Dr. Velan Sivasubramanian

The applicant sought a determination of catastrophic impairment (CAT) under Criterion 8 (mental and behavioural disorders) and entitlement to post-104-week income replacement benefits (IRBs) following a motor vehicle accident.

The Tribunal found that the applicant's psychological and physical impairments were primarily caused by a pre-existing slip and fall incident, not the motor vehicle accident.

The Tribunal noted significant credibility issues, including surveillance footage and evidence of the applicant's ongoing involvement in complex real estate and construction projects, which contradicted his reported functional limitations.

The application was dismissed, and claims for an award and interest were denied.

The applicant was struck by a vehicle while cycling and sought income replacement benefits (IRBs) under the Statutory Accident Benefits Schedule.

The respondent terminated pre-104 week IRBs on March 1, 2021, based on insurer's examinations.

The Tribunal found the applicant was not entitled to the remainder of the pre-104 week IRBs, as her ongoing post-concussive symptoms were attributable to a pre-accident sports injury rather than the subject accident.

However, the Tribunal found the applicant experienced a severe deterioration in her accident-related psychological conditions, culminating in a catastrophic impairment finding and multiple hospitalizations for suicidal ideation.

Applying the stringent post-104 week test, the Tribunal concluded the applicant suffered a complete inability to engage in any suitable employment as of April 11, 2023.

The applicant was awarded post-104 week IRBs from that date onward, plus interest.

The applicant sought a determination that he sustained a catastrophic impairment as a result of a 2016 motor vehicle accident, claiming marked impairments in social functioning and adaptation, and a whole person impairment (WPI) of 55% or more.

The Tribunal found that the applicant's psychological impairments were largely attributable to pre-existing substance abuse issues rather than the accident.

Preferring the evidence of the respondent's psychiatric assessor, the Tribunal concluded the applicant suffered only mild impairments and a 14% mental/behavioural WPI, falling short of the catastrophic impairment thresholds.

The application for attendant care benefits, assessment costs, and interest was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming she sustained a catastrophic impairment due to mental and behavioural disorders.

The Tribunal found the applicant met the catastrophic impairment threshold under Criterion 8, demonstrating marked impairments in activities of daily living, social functioning, and adaptation.

The Tribunal preferred the evidence of the applicant's assessors, noting the respondent's assessors failed to adequately consider the applicant's reliance on her partner and conducted flawed situational assessments.

The Tribunal awarded the cost of an in-home assessment but denied the claim for attendant care benefits, finding the proposed hours were overestimated and included tasks the applicant could perform independently.

The applicant sought statutory accident benefits following a 2022 motor vehicle accident, claiming catastrophic impairment under Criterion 8, income replacement benefits, attendant care benefits, and various treatment plans.

The Licence Appeal Tribunal dismissed the majority of the claims, finding the applicant's self-reports of pre-accident functioning were inaccurate, as he was receiving long-term disability and Canada Pension Plan disability benefits prior to the accident.

Surveillance evidence and testimony contradicted the applicant's claims of severe social and functional isolation.

The Tribunal found the applicant did not sustain a catastrophic impairment, was not entitled to an IRB, and was only entitled to a minor portion of one treatment plan due to a late denial by the insurer.

The applicant sought a determination that she sustained a catastrophic impairment due to mental and behavioural disorders following a motor vehicle accident, as well as entitlement to various treatment plans and an award for unreasonable delay.

The Tribunal found that the applicant did not sustain a catastrophic impairment, as she failed to prove a marked impairment in three of the four areas of function under Criterion 8 of the AMA Guides.

The Tribunal preferred the evidence of the respondent's psychiatrist, noting the applicant's significant pre-existing physical and mental impairments.

Several treatment plans for psychological and chronic pain assessments were approved as reasonable and necessary, subject to the non-catastrophic limit, while others were denied.

The claim for a special award was dismissed.

The respondent insurer requested a reconsideration of a Tribunal decision that found the applicant catastrophically impaired based on a 55% whole person impairment rating.

The respondent argued the Tribunal provided insufficient reasons, reversed the burden of proof regarding psychiatric impairments, and erred in its assessment of musculoskeletal and headache impairments.

The Vice-Chair dismissed the request, finding that the original panel provided comprehensive, logical reasons for preferring the applicant's medical experts and correctly applied the AMA Guides.

No errors of law, fact, or procedural fairness were established.

The applicant sought statutory accident benefits following a 2018 motor vehicle accident.

The Tribunal first held that the applicant was statute-barred from disputing the denial of 14 treatment plans because he failed to apply within the two-year limitation period and did not establish grounds for an extension under s. 7 of the LAT Act.

On the substantive issues, the Tribunal found the applicant did not sustain a catastrophic impairment under Criterion 7 (falling short of the 55% whole person impairment threshold) or Criterion 8 (failing to establish marked impairments in three spheres of functioning).

The Tribunal also dismissed the claims for the remaining treatment plans, finding the applicant failed to meet his evidentiary onus to prove they were reasonable and necessary.

Claims for interest and an award were consequently dismissed.

The applicant requested a reconsideration of a Tribunal decision that found she did not sustain a catastrophic impairment.

The applicant argued the Tribunal breached procedural fairness by shortening the hearing from 7 to 4 days and erred in its assessment of expert evidence, the AMA Guides, and causation.

The Tribunal dismissed the request, finding the shortened hearing was proportional given the reduced witness list and that the applicant was improperly attempting to re-weigh the evidence.

The Tribunal confirmed its preference for the respondent's psychiatric expert over the applicant's psychological expert.

