Erin D. Langis

The applicant sought various statutory accident benefits following a motor vehicle accident, including a determination of catastrophic impairment, income replacement benefits, attendant care benefits, and numerous treatment plans.

The Tribunal found that the applicant did not meet the criteria for catastrophic impairment, as he did not demonstrate a Class 4 impairment in three of four domains.

The Tribunal also dismissed the claims for income replacement and attendant care benefits, finding the applicant failed to meet his evidentiary burden.

While the Tribunal found some of the insurer's notices defective, triggering the 'shall pay' provision for a cognitive assessment, most of the insurer's denials were deemed compliant with the Schedule.

The Tribunal ordered payment for cognitive and neurological assessments but dismissed the remaining claims and the request for a special award.

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

The insurer denied several treatment plans for physiotherapy, psychological services, and various assessments.

The Tribunal first determined that the applicant was not barred from disputing a treatment plan denied more than two years prior, applying the COVID-19 limitation period suspension under O. Reg. 73/20 and granting an extension under s. 7 of the LAT Act.

On the merits, the Tribunal denied the physiotherapy and chronic pain assessment plans, finding the applicant's physical injuries were predominantly soft-tissue and had resolved.

However, the Tribunal approved the psychological, cognitive, biopsychosocial, and driving therapy plans, preferring the evidence of the applicant's assessors and certain insurer examinations that confirmed the applicant suffered from accident-related depression and anxiety.

Claims for an award and costs were dismissed due to lack of supporting submissions.

The applicant was injured in a motor vehicle accident and sought ongoing income replacement benefits (IRBs) after the insurer terminated them.

The insurer argued the applicant's impairments were due to pre-existing degenerative disc disease and osteoarthritis.

The Tribunal found that the applicant suffered from chronic pain syndrome caused by the accident, applying the AMA Guides criteria.

Given her limited English, lack of higher education, and history of physically demanding work, the Tribunal concluded she met both the substantial inability test and the complete inability test.

The Tribunal ordered the insurer to pay the ongoing IRBs with interest.