Dr. Prendergast

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

The respondent denied certain psychological and chiropractic treatment plans, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Licence Appeal Tribunal found that the applicant failed to prove his injuries warranted removal from the MIG, as there was insufficient evidence of pre-existing conditions, psychological impairment, post-concussive syndrome, or chronic pain.

The Tribunal preferred the respondent's expert reports, which concluded the applicant suffered only uncomplicated soft tissue injuries.

The application for medical benefits, interest, and an award was dismissed in its entirety.

The applicant sought statutory accident benefits, claiming he suffered physical and psychological injuries when he jumped out of the way of a reversing vehicle.

The respondent denied the claim on the basis that the incident was not an 'accident' under s. 3(1) of the Statutory Accident Benefits Schedule.

The Tribunal found that the applicant's alleged injuries did not arise out of the ordinary use or operation of an automobile, failing the purpose test.

The medical evidence showed significant pre-existing conditions and no contemporaneous reports of injury, undermining the applicant's credibility.

The application was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, including funding for chiropractic and psychological treatment plans, and argued for removal from the Minor Injury Guideline (MIG) due to chronic pain and psychological impairments.

The adjudicator found that the applicant's physical injuries were predominantly minor, consisting of sprains and strains, and that the evidence did not support a chronic pain diagnosis sufficient to warrant removal from the MIG.

Relying on the insurer's psychological assessment, the adjudicator also found no diagnosable psychological condition.

Consequently, the applicant failed to meet the burden of proving entitlement to treatment outside the MIG, and the disputed treatment plans were deemed not reasonable and necessary.

The application was dismissed.

The applicant, a pedestrian struck by a vehicle, sought statutory accident benefits for attendant care, assistive devices, and psychological and physiological treatment.

The insurer denied the claims.

The Licence Appeal Tribunal found that the applicant was entitled to the psychological treatment plan, as the evidence demonstrated that his pre-existing psychological issues were exacerbated by the accident.

However, the claims for attendant care and assistive devices were dismissed because the applicant failed to prove they were reasonable and necessary, and failed to provide evidence that the expenses were incurred.

A claim for a special award was also dismissed, as the insurer's denials were not improper.

The applicant sought medical benefits for psychological treatment following a motor vehicle accident.

The respondent insurer denied the treatment plans.

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

The applicant had returned to work, was independent in self-care, and denied a desire for psychotherapy.

Insurer examinations concluded the applicant did not evidence clinically significant symptoms of mental illness and had reached maximum medical improvement.

The application was dismissed.

The applicant sought non-earner benefits, medical and rehabilitation benefits, and a special award following a 2012 motor vehicle accident.

The arbitrator dismissed all claims, finding the applicant lacked credibility due to numerous inconsistencies, misrepresentations, and evidence of symptom exaggeration.

The arbitrator placed little weight on the applicant's treating practitioners, preferring the evidence of the insurer's assessors who conducted more thorough document reviews and found the applicant did not suffer a complete inability to carry on a normal life and that the proposed treatments were not reasonable and necessary.

The applicant was seriously injured in a motor vehicle accident in Georgia and sought a determination that he sustained a catastrophic impairment under the Statutory Accident Benefits Schedule.

The parties' medical experts disagreed on the applicant's whole person impairment (WPI) rating, with the applicant's experts assessing it between 62% and 71%, and the insurer's experts assessing it between 48% and 51%.

The arbitrator preferred the evidence of the applicant's experts, finding that the applicant's physical and psychological impairments, when combined, exceeded the 55% threshold.

The arbitrator also found that the accident materially contributed to the applicant's impairments, including his atrial fibrillation and peripheral neuropathy, despite the insurer's arguments regarding pre-existing susceptibility.

The applicant was found to have sustained a catastrophic impairment.

A motion by the father for unsupervised access to his two young sons on a gradually increasing schedule was opposed by the Children's Aid Society, which sought to reduce his current supervised bi-weekly access to once every two months.

The court considered the father's significant mental health history, including schizophrenia and substance abuse issues, his recent stabilization following an absolute discharge from the Ontario Review Board in December 2014, and the quality of his interactions with the children during supervised visits.

The court found that while maintaining contact with the father and paternal family was in the children's best interests, the father had not demonstrated the ability to meet the children's needs without supervision and had not shown meaningful improvement in parenting skills over 22 months of supervised access.

The appellant, who was found not criminally responsible on account of mental disorder, appealed a disposition of the Ontario Review Board ordering his continued detention at the Centre for Addiction and Mental Health.

The Court of Appeal found that the Board erred in its application of the Winko test by failing to properly assess whether the appellant posed a significant threat to public safety, specifically regarding the risk of serious physical or psychological harm.

The appeal was allowed and the matter returned to the Board for rehearing.

The applicant sought income replacement benefits, a special award, and interest following a motor vehicle accident.

She claimed to be completely disabled by chronic pain and psychological distress.

The insurer denied the claims, arguing the applicant was not credible and was malingering.

The arbitrator dismissed the applicant's claims, finding her evidence riddled with inconsistencies, including a failure to report pre-existing medical conditions and psychometric test results indicating a lack of effort or intentional poor performance.

The arbitrator preferred the evidence of the insurer's experts and concluded the applicant failed to prove she suffered a complete inability to engage in employment as a result of the accident.

The insurer brought a motion to stay the arbitration hearing on the basis that the claimant refused to attend an insurer's medical examination (IME) with a neuro-psychiatrist.

The claimant argued the request was neither reasonable nor timely, as it was made close to the hearing date and the insurer already had numerous assessments in its favour.

The arbitrator found that the insurer's request was not reasonably necessary, noting that the insurer had ample time to request the IME earlier and that the chosen doctor had already concluded from a paper review that the claimant's injuries were not accident-related.

The motion was dismissed and the arbitration was ordered to proceed.