Dr. Reuven Lexier

The applicant sought a reconsideration of a Licence Appeal Tribunal decision that denied her entitlement to an income replacement benefit and found her injuries fell within the Minor Injury Guideline.

The applicant alleged multiple errors of law and fact, including the misapplication of the standard for causation, omission of relevant evidence, and misinterpretation of section 11 of the Schedule, as well as breaches of procedural fairness.

The adjudicator dismissed the request for reconsideration, finding that the applicant was primarily attempting to relitigate factual findings and the weighing of evidence from the original hearing.

The adjudicator concluded that no legal or factual errors were established that would have likely changed the outcome, and no procedural fairness violations occurred.

The applicant's request for costs was also denied.

The applicant sought statutory accident benefits, including an income replacement benefit (IRB) and funding for a rheumatological assessment, following a motor vehicle accident while riding a TTC bus.

The respondent denied the benefits, arguing the applicant's injuries were minor and that an intervening workplace accident was the true cause of her ongoing impairments.

The Tribunal found that the applicant failed to establish a substantial or complete inability to perform her pre-accident employment, noting she had returned to physical labour before the workplace accident occurred.

The Tribunal also found the applicant did not establish removal from the Minor Injury Guideline and dismissed the claim for the assessment due to the failure to produce the treatment plan.

The application was dismissed.

The applicant sought entitlement to a non-earner benefit and various medical and rehabilitation benefits following a motor vehicle accident.

The Licence Appeal Tribunal found that the applicant was statute-barred from claiming the non-earner benefit and several treatment plans because she failed to attend required section 44 insurer's examinations prior to applying to the Tribunal.

The remaining treatment plans were denied because they were either incurred before submission or the applicant failed to provide sufficient medical evidence to prove they were reasonable and necessary.

The application was dismissed in its entirety.

The applicant was injured in a motor vehicle accident and received income replacement benefits (IRBs) from the respondent insurer.

The insurer terminated the IRBs, and the applicant appealed to the Licence Appeal Tribunal seeking IRBs for a disputed period of approximately three weeks before she returned to work.

The Tribunal found that the applicant failed to provide contemporaneous medical evidence demonstrating a substantial inability to perform the essential tasks of her pre-accident employment as a hairdresser.

Relying on the respondent's multidisciplinary independent medical examination, the Tribunal dismissed the claim for IRBs, interest, and costs.

The applicant, a passenger on a TTC bus involved in a collision, sought statutory accident benefits for physiotherapy and psychological treatments.

The Licence Appeal Tribunal denied the claims for physiotherapy, finding the applicant failed to prove the back pain was caused by the accident rather than a pre-existing knee injury.

However, the Tribunal allowed the claims for the cost of preparing an OCF-18 for a psychological assessment and the unpaid portion of a psychological treatment plan, finding them reasonable and necessary.

The respondent was ordered to pay interest on the overdue amounts.

The applicants, who were injured in a rear-end motor vehicle collision, sought arbitration after the insurer terminated their statutory accident benefits.

Mr. Narain claimed ongoing income replacement benefits, medical benefits, housekeeping expenses, and the cost of a medical assessment.

Ms. Mangroo claimed income replacement benefits, medical benefits, and housekeeping expenses.

The arbitrator found Mr. Narain credible regarding his ongoing back and knee pain, granting his claim for income replacement benefits and the cost of a physiatrist's report, but dismissed his claims for further medical treatment and housekeeping expenses.

Conversely, the arbitrator found Ms. Mangroo to be an unreliable witness due to numerous inconsistencies in her evidence and dismissed all of her claims, concluding she failed to prove a substantial inability to perform her pre-accident employment or housekeeping tasks.

The applicant was injured in a motor vehicle accident in 1997 and received income replacement benefits until the insurer terminated them in November 1997 based on early medical opinions.

The applicant applied for arbitration, claiming ongoing entitlement to income replacement benefits due to cognitive, psychological, and physical impairments.

The arbitrator found that the applicant sustained impairments as a result of the accident and met the tests for both substantial inability within the first 104 weeks and complete inability thereafter.

The arbitrator preferred the evidence of the applicant, his family, and his medical-legal experts over the insurer's experts.

