Dr. J. Pilowsky

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to various treatment plans and assessments outside the Minor Injury Guideline (MIG) due to chronic pain and psychological impairments.

The Licence Appeal Tribunal found that the applicant's injuries were predominantly minor soft-tissue injuries.

The Tribunal preferred the respondent's medical assessments, noting that the applicant's contemporaneous medical records did not support a concussion, chronic pain with functional impairment, or a psychological condition.

As the applicant remained within the MIG, the disputed treatment plans were not payable, and claims for interest and a special award were dismissed.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for a psychological assessment, physical therapy, and psychological treatment.

The respondent insurer denied portions of the treatment plans.

The Tribunal found that the applicant failed to prove the disputed costs for the psychological assessment and treatment were reasonable and necessary, as the insurer's examiners had found the proposed costs excessive or partially unnecessary.

However, the Tribunal awarded the cost of the physical therapy based on the recommendation of the applicant's family doctor, which the insurer failed to rebut with medical evidence.

The applicant was injured in a motor vehicle accident and sought medical benefits for two chiropractic treatment plans and one psychological treatment plan under the Statutory Accident Benefits Schedule.

The respondent denied the plans based on insurer's examinations.

The Licence Appeal Tribunal found the first chiropractic treatment plan reasonable and necessary, noting the applicant's ongoing pain and the physical impairments documented even in the respondent's own medical examination.

However, the Tribunal dismissed the claims for the second chiropractic plan and the psychological plan, finding insufficient evidence of ongoing physical impairment and concluding the applicant had already reached her psychological treatment goals.

The applicant was awarded the cost of the first chiropractic plan plus interest.

The 79-year-old applicant sought non-earner benefits following a motor vehicle accident.

The insurer paid benefits until January 28, 2017, but terminated them based on multidisciplinary assessments indicating the applicant no longer suffered a complete inability to carry on a normal life.

The Tribunal applied the Heath framework and found that, due to successful physiotherapy and psychotherapy, the applicant had recovered sufficiently to engage in substantially all of his pre-accident activities.

The Tribunal also found the applicant non-compliant for failing to attend a scheduled insurer examination in September 2018, providing an independent basis for termination.

The application was dismissed.

The applicant sought ongoing income replacement benefits (IRBs) beyond the 104-week mark following a motor vehicle accident.

The Licence Appeal Tribunal found that while the accident caused the applicant's impairments, she failed to prove a complete inability to engage in any employment for which she was reasonably suited by education, training, or experience.

The Tribunal preferred the respondent's independent medical examinations and functional evaluations over the applicant's subjective complaints and expert evidence, noting credibility issues and the employer's willingness to accommodate her.

The application for IRBs, interest, and a special award was dismissed, and no costs were awarded.

The applicant was injured in a rear-end motor vehicle accident and sought statutory accident benefits for physical and psychological treatment.

The respondent insurer denied two treatment plans on the basis of an insurer's examination that concluded the injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found the treatment plans reasonable and necessary, preferring the evidence of the treating psychologist and other insurer's examiners who noted ongoing pain and psychological disturbance over the physician who erroneously applied the MIG.

The applicant was awarded the claimed medical benefits plus interest.

The applicant sought statutory accident benefits for physiotherapy, a chronic pain program, and an orthopaedic assessment following a rear-end collision.

The respondent insurer denied the claims, arguing the applicant failed to prove the impairments were caused by the accident.

The Tribunal found that the applicant had an extensive pre-accident medical history, including knee replacements, fibromyalgia, and depression, and failed to provide sufficient clinical notes and records to establish a baseline for comparison.

The Tribunal gave no weight to the applicant's expert reports due to factual inaccuracies and incomplete medical reviews.

The application was dismissed as the applicant failed to prove causation on a balance of probabilities.

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

The respondent denied claims for a psychological assessment and treatment, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the respondent failed to comply with the notice requirements under s. 38(8) of the Schedule because its Explanation of Benefits did not provide valid medical reasons for denying the psychological assessment.

Consequently, the applicant was removed from the MIG, and the cost of the assessment was payable.

The Tribunal also found the psychological treatment plan reasonable and necessary, as the respondent provided no competing psychological evidence.

The claim for an award under Regulation 664 was dismissed, but interest was awarded on the overdue benefits.

The applicant was seriously injured in a motor vehicle accident and sought statutory accident benefits, including non-earner benefits, attendant care benefits, and medical/rehabilitation benefits.

The insurer terminated benefits based on insurer examinations concluding the applicant had reached maximum medical improvement.

The Tribunal found the applicant's ongoing pain and psychological impairments continuously prevented her from engaging in substantially all of her pre-accident activities, entitling her to non-earner benefits.

The Tribunal also determined the reasonable and necessary quantum of attendant care benefits and ordered a 5 percent award against the insurer for unreasonably delaying payment of medical and rehabilitation expenses.

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

The respondent denied payment, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Licence Appeal Tribunal found that the applicant's psychological impairments, specifically Somatic Symptom Disorder and Posttraumatic Stress Disorder, took his injuries outside the MIG.

The Tribunal ordered the respondent to pay for a chronic pain assessment and two treatment plans for physiotherapy and chiropractic services, finding them reasonable and necessary.

Two other physiotherapy treatment plans were denied.

Interest was awarded on the overdue payments.

