Dr. Harrington

The applicant requested a reconsideration of a Tribunal decision denying her entitlement to a post-104 income replacement benefit (IRB).

The applicant argued the adjudicator erred in law and breached procedural fairness by failing to determine substantive entitlement to the IRB, even if the quantum was zero.

The adjudicator agreed it was an error not to address the substantive threshold but found this was not a material breach or an error that would have changed the outcome.

The adjudicator reviewed the medical and vocational evidence, preferring the respondent's multidisciplinary assessments which concluded the applicant did not suffer a complete inability to engage in suitable employment.

The request for reconsideration was dismissed, and the respondent's request for costs was denied.

The applicant sought a non-earner benefit following a motor vehicle accident.

The Tribunal found that the respondent insurer failed to comply with its procedural obligations under s. 36(4) of the Schedule by responding late to the application, and ordered payment of the benefit for the period of non-compliance.

However, for the remaining period, the Tribunal dismissed the claim, finding the applicant failed to prove a complete inability to carry on a normal life.

The applicant's evidence lacked objective support, and the respondent's independent examination assessors noted inconsistencies and symptom exaggeration.

The applicant sought statutory accident benefits following a 2014 motor vehicle accident, specifically claiming $2,486.00 for a physiatry assessment and an award for unreasonably withheld payments.

The adjudicator found that the applicant failed to prove the assessment was reasonable and necessary, preferring the insurer's medical examination report which found normal neurological findings and functional range of motion.

The applicant's expert evidence on chronic pain was rejected due to reliance on subjective reporting without objective validity testing.

The claim for an award under s. 10 of O. Reg. 664 was also dismissed, as the insurer reasonably relied on its assessors' reports in denying the benefit.

The applicant sought statutory accident benefits following a motor vehicle accident, including an income replacement benefit and various medical and rehabilitation benefits.

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

The Tribunal found that the applicant's physical injuries were predominantly minor and that he failed to establish a psychological impairment or chronic pain condition that would remove him from the MIG.

The Tribunal preferred the respondent's psychological assessment over the applicant's, noting the latter omitted a significant life event.

The Tribunal also found the applicant failed to prove he missed work as a result of the accident, dismissing the claim for an income replacement benefit.

The application was dismissed in its entirety.

The insurer brought a motion for reconsideration of a Licence Appeal Tribunal decision which found that the insured's left shoulder SLAP tear and pre-existing lower back condition fell outside the Minor Injury Guideline (MIG).

The insurer argued the hearing adjudicator ignored medical evidence and failed to provide sufficient reasons for preferring the insured's medical experts over the insurer's experts.

The Executive Chair dismissed the request, finding that the adjudicator reasonably weighed the evidence, was not required to explicitly mention every piece of evidence, and made no significant error of fact or law.