

The insurer terminated her income replacement benefits and denied medical and rehabilitation benefits, maintaining for nearly three years that her injuries fell within the Minor Injury Guideline (MIG).

The arbitrator found that the applicant suffered a substantial inability to perform her pre-accident employment and, post-104 weeks, a complete inability to engage in suitable employment due to chronic pain.

The arbitrator granted the claimed income replacement benefits, medical benefits, and costs of examinations.

Furthermore, the arbitrator awarded a $25,000 Special Award against the insurer, finding that it had unreasonably delayed and denied benefits by relying on patently flawed medical reports and ignoring credible evidence of the applicant's chronic pain.

The applicant claimed statutory accident benefits following a motor vehicle accident in November 2009.

She sought medical, caregiver, attendant care, and housekeeping benefits.

The arbitrator found the applicant's evidence to be vague, insubstantial, and prone to exaggeration.

The arbitrator preferred the evidence of the insurer's occupational therapist, who observed the applicant in her home and concluded she did not suffer a substantial inability to perform caregiving or housekeeping tasks.

The applicant failed to prove her entitlement to the claimed benefits on a balance of probabilities.

The application was dismissed, with the issues of a special award and expenses deferred.

The applicant sought statutory accident benefits following two motor vehicle accidents in 2007.

The arbitrator found the applicant's evidence to be unreliable due to poor recall and contradictions with documentary evidence, including Ontario Works records showing he had returned to work.

Relying on the medical evidence, particularly the applicant's orthopaedic surgeon, the arbitrator concluded the applicant suffered a complete inability to engage in suitable employment for a limited period.

The applicant was awarded income replacement benefits from July 7, 2009, to August 1, 2010, but his claims for various assessment costs and a special award were dismissed.

The applicant was injured in a motor vehicle accident and sought ongoing income replacement benefits (IRBs) after the insurer terminated them.

The insurer argued the applicant was unemployed at the time of the accident and exaggerated his symptoms.

The arbitrator found the applicant was employed through a temporary placement agency at the time of the accident and that his pre-accident health issues did not prevent him from working.

Relying on objective medical evidence of a torn shoulder tendon, the arbitrator rejected the insurer's expert opinions that the applicant was magnifying his symptoms.

The arbitrator concluded the applicant was substantially unable to perform the essential tasks of his employment and awarded IRBs up to the date he reported limitations from unrelated health conditions.

The parties settled the applicant's claims for statutory accident benefits prior to the arbitration hearing.

The applicant sought $15,710.81 in legal fees and disbursements.

The insurer agreed the applicant was entitled to expenses but disputed the amount, arguing the hours claimed were excessive and certain expert reports were not reasonably required.

The arbitrator found the preparation time and correspondence hours reasonable, and accepted that the disputed expert reports were reasonably required.

The arbitrator fixed costs and disbursements at $12,000 inclusive of GST.

Following the settlement of a statutory accident benefits dispute, the parties were unable to agree on the quantum of expenses payable by the insurer.

The applicants sought $32,034.60 in fees and disbursements.

The insurer disputed the time claimed by a second lawyer retained for the hearing, the time claimed for correspondence, and the fees charged for expert reports.

The arbitrator found that retaining alternate counsel due to a scheduling conflict was reasonable and did not result in significant duplication of time.

The arbitrator also found the correspondence time and expert report fees to be reasonable, noting that the FSCO Professional Services Guideline rates do not strictly apply to medical-legal reports prepared for arbitration.

The applicants were awarded their full claimed expenses of $32,034.60.

The applicant was injured in a motor vehicle accident and sought ongoing income replacement benefits after the 104-week mark.

The insurer had reinstated benefits prior to the pre-hearing but did not concede entitlement.

The arbitrator found that the applicant suffered a complete inability to engage in any suitable employment due to chronic pain, reduced endurance, and inability to sit, stand, or keyboard for significant periods.

The applicant was awarded ongoing income replacement benefits and her arbitration expenses.

The applicant was injured in a motor vehicle accident and received income replacement benefits until the insurer terminated them after 104 weeks.

The applicant sought arbitration, claiming a complete inability to engage in any employment for which she was reasonably suited.

The arbitrator reviewed the applicant's education, training, and work history, noting she primarily worked part-time.

Relying on the consensus of the applicant's own medical experts that she could return to part-time sedentary work, the arbitrator found she did not meet the test for complete inability to work.

The application for income replacement benefits and a special award was dismissed.

The applicant sought interim housekeeping and income replacement benefits pending arbitration of his claim arising from a motor vehicle accident.

The arbitrator applied the three-part test for interim mandatory orders, requiring the applicant to establish a strong prima facie case, irreparable harm, and that the balance of convenience favoured granting the relief.

The arbitrator found the applicant failed to establish it was more probable than not he would succeed at the hearing, failed to demonstrate irreparable harm given the availability of an earlier hearing date, and found the balance of convenience favoured the insurer.

The motion for interim benefits was dismissed.

The applicant sought interim income replacement benefits after the insurer terminated them.

The arbitrator found that the insurer's termination of benefits was based on a flawed Designated Assessment Centre (DAC) process, which failed to comply with section 64 of the Statutory Accident Benefits Schedule.

The arbitrator also found that the applicant established a strong prima facie case for entitlement to benefits and demonstrated financial urgency.

The insurer was ordered to pay interim benefits of $313.77 per week, with the issues of a special award and expenses reserved for the main arbitration hearing.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including medical/rehabilitation benefits and income replacement benefits.

The insurer terminated treatment payments and income replacement benefits based on medical assessments.

At arbitration, the tribunal ordered the insurer to pay for physiotherapy treatment up to the date the applicant received the Designated Assessment Centre (DAC) reports, at the rates charged by the clinic.

However, the tribunal dismissed the claim for ongoing income replacement benefits, finding that the medical evidence, including psychiatric and orthopaedic assessments, did not establish a substantial inability to perform the essential tasks of her pre-accident employment as a sewing machine operator.