The applicant sought payment for several treatment plans and assessments following a motor vehicle accident, which the respondent insurer denied.

The Licence Appeal Tribunal found that the applicant failed to provide sufficient medical evidence to prove the treatment plans were reasonable and necessary.

The Tribunal preferred the evidence of the insurer's assessors, who concluded the physical injuries were minor and had largely resolved, and that there was no objective evidence linking the applicant's psychological issues to chronic physical pain.

The application was dismissed.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits from her insurer.

The insurer terminated her income replacement benefits and denied medical and rehabilitation benefits, maintaining for nearly three years that her injuries fell within the Minor Injury Guideline (MIG).

The arbitrator found that the applicant suffered a substantial inability to perform her pre-accident employment and, post-104 weeks, a complete inability to engage in suitable employment due to chronic pain.

The arbitrator granted the claimed income replacement benefits, medical benefits, and costs of examinations.

Furthermore, the arbitrator awarded a $25,000 Special Award against the insurer, finding that it had unreasonably delayed and denied benefits by relying on patently flawed medical reports and ignoring credible evidence of the applicant's chronic pain.

The plaintiff's counsel of record brought a motion seeking directions for a capacity assessment of the plaintiff and the appointment of the Public Guardian and Trustee (PGT) as her litigation guardian.

The court dismissed the request for a capacity assessment, finding that sufficient medical evidence had already been filed.

Relying on psychological and psychiatric reports indicating the plaintiff suffered from severe cognitive deficits, paranoia, and delusions, the court found the plaintiff was a party under disability incapable of instructing counsel or making litigation decisions.

The court appointed the PGT as litigation guardian and granted counsel's motion to be removed from the record.

The plaintiff's counsel of record brought a motion seeking a court-ordered capacity assessment of the plaintiff and the appointment of the Public Guardian and Trustee as her litigation guardian.

The plaintiff opposed the motion.

The court found that counsel had not followed the proper procedure under Rule 7.03(6) by failing to serve a Request for Appointment of Litigation Guardian prior to bringing the motion, which took the plaintiff by surprise.

To ensure fairness, the court adjourned the motion and granted the plaintiff time to deliver responding materials.

The defendants brought a motion seeking an order to compel the plaintiff to attend a further defence orthopedic examination.

The plaintiff opposed the motion.

The court applied the seven-factor test from Bonello v. Taylor, 2010 ONSC 5723, for ordering further examinations.

The court noted that the defendants had previously chosen a physiatrist for examination despite knowing the plaintiff would rely on an orthopedic surgeon's report.

No significant change in the plaintiff's condition was demonstrated, and the defendants' own physiatrist's addendum report confirmed his original opinion remained unaltered, even after new information about a subsequent accident.

The court found that the defendants failed to demonstrate the necessity for a second physical examination and dismissed the motion.

The defendants brought a motion for an order compelling the plaintiff to attend an in-person vocational assessment with a non-health practitioner and to provide raw test data from previous neuropsychological assessments to the defence expert.

The plaintiff opposed the motion.

The court held that it has inherent jurisdiction to order an examination by a non-health practitioner to ensure trial fairness, and that the raw test data was relevant and necessary for the defence expert to prepare his report.

The motion was granted.

The respondent sought to vary a temporary child and spousal support order on the basis of a material change in circumstances.

The respondent had been ordered to pay support based on imputed income of $86,000 annually as a car salesman.

He subsequently obtained new employment at a lower salary of $60,000 annually, claiming he chose the position to spend more time with the children.

The court dismissed the motion to vary, finding that the respondent had not established changed circumstances sufficient to overcome the res judicata effect of the imputed income determination.

The court held that a parent's obligation to support children at the level they are capable of earning takes precedence over personal choices regarding work-life balance.

The offender was found guilty of theft under $5000 and criminal harassment after stealing his ex-partner's diaries and cellphone, and using the information to distribute sexually explicit photos and videos of her to her family and friends.

He also created a fake dating profile in her name.

The court balanced the paramount principles of denunciation and deterrence with the offender's status as a first-time offender and sole provider for his family.

The court imposed a blended sentence of 90 days intermittent custody and a concurrent 6-month conditional sentence, followed by 3 years of probation.

The accused was convicted of theft under $5,000 and criminal harassment.

The offences involved the theft of personal items (diaries, address book, cellphone) and a subsequent orchestrated campaign of harassment including distribution of intimate images and creation of a fake dating profile to cause fear and control the victim.

The court imposed a blended sentence of 90 days intermittent imprisonment concurrent with a 6-month conditional sentence with strict conditions, followed by 3 years probation.

The sentencing balanced deterrence and denunciation with rehabilitation, considering the accused's family responsibilities and lack of prior record.

The mother, sister, and two brothers of a murder victim appealed a decision of the Criminal Injuries Compensation Board denying them compensation for nervous shock.

The Board had denied compensation based on the deceased's contributory conduct and a finding that the claimants did not meet the criteria for nervous shock because they did not witness the murder.

The Divisional Court allowed the appeal for three of the claimants, finding the Board erred in law by failing to conduct a proportionality analysis between the victim's conduct and the offenders' actions.

The Court also held the Board erred in its application of the nervous shock criteria, as the common law does not strictly require claimants to directly witness the event if they come upon the immediate aftermath.