Dr. Mustafa

The appellant, who was injured in a motor vehicle accident, appealed and sought judicial review of a Licence Appeal Tribunal decision denying her catastrophic impairment benefits.

The Divisional Court found that while there was no breach of procedural fairness, the Adjudicator's findings regarding the appellant's whole person impairment under Criterion 6 of the AMA Guides were unreasonable.

Specifically, the Adjudicator unreasonably dismissed evidence of double vision, peripheral neuropathy, and medication side effects.

The court quashed the decision and remitted the matter to the LAT for a new hearing before a different adjudicator.

The applicant sought judicial review of a Licence Appeal Tribunal (LAT) decision dismissing her claims for statutory accident benefits, including income replacement benefits, catastrophic impairment designation, and attendant care benefits.

The Divisional Court dismissed the application, finding that the LAT's decisions regarding the 104-week deadline for income replacement benefits, the assessment of catastrophic impairment criteria, and the reduction of attendant care benefits were reasonable.

The court also rejected the applicant's claims of procedural fairness violations, concluding that the LAT appropriately controlled its own process.

The applicant sought a determination that he sustained a catastrophic impairment under Criterion 8 of the Schedule and claimed entitlement to a post-104 income replacement benefit (IRB) following a motor vehicle accident.

The Tribunal found that the applicant did not meet the threshold for catastrophic impairment, as he did not demonstrate a marked impairment in at least two of the four functional domains, specifically finding his social functioning was compatible with some useful functioning.

However, the Tribunal granted the applicant's claim for a post-104 IRB, finding that the combination of his physical, psychological, cognitive, and visual impairments resulted in a complete inability to engage in any employment for which he was reasonably suited by education, training, or experience.

Interest was awarded on the overdue IRB payments.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision which found she was not catastrophically impaired and denied her claims for attendant care, treatment plans, housekeeping, and costs.

The applicant argued the Tribunal breached procedural fairness and made errors of fact and law in assessing various Whole Person Impairment (WPI) ratings, including those for upper extremity, mental status, diplopia, medications, and social functioning.

The Adjudicator dismissed the request, finding no material breach of procedural fairness as the applicant had ample opportunity to present her case during the 11-day hearing.

Furthermore, the Adjudicator concluded that no errors of fact or law were made that would have resulted in a different outcome.

The applicant requested a reconsideration of a Tribunal decision denying her entitlement to a post-104 income replacement benefit (IRB).

The applicant argued the adjudicator erred in law and breached procedural fairness by failing to determine substantive entitlement to the IRB, even if the quantum was zero.

The adjudicator agreed it was an error not to address the substantive threshold but found this was not a material breach or an error that would have changed the outcome.

The adjudicator reviewed the medical and vocational evidence, preferring the respondent's multidisciplinary assessments which concluded the applicant did not suffer a complete inability to engage in suitable employment.

The request for reconsideration was dismissed, and the respondent's request for costs was denied.

The applicant, a pedestrian struck by a vehicle, sought statutory accident benefits including a catastrophic impairment designation under Criterion 4, income replacement benefits, and various treatment plans.

The adjudicator found the applicant did not meet the test for catastrophic impairment, preferring the respondent's neurologist who concluded there was no diagnostic evidence of brain trauma from the accident.

Claims for income replacement benefits and a central vacuum system were dismissed, while treatment plans for physiotherapy and occupational therapy were approved as reasonable and necessary.

Requests for costs by both parties were denied.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming he sustained a catastrophic impairment under criterion 7 of the Schedule.

The central dispute involved competing psychological assessments, with the applicant's expert assigning a 20% whole person impairment rating and the respondent's expert assigning 0%.

The Tribunal preferred the respondent's expert, finding that the assigned scores more accurately reflected the applicant's level of functioning and testimony regarding his return to work and socializing.

As a result, the applicant failed to meet the 55% threshold for catastrophic impairment.

The claims for various assessments, an award, and interest were consequently dismissed.

The applicant sought statutory accident benefits following a 2018 motor vehicle accident, including a determination of catastrophic impairment, income replacement benefits (IRBs), attendant care benefits (ACBs), and medical benefits.

The Tribunal found the applicant was barred from claiming IRBs because she failed to apply or qualify within 104 weeks of the accident.

The Tribunal also determined the applicant did not sustain a catastrophic impairment, finding the impairment ratings provided by her assessors were inflated and unsupported by the medical record.

The applicant was awarded ACBs of $905.34 per month from May 31, 2022, subject to proof the expenses were incurred, but her claims for medical benefits, examination expenses, and an award for unreasonable delay were dismissed.

The applicant sought entitlement to statutory accident benefits for occupational therapy, psychological treatment, and an activity rest schedule evaluation following a motor vehicle accident.

The respondent insurer had removed the applicant from the Minor Injury Guideline but denied the specific treatment plans.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to provide sufficient medical evidence to prove on a balance of probabilities that any of the disputed treatment plans were reasonable and necessary.

The Tribunal relied on the respondent's section 44 multidisciplinary assessors, who concluded the treatments were not required.