Dr. Ivan Kiss

The applicant requested a reconsideration of a previous Licence Appeal Tribunal decision that denied her entitlement to a treatment plan for vestibular physiotherapy.

The applicant argued the Tribunal erred in law by applying the incorrect legal test for res judicata.

The Adjudicator agreed, finding that the previous decision relied on an incorrect four-part test rather than the binding three-part test from the Supreme Court of Canada, and failed to properly analyze whether the same issue had been previously decided.

Upon reconsidering the merits, the Adjudicator found the applicant was partially entitled to the treatment plan in the amount of $2,697.28, as the treatment was reasonable and necessary for her accident-related post-concussion symptoms, though costs incurred prior to the plan's submission were excluded under s. 38(2) of the Schedule.

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

The Licence Appeal Tribunal found the applicant was entitled to $2,700 for social work services and various expenses for medical cannabis, preferring the evidence of her treating practitioners over the insurer's assessors.

However, the Tribunal dismissed claims for case management services and a Cefaly device for lack of supporting medical evidence.

A claim for vestibular physiotherapy was dismissed as barred by res judicata, as it had been denied in a previous Tribunal decision and the applicant's new evidence did not conclusively impeach the original result.

The applicant sought a determination of catastrophic impairment following a motor vehicle accident.

The respondent scheduled psychological and occupational therapy insurer's examinations (IEs).

The applicant attended both, but the psychologist passed away before finalizing his report, and the applicant declined to participate in the situational portion of the occupational therapy IE.

The respondent scheduled a second set of IEs, which the applicant refused to attend.

The Tribunal found that a second in-person psychological IE was not reasonably necessary, as the respondent possessed the draft report and raw data.

However, the Tribunal found the situational occupational therapy assessment was reasonably necessary.

The Tribunal stayed the proceeding until the applicant complied with the situational assessment requirement.

The applicant was severely injured in a head-on motor vehicle collision and applied for statutory accident benefits.

After exhausting non-catastrophic limits, she sought a determination of catastrophic impairment and entitlement to further attendant care, housekeeping, and medical/rehabilitation benefits.

The Tribunal found the applicant catastrophically impaired under Criterion 7, accepting a combined Whole Person Impairment rating of 59% based on physical and mental/behavioral impairments, including a mild traumatic brain injury.

The Tribunal awarded attendant care and housekeeping benefits for incurred amounts, as well as an occupational therapy treatment plan, but dismissed claims for physiotherapy and a special award.

The applicant was also ordered to repay income replacement benefits received while employed.

The applicant was injured in a motor vehicle accident in 1997 and received income replacement benefits until the insurer terminated them in November 1997 based on early medical opinions.

The applicant applied for arbitration, claiming ongoing entitlement to income replacement benefits due to cognitive, psychological, and physical impairments.

The arbitrator found that the applicant sustained impairments as a result of the accident and met the tests for both substantial inability within the first 104 weeks and complete inability thereafter.

The arbitrator preferred the evidence of the applicant, his family, and his medical-legal experts over the insurer's experts.

The insurer was ordered to pay ongoing income replacement benefits, interest from the date the applicant's counsel first contacted the insurer in 2001, and a $5,000 special award for unreasonably failing to reinstate benefits after receiving further medical evidence of disability.