The insurer was ordered to pay ongoing income replacement benefits, interest from the date the applicant's counsel first contacted the insurer in 2001, and a $5,000 special award for unreasonably failing to reinstate benefits after receiving further medical evidence of disability.

The Applicant was injured in a motor vehicle accident and sought income replacement benefits after the Insurer terminated them.

The Insurer argued the Applicant could return to her pre-accident employment as a bartender.

The Arbitrator found the Applicant suffered a Grade II whiplash injury and was substantially unable to perform the essential tasks of her demanding pre-accident job, which included repetitive bending, reaching, and lifting.

The Applicant was awarded income replacement benefits and interest, but was ordered to pay the Insurer's arbitration expenses for the first day of the hearing due to her failure to appear.

The applicant was injured in a motor vehicle accident and claimed weekly benefits and yard maintenance expenses from his insurer.

The insurer denied the claims, arguing the applicant's disability was not caused by the accident and that he lacked motivation.

The arbitrator found that the accident aggravated the applicant's pre-existing spinal degeneration, causing a substantial inability to perform his essential daily tasks, including home renovations and strenuous recreational activities.

The arbitrator awarded three years of weekly benefits and partial yard maintenance expenses.

Furthermore, the arbitrator ordered the insurer to pay a $10,000 special award under section 282(10) of the Insurance Act, finding that the insurer's continued denial of the claim after receiving objective MRI evidence was unreasonable.

The applicant claimed he was injured when a public transit bus braked suddenly, causing him to support his weight on his leg.

He sought ongoing statutory accident benefits, claiming physical and psychological impairments prevented him from continuing his English as a Second Language classes and carrying on a normal life.

The arbitrator dismissed the claim, finding the applicant's evidence lacked credibility and that he had concealed his refugee status from medical assessors.

The medical evidence established that the applicant's knee complaints were likely idiopathic and that he suffered no physical or psychological impairment disabling him from his studies or normal activities.

The arbitrator also denied the applicant's request for hearing expenses due to his lack of candour and failure to present a bona fide claim.

The Applicant sought ongoing weekly income benefits following a minor motor vehicle accident.

The Insurer terminated benefits after 10 months.

The Arbitrator found the Applicant's claims of disabling physical and psychological pain to be unsupported by objective medical evidence and contradicted by surveillance footage showing him engaging in normal activities without restriction.

The claim for ongoing benefits was dismissed.

The Applicant was awarded half of his arbitration expenses and the return of a $2,000 assessment fee, as the claim was not found to be frivolous or vexatious.

The applicant was injured in a motor vehicle accident and applied for statutory accident benefits.

At the time of the accident, he was receiving Workers' Compensation Benefits for a prior work-related injury.

The arbitrator determined that the applicant's gross weekly income must be calculated by averaging his actual income over the four-week period preceding the accident, without disregarding periods of unemployment.

The arbitrator also held that the Workers' Compensation Benefits received by the applicant must be deducted from the weekly income benefits payable by the insurer.

The applicant was awarded weekly income benefits for a limited period, as the arbitrator found that his ongoing inability to work after January 19, 1994, was substantially caused by pre-existing conditions not related to the motor vehicle accident.

The applicant, a self-employed martial arts instructor, sought statutory accident benefits following a motor vehicle accident.

The insurer terminated weekly benefits in May 1991 and sought repayment of overpaid amounts.

The arbitrator found that based on surveillance evidence and medical reports, the applicant was no longer substantially unable to perform the essential tasks of his occupation after March 11, 1991.

Due to unreliable financial documentation and unexplained discrepancies in the applicant's accounting evidence, the arbitrator awarded only the minimum weekly benefit of $185.60 for the eligible period.

The insurer was ordered to be repaid the overpaid benefits, less the cost of the applicant's treatment.

The applicant was injured in a motor vehicle accident and received weekly statutory accident benefits until the insurer terminated them.

The applicant sought arbitration to reinstate the benefits, claiming a substantial inability to perform essential tasks.

The arbitrator reviewed conflicting medical evidence and preferred the functional abilities evaluation of an occupational therapist, which demonstrated the applicant could perform his essential daily tasks.

The claim for ongoing weekly benefits was dismissed, though the applicant was awarded the expenses of the arbitration.