Dr. Nadia Brown

The insurer applied to the Licence Appeal Tribunal seeking repayment of income replacement benefits (IRBs) paid to the respondent, alleging wilful misrepresentation of post-accident employment.

The adjudicator found no wilful misrepresentation, as the respondent's singing activities did not generate proven income and she had disclosed her temporary spa employment to the insurer's medical examiner.

However, the insurer was entitled to repayment of $907.54 for overpayments made within the 12 months prior to its notice.

The adjudicator also determined that the respondent's injuries fell outside the Minor Injury Guideline (MIG) due to a concussion diagnosis supported by contemporaneous clinical notes.

The respondent was awarded costs for an accounting report and an oculo-visual assessment, but claims for a psychological assessment, chiropractic treatment, and a special award were dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming she sustained a catastrophic impairment due to a mental or behavioural disorder under Criterion 8 of the Schedule.

The Tribunal assessed the applicant's functioning across four spheres: activities of daily living, social functioning, concentration, persistence and pace (CPP), and adaptation.

While the Tribunal found a marked impairment in CPP, it concluded the applicant only sustained moderate impairments in the other three spheres.

As the applicant did not demonstrate a marked impairment in three or more spheres, or an extreme impairment in one, the application was dismissed.

The applicants sought an order appointing section 3 counsel for the respondent, Joan Horneman, under the Substitute Decisions Act, 1992, due to her alleged incapacity to instruct counsel.

The court dismissed the motion, finding it lacked jurisdiction because Ms. Horneman already had legal representation.

The court further held that even if jurisdiction existed, appointing section 3 counsel would be inappropriate given Ms. Horneman's undisputed incapacity to instruct counsel, as section 3 counsel cannot act without instructions and their communications are privileged, making it difficult to assess the reliability of any information about the person's wishes.

The decision emphasized the distinction between the role of section 3 counsel and a litigation guardian.

The applicant sought a determination of catastrophic impairment under Criterion 8 (mental and behavioural disorders) and entitlement to various medical and rehabilitation benefits following a motor vehicle accident.

The Tribunal found that the applicant did not sustain a catastrophic impairment, placing limited weight on her experts due to her inconsistent self-reporting and failure to account for intervening events.

The Tribunal denied the disputed treatment plans for occupational therapy, physiotherapy, psychological services, and bathroom renovations, finding them not reasonable and necessary.

However, the Tribunal granted the cost of prescribed cannabis oil, noting that a treatment plan was not required for expenses under $250, and ordered a 35% award against the respondent for unreasonably withholding payment for the cannabis oil.

The applicant sought statutory accident benefits following a 2018 motor vehicle accident, claiming she sustained a catastrophic impairment due to a mental or behavioural disorder.

The Licence Appeal Tribunal found that the applicant's impairments were compatible with some useful functioning and did not reach the marked impairment threshold in three of four spheres of function.

The Tribunal also dismissed claims for attendant care benefits, finding the provider did not qualify as a professional under the Schedule and no economic loss was proven.

Claims for various treatment plans and a section 10 award for unreasonable delay were also dismissed.

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

The insurer denied benefits on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant argued she should be removed from the MIG due to a psychological injury and a pre-existing anxiety condition.

The Tribunal found insufficient contemporaneous medical evidence to establish an accident-related psychological impairment or that a pre-existing condition prevented her maximal recovery.

The applicant's injuries were deemed predominantly minor, but she was entitled to the disputed psychological assessment up to the remaining MIG limit.

The applicant sought a catastrophic impairment designation and approval for various treatment plans following a motor vehicle accident.

The Licence Appeal Tribunal found that the applicant did not meet the threshold for catastrophic impairment, as he only demonstrated marked impairment in two of the required three areas of function (social functioning and adaptation).

The Tribunal approved several treatment plans, including occupational therapy, psychological therapy, and a mobile phone, finding them reasonable and necessary to address the applicant's accident-related impairments.

Other treatment plans, including those for optometric services and a computer, were denied.