Varun Madan

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that found she was not catastrophically impaired and denied her claims for attendant care benefits.

The applicant argued the Tribunal failed to properly engage with her expert's diagnosis of Somatic Symptom Disorder and improperly relied on surveillance evidence.

The Vice-Chair dismissed the request, finding the applicant was attempting to re-litigate the Tribunal's weighing of the evidence rather than identifying an error of law or fact under Rule 18.2.

The applicant sought statutory accident benefits following a motor vehicle accident, including attendant care benefits, chiropractic treatment, and psychological services.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to prove the proposed treatments and attendant care were reasonable and necessary.

The Tribunal also found no basis for an award for unreasonable delay or interest, as no benefits were overdue.

The applicant sought statutory accident benefits following a 2018 motor vehicle accident, claiming catastrophic impairment under Criteria 6, 7, and 8 of the Schedule.

The Tribunal gave no weight to the applicant's key expert witness, who failed to attend the hearing for cross-examination, citing procedural fairness.

Relying on surveillance evidence that contradicted the applicant's claims of severe impairment and social isolation, the Tribunal found the applicant did not meet the threshold for catastrophic impairment.

Consequently, claims for medication expenses beyond the non-catastrophic limit, a special award, and interest were dismissed.

The applicant was involved in a motor vehicle accident and sought a determination of catastrophic impairment and entitlement to income replacement benefits (IRBs) and a treatment plan.

The Tribunal found the applicant sustained a catastrophic impairment under Criterion 8 due to marked impairments in social functioning, concentration, persistence and pace, and adaptation resulting from accident-related psychological disorders.

The Tribunal denied the applicant's claim for IRBs during the first 104 weeks post-accident, finding she did not suffer a substantial inability to perform the essential tasks of her employment.

However, the Tribunal granted IRBs from September 1, 2024 onward, finding her condition had deteriorated such that she suffered a complete inability to engage in any employment for which she was reasonably suited.

The claim for a second catastrophic assessment treatment plan was denied.

The applicant sought attendant care benefits and payment for two treatment plans following a motor vehicle accident.

The Licence Appeal Tribunal dismissed the application, finding the applicant's testimony lacked credibility and the medical evidence, including surveillance and family physician records, demonstrated she did not require the claimed attendant care.

The Tribunal also denied the treatment plans, noting a lack of evidence for the first and finding the second sought unreasonable duplicate fees for catastrophic impairment assessments under section 25(5) of the Schedule.

Claims for an award and interest were consequently dismissed.

The applicant sought a determination that she sustained a catastrophic impairment under Criterion 8 of the Statutory Accident Benefits Schedule following a motor vehicle accident.

The applicant claimed marked impairments in social functioning, concentration, persistence and pace, and adaptation due to psychological issues including depression and anxiety.

The Tribunal preferred the evidence of the respondent's assessors, finding that the applicant's impairments were moderate (Class 3) rather than marked (Class 4).

The Tribunal noted the applicant's ability to maintain relationships, travel, manage her children's schedules, and handle personal affairs, concluding she did not meet the threshold for catastrophic impairment.

The application was dismissed.

The applicant sought a determination of catastrophic impairment and entitlement to income replacement benefits (IRB), attendant care benefits (ACB), and various treatment plans following a 2018 motor vehicle accident.

The Tribunal found the applicant did not meet the 55% whole person impairment threshold under Criterion 7, concluding his combined physical and mental impairment rating was 40%.

The Tribunal also found the applicant failed to prove a complete inability to engage in suitable employment, dismissing the claim for post-104-week IRB.

As the applicant was not catastrophically impaired and had exhausted non-catastrophic limits, the claims for ACB and treatment plans were also dismissed.

The applicant, who has a pre-existing diagnosis of autism, sought statutory accident benefits following a motor vehicle accident.

She claimed entitlement to a non-earner benefit, various medical benefits including occupational therapy, physical therapy, and a chronic pain assessment, as well as an award and interest.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to establish a complete inability to carry on a normal life, as there was insufficient evidence comparing her pre- and post-accident activities.

The Tribunal preferred the respondent's expert evidence, which indicated no objective ongoing accident-related impairments and found the disputed treatment plans were either duplicative or not reasonable and necessary.

The applicant sought statutory accident benefits following a rear-end motor vehicle collision.

The Licence Appeal Tribunal considered claims for a non-earner benefit, an attendant care assessment, psychotherapy treatment, and a chronic pain assessment.

Applying the Heath test, the Tribunal found the applicant failed to establish a complete inability to carry on a normal life, noting inconsistencies in her evidence and symptom magnification identified by the respondent's psychological expert.

The Tribunal denied the non-earner benefit, attendant care assessment, and psychotherapy treatment, preferring the respondent's expert evidence.

However, the Tribunal granted the chronic pain assessment, finding it reasonable and necessary given the respondent's own medical expert's diagnosis of chronic neck and back pain.

Claims for an award under Regulation 664 were dismissed.

The applicant sought various medical assessments following a 2010 motor vehicle accident.

The respondent insurer denied the assessments.

The Licence Appeal Tribunal found that the chronic pain and physiatry assessments were reasonably required due to consistent medical evidence of ongoing ankle pain and the risk of progressive osteoarthritis.

However, the Tribunal dismissed the claims for work site, psychological, attendant care, and function and impairment assessments, finding insufficient evidence to support their necessity, particularly given the applicant's independence in self-care and lack of documented psychological symptoms prior to 2014.

Interest was awarded on the overdue payments for the approved assessments.

The applicant was injured in a motor vehicle accident and applied for weekly caregiver benefits, claiming he was the primary caregiver for his two young children.

The insurer denied the claim.

At arbitration, the evidence showed that while the applicant was an involved father, he worked full-time in a limousine business, whereas his wife was a full-time homemaker who handled the majority of day-to-day childcare tasks.

The arbitrator concluded that the applicant's wife, not the applicant, was the primary caregiver at the time of the accident.

As caregiver benefits are only available to the primary caregiver, the application was dismissed.