7 total
Non-earner benefit payable due to defective denial notice; chronic pain assessment approved but functional assessment denied.
The applicant sought statutory accident benefits following a motor vehicle accident, including a non-earner benefit (NEB), a functional abilities assessment, and a chronic pain assessment.
The Tribunal found the respondent failed to comply with a production order regarding the NEB denial letter and drew an adverse inference, concluding the respondent failed to provide proper notice under s. 36(4) of the Schedule.
Consequently, the NEB was payable under s. 36(6).
The Tribunal denied the functional abilities assessment, finding the applicant's physical condition did not limit his daily tasks or employment.
However, the Tribunal approved the chronic pain assessment based on consistent reports of ongoing pain.
Claims for an award and costs were dismissed.
Applicant denied non-earner benefits and most treatment plans due to lack of objective impairment evidence.
The applicant sought statutory accident benefits following a motor vehicle accident, including a non-earner benefit (NEB), various treatment plans, and an award for unreasonable delay.
The Tribunal found the applicant was not entitled to the NEB, as he failed to prove a complete inability to carry on a normal life, noting he returned to full-time work shortly after the accident.
Most treatment plans were denied for lack of objective evidence of impairment, relying on the respondent's insurer examinations.
However, a functional abilities evaluation was approved based on psychological reports indicating a need to investigate functional impairments.
The claim for an award was dismissed as the insurer adjusted the claim in good faith.
Applicant removed from Minor Injury Guideline for chronic pain but denied non-earner benefit.
The applicant sought statutory accident benefits following a motor vehicle accident.
The adjudicator found that the applicant should be removed from the Minor Injury Guideline due to chronic pain with functional impairment.
However, the applicant was not entitled to a non-earner benefit because he did not suffer a complete inability to carry on a normal life, as he continued to work part-time and perform some daily activities.
The adjudicator approved several treatment plans for physiotherapy and an in-home assessment because the insurer failed to provide valid denial notices under s. 38(8) of the Schedule.
Claims for a chiropractic examination, an award, and costs were dismissed.
Application for accident benefits dismissed; injuries found to fall within the Minor Injury Guideline.
The respondent insurer denied certain medical benefits and assessments on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).
The Tribunal found that the applicant's injuries, including a cervical strain and a left shoulder calcific tendinosis, were predominantly minor injuries or unrelated to the accident.
The Tribunal concluded that the applicant did not suffer from chronic pain caused by the accident and that the disputed treatment plans were not reasonable and necessary.
The application was dismissed.
Civil action against police for excessive force dismissed; controlled take-down deemed justified under Criminal Code.
The plaintiff brought a civil action against the Toronto Police Services Board and individual officers, alleging they used excessive force during his arrest and were negligent in his subsequent detention.
The plaintiff claimed he was severely beaten without warning, while the police testified they executed a controlled take-down after he resisted arrest.
The court found the police officers' evidence credible and reliable, concluding that the force used was necessary, justified, and not excessive under section 25(1) of the Criminal Code.
The court also dismissed the plaintiff's claims of negligence and breach of fiduciary duty, ultimately dismissing the action in its entirety.
Applicant's injuries fell outside the Minor Injury Guideline due to chronic pain and psychological impairments.
The Applicant was injured in a rear-end motor vehicle accident and sought accident benefits from the Insurer.
The Insurer denied various treatment plans on the basis that the Applicant's injuries fell within the Minor Injury Guideline (MIG).
The Arbitrator found that the Applicant's injuries fell outside the MIG due to chronic pain, psychological impairments, and radicular symptoms.
The Arbitrator approved several treatment plans for chronic pain assessment, psychological assessment and treatment, active treatment, and a home assessment, while denying others as duplicative or unnecessary.
The Applicant was also awarded interest on overdue payments.
Applicant's chronic pain and psychological impairment removed her from the Minor Injury Guideline; treatment plans partially approved.
The applicant was injured in a rear-end motor vehicle accident and sought statutory accident benefits from the insurer.
The insurer denied several treatment plans, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).
The arbitrator found that the applicant's ongoing chronic pain and worsening psychological condition, which interfered with her functioning, removed her from the MIG.
The arbitrator approved treatment plans for physical therapy, psychological assessment and treatment, and chronic pain assessment, but denied several other assessments as premature or unnecessary.
The applicant was also awarded interest on overdue benefits.