Dr. Keith Meloff

The appellant was struck by a car while riding his bicycle and applied for a determination of catastrophic impairment based on a Glasgow Coma Scale score of 8.

The Licence Appeal Tribunal denied the application.

On appeal, the Divisional Court found that the Tribunal breached procedural fairness by refusing to admit a video of the accident, permitting the respondent's expert to testify beyond the scope of his report, and refusing to allow the appellant to call reply evidence.

The appeal was granted and the matter remitted to the Tribunal for a new hearing before a different adjudicator.

The applicant sought payment for five chiropractic treatment plans following a motor vehicle accident.

The Licence Appeal Tribunal found that the insurer failed to comply with the 10-day notice requirement under section 38(8) of the Schedule for three of the plans, ordering the insurer to pay for treatment incurred during the non-compliance periods.

However, the Tribunal dismissed the appeal regarding the substantive entitlement to the treatment plans, finding the applicant failed to prove they were reasonable and necessary.

The objective medical evidence and independent assessments indicated the applicant had reached maximum medical recovery and would not benefit from further facility-based treatment.

The applicant was struck by a motor vehicle while riding his bicycle and sought a determination of catastrophic impairment based on a Glasgow Coma Scale (GCS) score of 9 or less.

The adjudicator found that the paramedic's delayed report, which recorded a GCS of 8/15 three months after the accident, lacked credibility and reliability.

Preferring the respondent's expert neurological evidence, the adjudicator concluded the applicant did not sustain a catastrophic impairment.

The claim for an award under Ontario Regulation 664 was also dismissed as there was no evidence the insurer unreasonably withheld or delayed payments.

The applicant sought Income Replacement Benefits (IRBs) and medical benefits following a rear-end motor vehicle accident.

The insurer denied the claims, arguing the applicant did not suffer a substantial or complete inability to work and that the medical treatments were not reasonable and necessary.

The arbitrator found that the applicant continued to work for 14 months post-accident and that her subsequent medical complaints, including blackouts and incontinence, were not causally linked to the accident by the medical experts.

The arbitrator dismissed the application, concluding the applicant failed to prove entitlement to IRBs, medical benefits, or a special award.

The applicant was injured in a motor vehicle accident and sought a determination of catastrophic impairment.

The insurer's assessors concluded he did not meet the threshold, and the applicant sought funding for rebuttal reports.

The insurer denied funding, arguing the new SABS eliminated this right and the applicant failed to meet the timelines under the old SABS.

The arbitrator found the applicant was not entitled to substantive interim benefits for the reports under either SABS.

However, applying the 'whole case approach,' the arbitrator awarded $10,500 as an interim expense to fund the rebuttal reports, citing the applicant's financial distress and the need for procedural fairness to answer the insurer's expert reports.

The applicant was injured in a motor vehicle accident and received income replacement benefits until the insurer terminated them after 104 weeks.

The applicant sought arbitration, claiming a complete inability to engage in any employment for which she was reasonably suited.

The arbitrator reviewed the applicant's education, training, and work history, noting she primarily worked part-time.

Relying on the consensus of the applicant's own medical experts that she could return to part-time sedentary work, the arbitrator found she did not meet the test for complete inability to work.

The application for income replacement benefits and a special award was dismissed.

The applicant was struck by a vehicle while crossing the street and claimed statutory accident benefits for income replacement, housekeeping, and travel expenses.

The insurer denied income replacement benefits after December 26, 1995, and housekeeping expenses.

At arbitration, the arbitrator found the applicant to be an unreliable historian whose testimony was contradicted by video surveillance showing him walking normally.

The medical evidence did not support the applicant's claims of debilitating physical or cognitive impairments preventing him from performing his job as a furniture assembler.

The claims for income replacement and housekeeping were dismissed, but the applicant was awarded $590 for uncontested travel expenses.