Dr. M. Mamelak

The applicant requested a reconsideration of a Tribunal decision that found his injuries fell within the Minor Injury Guideline (MIG).

The respondent brought a motion to exclude new evidence submitted by the applicant, including a psychiatric assessment report by Dr. Mamelak.

The Tribunal granted the motion to exclude the new evidence, finding it could have been obtained earlier and was an attempt to re-argue the case.

On the reconsideration request, the Tribunal found the applicant failed to demonstrate any violation of natural justice or procedural fairness under Rule 18.2(a).

Furthermore, the Tribunal held that the applicant did not identify any significant error of law or fact under Rule 18.2(b), but rather attempted to re-litigate issues regarding pre-existing conditions, chronic pain, and psychological impairment.

The request for reconsideration was dismissed.

The appellant appealed an Arbitrator's decision finding that he was not catastrophically impaired and dismissing his claims for statutory accident benefits.

The appellant argued that the Arbitrator erred in relying on surveillance evidence and the respondent's medical experts rather than his own presentation at the hearing and his family's testimony.

The Director's Delegate dismissed the appeal, finding that the Arbitrator made no errors of law.

The Arbitrator was entitled to weigh the evidence, including surveillance videos showing the appellant engaging in complex activities that contradicted his family's testimony and his presentation to his own medical experts.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for caregiving, housekeeping, attendant care, and medical expenses, as well as a special award.

The arbitrator found that the applicant failed to establish on a balance of probabilities that she suffered a substantial inability to perform her pre-accident caregiving and housekeeping tasks, or that she required the claimed attendant care assistance.

The arbitrator noted inconsistencies in the applicant's evidence, her failure to disclose her ongoing receipt of ODSP benefits to medical assessors, and preferred the evidence of the insurer's occupational therapist who found the applicant could perform her activities of daily living with assistive devices.

All claims for benefits, interest, and a special award were dismissed.

The Applicant sought statutory accident benefits, including a determination of catastrophic impairment, income replacement benefits, housekeeping, and attendant care, following a 2003 motor vehicle accident.

The Insurer relied on extensive surveillance video taken over four years showing the Applicant driving on highways, running errands, and performing complex tasks, which starkly contradicted the Applicant's presentation to medical assessors and his family's testimony that he was severely cognitively and physically impaired.

The Arbitrator found the Applicant's medical evidence and family testimony unreliable due to the glaring inconsistencies with the objective surveillance evidence.

The Arbitrator preferred the Insurer's medical experts, concluded the Applicant was not catastrophically impaired, and dismissed all claims for benefits and a special award.

The appellant was injured in a 1993 motor vehicle accident and sought rehabilitation and attendant care benefits.

The arbitrator dismissed the claims, finding the appellant failed to establish that the accident materially contributed to her physical, cognitive, and psychological conditions, largely due to a lack of pre-accident medical records and reliable evidence.

On appeal, the appellant argued the arbitrator erred by admitting insurer medical reports without cross-examination and by misapplying the burden of proof.

The Director's Delegate dismissed the appeal, holding that the failure to cross-examine does not compel acceptance of an expert's report and that the burden of proving causation remained on the appellant.

The applicant sought statutory accident benefits for rehabilitation and care services following a 1993 motor vehicle accident.

The insurer denied the claims, arguing the applicant's pervasive physical, cognitive, and psychological conditions were not caused by the accident.

The arbitrator dismissed the applicant's claims, finding she failed to prove on a balance of probabilities that the accident materially contributed to her impairments.

The arbitrator noted a complete absence of pre-accident medical records, relying solely on the applicant's unreliable self-reporting, and drew an adverse inference from her failure to call pre-accident treating physicians or lay witnesses to corroborate her pre-accident health and functional abilities.

The appellant appealed an Arbitrator's decision dismissing his claims for income replacement benefits, medical expenses, and housekeeping benefits following a motor vehicle accident.

The Arbitrator had dismissed the claims primarily based on adverse credibility findings, noting inconsistencies between the appellant's reported symptoms and surveillance evidence showing him driving for extended periods.

The Director's Delegate dismissed the appeal, finding that the Arbitrator's factual conclusions were supported by the evidence and did not constitute an error of law.

The Arbitrator reasonably preferred the respondent's expert evidence and rejected the appellant's experts due to their reliance on the appellant's subjective and exaggerated complaints.

The appellant was injured in a motor vehicle accident and received income replacement benefits for two years until the insurer terminated them, arguing she did not meet the 'any occupation' test.

At arbitration, the Arbitrator ordered benefits reinstated but only until September 2000, inferring from a psychiatrist's report that the appellant could perform some work.

On appeal, the Director's Delegate found the Arbitrator erred in law by drawing an inference that was not supported by the evidence, as the psychiatrist's report did not recommend a work trial but merely suggested one to prove his unqualified opinion that she was completely disabled.

The appeal was allowed and the issue of entitlement to benefits was remitted to a new arbitration hearing.

The applicant was injured in a rear-end motor vehicle accident and sought statutory accident benefits, including income replacement, medical, housekeeping, and examination expenses.

The insurer terminated income replacement benefits, arguing the applicant was malingering.

The arbitrator reviewed extensive medical evidence, surveillance footage, and the applicant's testimony.

The arbitrator found the applicant lacked credibility, noting inconsistencies between his claimed severe impairments, such as a driving phobia, and surveillance showing him driving for hours.

The arbitrator concluded the applicant was exaggerating his symptoms for financial gain and was capable of returning to work.

All claims for benefits and expenses were dismissed.

The applicant was injured in a motor vehicle accident and received income replacement benefits for 104 weeks.

The insurer terminated benefits, and the applicant sought ongoing income replacement, attendant care, and housekeeping benefits.

The arbitrator found that the applicant did not suffer a complete inability to engage in suitable employment due to physical injuries, but did suffer such an inability due to psychological complications (severe depression and anxiety) until her condition stabilized.

The arbitrator awarded income replacement benefits for a closed period.

The claims for attendant care and housekeeping expenses were dismissed because the applicant failed to prove she incurred a cost or obligation to pay her husband for those services.

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 three motor vehicle accidents.

She applied for statutory accident benefits.

The insurer relied on section 21(9) of the Schedule to delay making a loss of earning capacity benefit (LECB) offer until two years after the second accident.

A RECDAC assessment concluded she could work full-time as a parking lot attendant.

The arbitrator found the applicant to be an unreliable historian due to her failure to disclose a significant pre-accident history of workplace injuries.

However, based on the medical evidence, the arbitrator found she suffered significant psychological and physical impairments.

The arbitrator concluded the RECDAC overestimated her functional abilities, finding she could only work part-time as a parking lot attendant.

Claims for acupuncture and a special award for delay were dismissed.