Susan Szainwald

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that denied her claim for outstanding attendant care benefits, and also brought a motion for the adjudicator to recuse himself due to alleged bias.

The Tribunal dismissed the recusal motion, finding no reasonable apprehension of bias or institutional bias.

However, the Tribunal granted the reconsideration request in part, finding a material breach of procedural fairness because the adjudicator had reframed the issues by failing to determine the reasonable and necessary quantum of the attendant care benefit, which had been an issue at the initial hearing.

Rehearing the issue based on the existing record, the Tribunal weighed competing occupational therapy assessments and concluded the applicant was entitled to an attendant care benefit of $1,962.55 per month on an ongoing basis.

The applicant sought statutory accident benefits following a motor vehicle accident, including a non-earner benefit, attendant care benefits, and numerous treatment plans for psychological, cognitive, and occupational therapy assessments and services.

The Tribunal found the claim for the non-earner benefit was statute-barred because the applicant failed to dispute the insurer's clear and unequivocal denial within the two-year limitation period.

The Tribunal dismissed the claims for the treatment plans and attendant care benefits, finding the applicant failed to prove they were reasonable and necessary for accident-related injuries, largely due to significant pre-existing psychological conditions and a lack of supporting medical evidence.

Claims for interest and an award for unreasonable delay were also dismissed.

The applicant sought statutory accident benefits following a 2015 motor vehicle accident, specifically claiming attendant care benefits (ACB) for services provided by her daughter and husband.

The Licence Appeal Tribunal dismissed the application, finding the applicant failed to prove the services were 'incurred' under s. 3(7)(e) of the Schedule.

The evidence lacked sufficient detail regarding the daughter's hours and tasks, and failed to establish that either family member sustained an economic loss as a result of providing care.

Consequently, claims for interest and a special award were also dismissed.

The applicant sought various statutory accident benefits following a 2017 motor vehicle accident, including treatment plans for physiotherapy, occupational therapy, a chronic pain assessment, and catastrophic impairment assessments.

The respondent denied the benefits.

The Tribunal found that the respondent's notices of denial were compliant with the Statutory Accident Benefits Schedule.

On the merits, the Tribunal held that the applicant failed to prove the treatment plans were reasonable and necessary, noting that the applicant's cognitive impairments were pre-existing and that she had reached maximal medical recovery for her accident-related physical injuries.

The application was dismissed.

The applicant sustained catastrophic injuries, including a traumatic brain injury, in a motor vehicle accident.

A dispute arose regarding the quantum of attendant care benefits under section 16 of the Statutory Accident Benefits Schedule.

The insurer reduced benefits from $6,000 to $2,132 per month, arguing the applicant's increased needs were due to post-accident drug abuse and traffic charges rather than the accident.

The arbitrator found the drug abuse was caused by the accident and that the applicant required 24-hour supervision until his rehabilitation stabilized in early 2011.

The applicant was awarded $6,000 per month for the disputed period up to March 2011, and $2,132 per month ongoing thereafter.