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

The Tribunal found the applicant did not meet the 55% whole person impairment threshold, preferring the respondent's medical experts who assessed a 25% combined impairment over the applicant's experts whose ratings were unsupported by the AMA Guides.

The Tribunal also dismissed claims for income replacement benefits, attendant care benefits, and various treatment plans due to a lack of supporting evidence.

The respondent's claim for repayment of income replacement benefits was also dismissed for lack of evidence.

The applicant was injured in a motor vehicle accident and sought post-104 income replacement benefits (IRBs) and the cost of an attendant care assessment.

The respondent denied the benefits and sought to exclude late-served s. 44 catastrophic impairment reports.

The Tribunal admitted the reports, finding no prejudice to the respondent.

On the merits, the Tribunal found the accident was a necessary cause of the applicant's back pain and surgeries.

Relying on both the applicant's and the respondent's medical experts, the Tribunal concluded the applicant suffered significant psychological impairments, including a marked to extreme impairment in adaptation to work settings, rendering her completely unable to engage in suitable employment.

The Tribunal awarded the post-104 IRBs but denied the attendant care assessment cost due to insufficient evidence.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision which found she was not catastrophically impaired and denied a treatment plan for a catastrophic assessment.

The applicant argued the adjudicator erred in weighing the medical evidence, particularly regarding a pre-existing 2019 accident, and placed undue weight on surveillance evidence showing her speeding.

The Vice-Chair dismissed the request, finding the applicant was improperly attempting to re-weigh the evidence rather than identifying an error of law or fact.

The Tribunal also upheld the denial of the treatment plan balance, noting the applicant failed to explain why an amount greater than the statutory cap was reasonably required.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming catastrophic impairment under Criterion 8 and entitlement to post-104-week income replacement benefits (IRB).

The Tribunal found the applicant catastrophically impaired, accepting expert evidence that she suffered marked impairments in social functioning, concentration, persistence, and pace, and adaptation due to accident-related mental and behavioural disorders.

However, the Tribunal dismissed the claim for IRB, finding the applicant failed to tender opinion evidence challenging the respondent's vocational and medical assessments that she could engage in suitable alternative employment.

A claim for an award under s. 10 of Regulation 664 was also dismissed due to the applicant's failure to provide required particulars.

The applicant sought a determination that she sustained a catastrophic impairment under Criterion 8 (mental or behavioural disorder) as a result of a motor vehicle accident, as well as payment for the unapproved balance of a catastrophic assessment treatment plan.

The respondent brought a preliminary motion arguing the claim was barred by res judicata due to a prior Tribunal decision denying non-earner benefits.

The adjudicator dismissed the motion, finding the prior decision did not rule on psychological impairments.

On the merits, the adjudicator found the applicant was not catastrophically impaired, preferring the respondent's psychiatric evidence that the applicant's impairments were pre-existing from a 2019 accident and that she had returned to her premorbid baseline.

Surveillance evidence and the applicant's ongoing activities, including attending college and travelling, contradicted claims of marked impairment.

The claim for the unapproved treatment plan balance was also dismissed as the applicant failed to justify costs exceeding the statutory maximums.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming she sustained a catastrophic impairment due to a mental or behavioural disorder under Criterion 8 of the Schedule.

The Tribunal assessed the applicant's functioning across four spheres: activities of daily living, social functioning, concentration, persistence and pace (CPP), and adaptation.

While the Tribunal found a marked impairment in CPP, it concluded the applicant only sustained moderate impairments in the other three spheres.

As the applicant did not demonstrate a marked impairment in three or more spheres, or an extreme impairment in one, the application was dismissed.

The applicant sought statutory accident benefits following two motor vehicle accidents in 2013 and 2014, claiming he sustained a catastrophic impairment due to mental and behavioural disorders.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to prove a marked or extreme impairment in any of the four functional domains.

The Tribunal preferred the evidence of the respondent's experts, noting that the applicant's experts failed to adequately consider his extensive pre-existing medical and psychiatric conditions, including chronic pain, depression, and strokes.

The Tribunal also found that the disputed treatment plans for a functional ability evaluation and an attendant care assessment were not reasonable and necessary, as the applicant's ongoing impairments were primarily attributable to the progression of his pre-accident conditions.

Claims for an award and interest were consequently dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, including chiropractic services, psychological services, and medication expenses.

The Licence Appeal Tribunal dismissed the application, finding that the proposed chiropractic and psychological treatments were not reasonable and necessary based on the respondent's expert medical assessments, which showed no objective physical impairments and a deterioration in mood despite prior psychological treatment.

The medication expense had already been reimbursed.

Claims for interest and a special award were also dismissed.

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

The applicant relied exclusively on procedural arguments, claiming the respondent failed to comply with notice provisions under the Schedule.

The Tribunal found the applicant remained in the Minor Injury Guideline and was not entitled to the disputed treatment plan, as he failed to lead substantive evidence and the respondent's notices regarding the treatment plan were compliant.

However, the Tribunal found the respondent's notice requiring an insurer's examination for the non-earner benefit was deficient under section 44(5) of the Schedule.

Consequently, the respondent was ordered to pay the non-earner benefit pursuant to section 36(6).

The claim for an award was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident while he was a passenger in a stolen truck.

The Tribunal found that the applicant knew or ought to have known the vehicle was stolen, barring him from receiving income replacement benefits under section 31 of the Schedule.

The Tribunal also determined that the applicant did not sustain a catastrophic impairment, preferring the respondent's expert evidence that the applicant's mental and behavioural issues, including substance abuse, predated the accident.

All claims for benefits, interest, and awards were dismissed.

The respondent was awarded $300 in costs due to the applicant's unreasonable conduct in failing to attend cross-examination.