Ronald Findlay

The applicant, who sustained a catastrophic impairment from a 2015 motor vehicle accident, sought $6,000 per month in attendant care benefits (ACBs), the cost of a cell phone and robotic vacuum, an award for unreasonable delay, and interest.

The Tribunal found the opinions of both parties' occupational therapists flawed and conducted its own assessment of the applicant's needs, awarding $3,062.92 per month in ACBs.

The Tribunal also approved $225 for the cell phone but denied the robotic vacuum.

The claim for a special award under s. 10 of Regulation 664 was dismissed as the applicant failed to prove the insurer acted unreasonably.

Interest was awarded on the overdue benefits.

The applicant sought statutory accident benefits following a motor vehicle accident, including non-earner benefits (NEBs) and various treatment plans for physiotherapy, a psychological assessment, and a chronic pain assessment.

The Tribunal found that the applicant failed to establish a complete inability to carry on a normal life, noting that the applicant's evidence only showed some activities were more difficult, not that he was prevented from engaging in them.

The Tribunal also dismissed the claims for the treatment plans, finding the applicant failed to provide sufficient evidence or submissions to establish that the proposed treatments were reasonable and necessary.

The claim for incurred physiotherapy expenses was dismissed as the expenses were incurred prior to the submission of a treatment plan.

The application was dismissed in its entirety.

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

The Licence Appeal Tribunal found that the applicant sustained a catastrophic impairment due to marked impairments in adaptation and concentration, persistence, and pace, stemming from somatic symptom disorder and major depressive disorder.

The Tribunal also found the applicant entitled to both pre-104 and post-104 income replacement benefits, as her physical and psychological impairments prevented her from working as a personal support worker or in any suitable employment.

Several treatment plans were deemed payable because Wawanesa failed to provide proper medical and other reasons for denial in its notices, violating s. 38(8) of the Schedule.

Finally, the Tribunal ordered a 30% special award under Regulation 664, finding that Wawanesa unreasonably withheld benefits by blindly following its assessors' reports without considering the totality of the medical evidence or continuously adjusting the file.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including attendant care benefits and physiotherapy treatment plans, which the respondent insurer denied.

The respondent raised a preliminary issue that the applicant's disputes were statute-barred by the two-year limitation period under s. 56 of the Schedule.

The Tribunal found that the attendant care benefit dispute was commenced within the limitation period because the initial denial was not clear and unequivocal.

For the $3,500.10 physiotherapy treatment plan, the Tribunal found the dispute was filed 45 business days late but granted an extension of time under s. 7 of the LAT Act, finding no prejudice to the respondent and some merit to the claim.

On the merits, the Tribunal found the $3,500.10 physiotherapy treatment plan was reasonable and necessary, but dismissed the claims for the $1,540.10 treatment plan and the remaining attendant care benefits for lack of evidence.

The applicant sought a $2,260 benefit for a chronic pain assessment following a motor vehicle accident, as well as a special award under Regulation 664 for unreasonable delay.

The adjudicator found that the applicant failed to prove the assessment was reasonable and necessary, noting that independent medical examinations and treating physicians did not diagnose chronic pain or indicate a need for further assessment.

The adjudicator also dismissed the applicant's request to exclude the respondent's evidence for alleged non-disclosure, finding the request overly broad and lacking evidence of prejudice.

The application for benefits and the claim for a special award were dismissed.