10 total
Reconsideration request dismissed; no reasonable apprehension of bias or errors of law in catastrophic impairment assessment.
The applicant requested a reconsideration of a Licence Appeal Tribunal decision that found she did not sustain a catastrophic impairment.
The applicant argued the adjudicator breached procedural fairness by demonstrating a reasonable apprehension of bias against her psychiatric assessor and by failing to consider all expert reports.
She also alleged errors of law and fact regarding the assessment of her pain and adaptation to work-like settings under the AMA Guides.
The Vice-Chair dismissed the request, finding no evidence of bias, noting the adjudicator properly weighed the evidence, and concluding there were no errors in the application of the catastrophic impairment criteria.
Prolotherapy treatment plan approved based on in-person assessment; neuro-optometric and psychological plans denied.
The applicant sought statutory accident benefits following a 2017 motor vehicle accident.
The respondent denied treatment plans for a neuro-optometric assessment, prolotherapy, and psychological services.
The Tribunal found the neuro-optometric assessment was not reasonable and necessary, as the supporting medical reports were either not contemporaneous or did not recommend further assessments.
The Tribunal approved the prolotherapy plan, preferring the in-person assessment of the applicant's physiatrist over the respondent's remote assessment.
The claim for the balance of psychological services was dismissed, as the applicant failed to justify the need for an updated assessment or the higher hourly rate for a psychotherapist.
Application for income replacement benefits dismissed due to lack of evidence proving employment.
The applicant sought income replacement benefits (IRBs) and a special award following a motor vehicle accident.
The respondent brought a motion to strike new evidence introduced in the applicant's reply submissions, which the Tribunal granted, finding the late introduction prejudicial.
On the merits, the Tribunal dismissed the application for IRBs, finding the applicant failed to prove she was employed at the time of the accident or establish the essential tasks of her alleged employment.
The Tribunal also found insufficient evidence to support a complete inability to work post-104 weeks.
The claims for interest and a special award were dismissed.
Applicant denied catastrophic impairment designation but granted post-104-week income replacement benefits due to combined impairments.
The applicant sought statutory accident benefits following a 2018 motor vehicle accident.
The Tribunal found the applicant did not sustain a catastrophic impairment under Criterion 8, as his mental and behavioural impairments were moderate (Class 3) rather than marked (Class 4) in the domains of activities of daily living and social functioning.
However, the Tribunal found the applicant was entitled to a post-104-week income replacement benefit, as his combined physical and psychological impairments resulted in a complete inability to engage in suitable employment.
Claims for occupational therapy and attendant care were dismissed as non-catastrophic funding was exhausted.
The applicant was awarded interest on overdue payments but denied a special award.
Catastrophic impairment claim dismissed; marked impairment in adaptation attributed to pre-existing psychological conditions.
The applicant sought a determination that she sustained a catastrophic impairment under Criterion 8 (mental and behavioural disorders) following a motor vehicle accident.
The Tribunal found that while the applicant sustained a mild neurocognitive disorder and a specific phobia as a result of the accident, her impairments in activities of daily living, social functioning, and concentration, persistence and pace were only moderate (Class 3).
Although the applicant demonstrated a marked impairment (Class 4) in adaptation, the Tribunal concluded this was caused by severe pre-existing psychological limitations rather than the accident.
The application was dismissed.
Reconsideration of catastrophic impairment decision dismissed as applicant failed to establish procedural unfairness or legal errors.
The applicant requested a reconsideration of a Licence Appeal Tribunal decision that found she had not sustained a catastrophic impairment.
The applicant argued the adjudicator committed a material breach of procedural fairness by failing to qualify her expert as a chronic pain expert, placing little weight on uncontested reports, and incorrectly interpreting the AMA Guides.
The applicant also alleged errors of law regarding the consideration of pain-based limitations and the application of the multidisciplinary approach.
The adjudicator dismissed the request, finding no breach of procedural fairness or errors of law, noting that the original decision properly weighed the evidence and correctly applied the relevant legal principles.
Catastrophic impairment claim dismissed; functional limitations attributed to physical pain rather than mental or behavioural disorders.
The applicant sought a determination that she sustained a catastrophic impairment under Criterion 8 (mental and behavioural disorders) following a 2012 motor vehicle accident.
The Tribunal first dismissed the applicant's preliminary motion for summary judgment, finding no jurisdiction to dispose of substantive issues without a hearing.
On the merits, the Tribunal preferred the evidence of the respondent's psychiatric expert over the applicant's expert, finding that the applicant's functional impairments were primarily caused by physical chronic pain rather than an accident-related mental or behavioural disorder.
The Tribunal concluded the applicant did not suffer a marked or extreme impairment in any of the four areas of functioning.
The application was dismissed, and the applicant was ordered to pay $250 in costs for unreasonable delays in producing disclosures.
Catastrophic impairment designation denied as applicant failed to meet the 55% whole person impairment threshold.
The applicant sought a catastrophic impairment designation and attendant care benefits following a motor vehicle accident.
The Tribunal evaluated the competing multidisciplinary assessments to determine if the applicant met the 55% whole person impairment threshold under Criterion 7.
The Tribunal rejected several of the applicant's proposed impairment ratings, including those for the lumbar spine, headaches, mental status, and medication, finding them inconsistent with the AMA Guides and medical evidence.
The Tribunal concluded the applicant's combined whole person impairment was 45%, falling short of the catastrophic impairment threshold.
The application for benefits, interest, and costs was dismissed.
Request for reconsideration of catastrophic impairment decision dismissed as no errors of law or fact were found.
The applicant requested a reconsideration of a decision finding she was not catastrophically impaired under Criterion 8 of the Schedule.
The applicant argued the adjudicator erred in law and fact by misapplying the Schedule, rejecting expert psychiatric opinions, misapplying the causation test, and ignoring evidence of deterioration.
The Tribunal dismissed the request, finding no errors of law or fact that would have changed the outcome.
The adjudicator noted that assigning weight to evidence and preferring certain evidence over expert opinions falls within the adjudicator's role and does not constitute an error of law.
Catastrophic impairment claim dismissed; psychological and functional limitations largely pre-dated the motor vehicle accident.
The applicant sought a determination that she sustained a catastrophic impairment (CAT) under Criterion 8 of the Statutory Accident Benefits Schedule following a motor vehicle accident.
The respondent argued the application was barred by res judicata and abuse of process due to a prior Tribunal decision denying post-104-week income replacement benefits.
The Tribunal rejected the preliminary objections, finding the applicant relied on new medical evidence.
On the merits, the Tribunal found the applicant's impairments, including her psychological and chronic pain conditions, largely pre-dated the accident.
The Tribunal rejected the applicant's expert evidence as flawed and concluded she did not suffer a marked impairment in three of four domains of function.
No co-appearing lawyers found.
No judges found.