Dr. Day

The applicant sought non-earner benefits and interest following a motor vehicle accident.

The Licence Appeal Tribunal applied the Heath test to determine if the applicant suffered a complete inability to carry on a normal life.

While the Tribunal accepted that the applicant's injuries prevented him from continuing his pre-accident employment and impacted his housekeeping duties, it found that his personal care tasks were not sufficiently affected.

The Tribunal concluded the applicant failed to meet the high threshold for non-earner benefits.

The application was dismissed.

The applicant sought accident benefits following a motor vehicle accident, arguing for removal from the Minor Injury Guideline (MIG) due to chronic pain and psychological impairments.

The Tribunal found the medical evidence, including clinical notes from the family doctor and a sports medicine physician, supported soft tissue injuries rather than accident-related chronic pain with functional impairment.

The Tribunal preferred the respondent's psychological assessment over the applicant's, concluding there was no accident-related psychological diagnosis.

The applicant was found to remain within the MIG, and claims for a psychological assessment, an award, interest, and costs were dismissed.

The court dismissed the defendant’s motion for summary judgment in a personal injury action arising from a 2015 motor vehicle collision.

The defendant argued the action was statute-barred, but the court found the limitation period did not begin to run until the plaintiff received a diagnosis in July 2020 that clarified the severity and cause of her injuries.

The court held that the plaintiff acted diligently and that there was not a sufficient body of evidence to support a claim until the feedback session with Dr. Day.

The action was therefore commenced in time.

The applicant sought accident benefits following a motor vehicle collision.

The adjudicator found that the applicant's injuries warranted removal from the Minor Injury Guideline (MIG) due to chronic pain syndrome, satisfying several criteria under the AMA Guides.

However, the applicant's claims for a non-earner benefit and a chiropractic treatment plan were dismissed.

The adjudicator concluded that the applicant did not suffer a complete inability to carry on a normal life, as she retained significant functional capacity to engage in pre-accident activities.

The treatment plan was denied because the applicant failed to provide substantive evidence demonstrating it was reasonable and necessary.

The applicant sought income replacement benefits (IRB) and approval for two treatment plans (interpretation services and an orthopaedic assessment) following a motor vehicle accident.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to prove she suffered a substantial inability to perform the essential tasks of her pre-accident employment as a customer service clerk.

The Tribunal also found the proposed treatment plans were not reasonable and necessary, as the applicant could communicate adequately in English and her injuries were uncomplicated soft tissue strains that did not warrant an orthopaedic assessment.

Claims for interest and a special award were consequently dismissed.

The worker, a Personal Support Worker, appealed a decision denying initial entitlement to WSIB benefits for tinnitus and hearing loss allegedly caused by COVID-19 vaccinations received in 2021.

The Appeals Resolution Officer found that while the employer used coercion making the vaccinations a compulsory part of employment, the medical evidence did not establish a causal link between the vaccines and the worker's hearing loss and tinnitus.

Relying on the opinions of Occupational Medicine Consultants, the Officer concluded that on a balance of probabilities, the conditions were not an adverse reaction to the vaccines.

The appeal was denied.

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 vehicular phobia and depressive disorder, warranted removal from the MIG.

The Tribunal approved the initial psychological assessment and the first block of psychotherapy sessions as reasonable and necessary.

However, subsequent treatment plans for additional psychotherapy were denied because the applicant had already made substantial gains and the new plans did not reflect his improved condition.

The applicant sought statutory accident benefits following a motor vehicle accident, disputing the respondent's denial of treatment plans for physical therapy, a chronic pain assessment, and psychological services.

The Tribunal found that the applicant failed to demonstrate the treatment plans were reasonable and necessary, preferring the respondent's medical evidence that the physical injuries had resolved and that the requested psychological treatment exceeded what was warranted.

The claims for an award and interest were also dismissed as no benefits were found to be outstanding.

Personal injury trial arising from a 2015 motor vehicle accident involving a plaintiff with a prior 2012 collision and earlier mental health history.

The court rejected the defence theory that the plaintiff was malingering or merely misattributing pre-existing impairments, and found that the 2015 accident caused soft tissue injuries, chronic pain, psychological injury, headaches, and cognitive deficits that permanently impaired work and daily functioning.

Applying the but-for causation test and the thin skull rule rather than the crumbling skull principle, the court held that the plaintiff had substantially recovered from the earlier accident but remained vulnerable to more serious consequences from the later collision.

The court awarded general damages, past and future income loss, future care costs, and derivative damages to the family claimant.

The applicant sought an income replacement benefit (IRB) of $400 per week following a motor vehicle accident, claiming psychological and physical impairments prevented him from performing his essential tasks as an AutoCAD technician.

The respondent denied the claim, arguing the applicant returned to work immediately, was terminated for being a poor fit, and lacked objective medical evidence of disability.

The Licence Appeal Tribunal dismissed the application, finding the applicant failed to provide contemporaneous, objective medical evidence demonstrating a substantial inability to perform his pre-accident employment tasks during the disputed period.

As no benefits were payable, the claim for interest was also dismissed.

