Dr. Valentin

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

The Tribunal first dismissed the insurer's preliminary motion to bar the application for non-attendance at an insurer's examination, finding the request was made years after the application was filed.

On the substantive issues, the Tribunal found the applicant entitled to income replacement benefits for the pre-104-week period due to psychological impairments, but not for the post-104-week period as she did not suffer a complete inability to work.

The Tribunal also approved several treatment plans for occupational therapy, chiropractic, physiotherapy, and massage services, finding them reasonable and necessary.

Claims for a social work treatment plan balance and a special award were dismissed.

The applicant sought a reconsideration of a Licence Appeal Tribunal decision that denied her claims for an income replacement benefit (IRB), attendant care benefits, and various treatment plans following a motor vehicle accident.

The applicant argued the Tribunal made errors of fact and law regarding her concussion diagnosis, surveillance evidence, and the medical assessments of several experts.

The Vice-Chair dismissed the request for reconsideration, finding that while there were minor factual inaccuracies in the original decision, they were not significant enough to have likely changed the result.

The Tribunal's original weighing of the medical evidence and surveillance footage was upheld.

The applicant sought income replacement benefits (IRB), attendant care benefits (ACB), and approval for numerous treatment plans following a motor vehicle accident.

The Licence Appeal Tribunal dismissed the application in its entirety.

The Tribunal found the applicant failed to prove a substantial inability to perform her pre-accident employment as a cashier or a complete inability to work post-104 weeks, relying on video surveillance showing no physical distress and independent medical examinations.

The ACB claim was dismissed because the care was provided by family members who did not suffer an economic loss, and the benefit was not deemed incurred as it was not unreasonably withheld.

The disputed treatment plans were found not reasonable and necessary, as the medical evidence did not support the claimed injuries, including a concussion, and the applicant had reached maximum medical improvement.

The plaintiff, a party under disability who suffered a traumatic brain injury after being struck by a car as a pedestrian, sought court approval of a proposed settlement in his tort and accident benefits claims.

The court reviewed the proposed contingency fee agreement and found it was not reasonable, reducing the fees to 25% for the tort action and 15% for the accident benefits claim.

The court also declined to order the settlement funds be paid as a lump sum, directing counsel to obtain structure options to protect the vulnerable plaintiff.

The applicant was involved in a minor rear-end collision while driving to her first day back at work following a prior incident that caused a concussion.

She sought a determination of catastrophic impairment due to mental or behavioural disorders, ongoing income replacement benefits, and approval of several treatment plans.

The Tribunal found that the applicant was not catastrophically impaired, as her function had improved to non-catastrophic levels and validity testing raised concerns about symptom magnification.

The Tribunal also dismissed the claim for ongoing income replacement benefits, finding that her current impairments were not caused by the subject accident.

The applicant was awarded one treatment plan for driver rehabilitation therapy and associated interest, while the remaining treatment plans were denied.

The minor applicant was struck by a garbage truck at age six and sought statutory accident benefits, claiming a catastrophic impairment.

The respondent insurer denied the catastrophic designation.

The Licence Appeal Tribunal considered competing neuropsychological evidence regarding the applicant's functioning and adaptation in the school setting.

The Tribunal preferred the evidence of the applicant's expert and found that the applicant sustained a class 4 marked impairment in adaptation due to mental and behavioural disorders caused by the accident.

The Tribunal concluded the applicant sustained a catastrophic impairment and is entitled to expanded benefits.

The applicant requested a reconsideration of a Tribunal decision that denied her claim for a non-earner benefit.

The applicant argued that the adjudicator made significant errors of law and fact by failing to properly interpret the evidence, including medical reports, clinical notes, and video surveillance, and by misapplying the Heath principles.

The adjudicator reviewing the reconsideration request found that the original decision provided a well-reasoned analysis of the evidence and submissions.

The adjudicator concluded that there was no significant error of law or fact that would have led to a different outcome, and dismissed the request for reconsideration.

The applicant sought a non-earner benefit following a motor vehicle accident, claiming a complete inability to carry on a normal life due to physical and psychological injuries.

The adjudicator dismissed the claim, preferring the respondent's independent medical examinations and video surveillance evidence over the applicant's expert reports.

The surveillance showed the applicant engaging in pre-accident activities such as shopping and walking without assistance, contradicting her self-reported limitations.

Claims for an award under Ontario Regulation 664 and interest were also dismissed.

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

The Insurer argued that a prior settlement was binding, but the Arbitrator found the Applicant's rescission letter valid despite lacking a fax cover page.

The Arbitrator declined to recuse himself after viewing the settlement documents.

The Applicant was precluded from arbitrating her claim for non-earner benefits because she failed to attend a mandatory section 44 medical examination.

The Arbitrator also found that the Applicant's injuries fell within the Minor Injury Guideline (MIG), as there was no compelling evidence linking her seizures to the accident, and multiple medical assessors concluded her injuries were minor.

Claims for a special award and interest were dismissed, and the Applicant was ordered to pay the Insurer's reasonable expenses.