Dr. Gary Moddel

The applicant sought a determination that she sustained a catastrophic impairment as a result of a 2016 motor vehicle accident under Criteria 6, 7, and 8 of the Statutory Accident Benefits Schedule.

The Tribunal reviewed multidisciplinary assessments from both parties.

For Criterion 6 (physical), the Tribunal found a 36% whole person impairment, preferring the respondent's assessors on headaches and neurocognitive issues but the applicant's assessor on extremity impairments.

For Criterion 7 (combined physical and mental), the Tribunal added a 10% mental impairment rating based on the respondent's psychiatrist, resulting in a 42% combined impairment, falling short of the 55% threshold.

For Criterion 8 (mental/behavioural domains), the Tribunal found moderate impairments across all domains, rejecting the applicant's claims of marked or extreme impairments.

The application was dismissed.

The applicant sought statutory accident benefits following a 2018 motor vehicle accident.

The Tribunal first held that the applicant was statute-barred from disputing the denial of 14 treatment plans because he failed to apply within the two-year limitation period and did not establish grounds for an extension under s. 7 of the LAT Act.

On the substantive issues, the Tribunal found the applicant did not sustain a catastrophic impairment under Criterion 7 (falling short of the 55% whole person impairment threshold) or Criterion 8 (failing to establish marked impairments in three spheres of functioning).

The Tribunal also dismissed the claims for the remaining treatment plans, finding the applicant failed to meet his evidentiary onus to prove they were reasonable and necessary.

Claims for interest and an award were consequently dismissed.

The applicant was injured in a rear-end motor vehicle accident and returned to work six weeks later.

Five months after the accident, the applicant suffered a hemorrhagic stroke at work, resulting in right-side hemiplegia and confinement to a wheelchair.

The applicant sought statutory accident benefits, arguing the stroke was caused by the accident.

The Licence Appeal Tribunal applied the 'but for' test and found the stroke was caused by pre-existing, uncontrolled hypertension, not the accident.

Consequently, the Tribunal dismissed the claims for an income replacement benefit, a medical benefit for an electric scooter, and an award under Ontario Regulation 664.

The applicant sought various medical and rehabilitation benefits following a motor vehicle accident, which the respondent insurer denied.

The Licence Appeal Tribunal found that the treatment plans for lidocaine injections, an EEG assessment, physiotherapy, a dietician assessment, assistive devices, and psychological services were reasonable and necessary to treat the applicant's chronic pain and psychological impairments.

The Tribunal denied the functional abilities evaluation due to the applicant's pain-focused behaviour rendering it inaccurate, and dismissed the claim for a Regulation 664 award.

The Applicant was injured in a motor vehicle rollover accident and applied for a determination of catastrophic impairment.

The Insurer disputed the claim.

At arbitration, multiple medical experts testified regarding the Applicant's physical, mental, and behavioural impairments.

The arbitrator found that the Applicant sustained a Class 4 (marked) impairment in Concentration, Pace and Persistence, and Adaptability, relying on the Applicant's neuropsychologist.

The arbitrator also found that the Applicant would have met the 55% Whole Person Impairment threshold based on a combination of physical and psychological ratings.

The arbitrator concluded that the Applicant sustained a catastrophic impairment within the meaning of the Statutory Accident Benefits Schedule.

The applicant sought statutory accident benefits following a motor vehicle accident, including costs for a physiatry assessment, an occupational therapy assessment, acupuncture, and pharmacotherapy.

The respondent denied the claims based on insurer's examinations concluding the applicant suffered only from minor physical injuries.

The Tribunal found the applicant's medical evidence, which diagnosed concussion, post-concussive disorder, and chronic pain, outweighed the respondent's evidence.

The Tribunal ordered the respondent to pay the disputed benefits and interest.

However, the Tribunal dismissed the applicant's claim for a special award, finding the respondent had reasonable grounds to doubt the claims based on its own specialist reports.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including a determination of catastrophic impairment, income replacement benefits, and attendant care benefits.

The insurer argued the applicant's low Glasgow Coma Scale score was due to a pre-accident drug overdose and high blood sugar, not a brain injury from the accident.

The arbitrator rejected the insurer's theory, finding the applicant sustained a catastrophic impairment due to a traumatic brain injury.

The arbitrator also awarded ongoing income replacement benefits and attendant care benefits, but declined to order a special award against the insurer.

The moving party sought court approval of a proposed $650,000 accident benefits settlement arising from a motor vehicle accident that caused catastrophic brain injury to the plaintiff as a child.

The court reviewed the medical evidence, future care needs, and the proposed allocation of settlement funds, including structured settlement arrangements and funds to be managed by the plaintiff’s mother.

The judge identified significant concerns regarding the adequacy of the settlement relative to future care needs, missing medical and economic reports, unclear accounting for certain funds, and the proposed guardianship and care arrangements.

The court concluded that the evidentiary record was insufficient to determine whether the settlement was in the plaintiff’s best interests.

The proposed settlement was therefore not approved and the matter was ordered to return with further evidence.

The applicant was injured in a motor vehicle accident and received statutory accident benefits until the insurer terminated them.

The applicant applied for arbitration, claiming ongoing weekly income benefits on the basis that severe, unpredictable headaches caused by the accident continuously prevented him from engaging in any occupation for which he was reasonably suited.

The Arbitrator found the applicant credible and accepted medical evidence that his severe headaches were debilitating and unpredictable.

The Arbitrator concluded that the applicant was continuously prevented from engaging in suitable employment and ordered the insurer to pay ongoing weekly income benefits and arbitration expenses.