The applicant was injured in a motor vehicle accident and sought medical benefits for optometric services and an occupational therapy assessment under the Statutory Accident Benefits Schedule.

The respondent denied the benefits, arguing the applicant's impairments were caused by a pre-existing brain aneurysm and other life stressors rather than the accident.

The Tribunal applied the 'but-for' test for causation and found the accident was a necessary cause of the applicant's increased symptoms.

The Tribunal preferred the evidence of the applicant's treating practitioners over the respondent's assessor, concluding the proposed treatment plans were reasonable and necessary.

The applicant was awarded the claimed benefits.

The applicant, a pedestrian struck by a vehicle in a parking lot, sought entitlement to attendant care benefits and various medical and rehabilitation benefits under the Statutory Accident Benefits Schedule.

The Licence Appeal Tribunal found the applicant entitled to a reduced attendant care benefit for a limited period, preferring the respondent's occupational therapy assessment which accounted for the applicant's right-hand dominance.

The Tribunal also approved treatment plans for chiropractic and physiotherapy services, finding them reasonable and necessary for pain relief.

However, claims for an orthopaedic mattress, extended psychological sessions, occupational therapy, and transportation expenses were dismissed due to non-attendance at an insurer's examination, lack of justification, and statutory limitations.

The applicant, a pedestrian struck by a vehicle, sought statutory accident benefits for physiotherapy and a chronic pain program.

The insurer denied the treatment plans based on insurer examinations concluding the applicant had reached maximum medical improvement.

The Tribunal found the applicant's chronic pain diagnosis more consistent with the evidence and approved the treatment plans as reasonable and necessary.

The Tribunal awarded interest on overdue payments but declined to order a special award under Regulation 664, finding no evidence the insurer acted unreasonably or in bad faith.

The applicant sought statutory accident benefits for two chiropractic treatment plans following a rear-end motor vehicle accident.

The insurer denied the plans.

At the Licence Appeal Tribunal, the adjudicator found that the applicant failed to prove the treatments were reasonable and necessary.

The medical evidence, including clinical notes and records, did not support an ongoing physical impairment requiring the proposed treatment.

The adjudicator accepted the insurer's orthopaedic assessment that the applicant's soft tissue injuries had resolved.

The application was dismissed.

The applicant was injured in a motor vehicle accident while riding his bicycle and sought statutory accident benefits, including non-earner benefits and the cost of a psychological assessment.

The Licence Appeal Tribunal found that the applicant did not suffer a complete inability to carry on a normal life, as he was able to perform substantially all of his pre-accident activities with only minor restrictions.

The claim for non-earner benefits was dismissed.

However, the Tribunal awarded $1,450.00 for a short course of psychotherapy to address the applicant's residual psychological symptoms, including intrusive memories and anxiety related to cycling.

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

The respondent denied the claims, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant contended he suffered psychological injuries, relying on a psychological assessment diagnosing him with PTSD and depression.

The Tribunal found the applicant's self-reported normal daily routine and lack of psychological complaints to his family doctor contradicted the psychological diagnosis.

The Tribunal concluded the applicant's injuries fell within the MIG and dismissed the application for the cost of a psychological assessment.

The applicant, a pedestrian struck by a vehicle, sought statutory accident benefits for medical and rehabilitation treatments.

The respondent denied the claims, arguing the injuries fell within the Minor Injury Guideline (MIG) and the $3,500 limit was exhausted.

The Tribunal found that the applicant's physical injuries were minor and that she failed to prove a pre-existing condition or a psychological impairment that would warrant removal from the MIG.

The Tribunal preferred the respondent's comprehensive psychological assessment over the applicant's pre-screen.

As the injuries fell within the MIG and the limit was exhausted, the claims for further treatment and interest were dismissed.

The applicant filed a Request for Reconsideration of a Tribunal decision finding that his injuries fell within the Minor Injury Guideline (MIG).

The applicant argued the Tribunal erred in law by basing its decision solely on credibility, violated procedural fairness by not holding an oral hearing, and made errors of fact regarding his reported activities.

The Vice Chair dismissed the request, finding the Tribunal properly weighed the totality of the medical and surveillance evidence, the applicant had consented to a written hearing and had opportunities to respond to the surveillance evidence, and the Tribunal made no significant errors of fact.

The applicant sought income replacement benefits and funding for a psychological treatment plan following a motor vehicle accident.

The Licence Appeal Tribunal dismissed the application, finding the applicant failed to prove on a balance of probabilities that he suffered a substantial inability to perform the essential tasks of his pre-accident employment as a security guard.

The Tribunal preferred the insurer's psychological assessment, which found no ongoing psychological impairment, and concluded the proposed treatment plan was not reasonable and necessary.

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

The respondent denied the treatment and assessment plans on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant's self-reports to his medical assessors were unreliable due to significant credibility issues raised by video surveillance and social media evidence, which showed him engaging in activities inconsistent with his reported limitations.

Consequently, the Tribunal placed minimal weight on the applicant's medical reports and concluded that he failed to prove his injuries fell outside the MIG.

The application was dismissed.