Dr. Veronica Kekosz

The applicant sought statutory accident benefits following a 2019 motor vehicle accident, specifically a $19,097.00 treatment plan for a catastrophic impairment (CAT) assessment and an award for unreasonable delay.

The Tribunal found the applicant was entitled to $9,266.00 for the CAT assessment, approving the physiatry, psychiatry, and occupational therapy components, but denying duplicative or premature elements like the intake assessment and OCF-19 completion.

The Tribunal admitted several late or disputed medical reports, finding them relevant and not prejudicial.

The claim for a special award was dismissed as the insurer's denial was not unreasonable, though interest was awarded on the overdue assessment costs.

The applicant, who was deemed catastrophically impaired following a motor vehicle accident, sought attendant care benefits and moving expenses.

The Licence Appeal Tribunal found the applicant entitled to $1,192.52 per month for attendant care, preferring the evidence of her treating occupational therapist regarding her need for emotional support and cueing.

The Tribunal denied the claim for moving expenses, finding the relocation was necessitated by the applicant's divorce rather than the accident, and thus did not qualify as a reasonable and necessary rehabilitation expense under the Schedule.

The applicant sought payment for various treatment plans, including chiropractic services, a brain SPECT scan, medical services, and physiotherapy, following a motor vehicle accident.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to prove the treatment plans were reasonable and necessary.

The Tribunal preferred the evidence of the respondent's insurer's examination over the applicant's medical reports, noting the lack of physical examinations or detailed explanations of rehabilitative benefits in the applicant's evidence.

Furthermore, the treatment plans themselves were not entered into evidence.

The applicant sought statutory accident benefits following a motor vehicle accident, arguing that his injuries warranted removal from the Minor Injury Guideline (MIG) due to pre-existing conditions, psychological impairments, and chronic pain.

The Tribunal found that the applicant failed to provide compelling medical evidence that his pre-existing back injury precluded recovery within the MIG.

Furthermore, the Tribunal was not persuaded that the applicant suffered a psychological impairment or chronic pain with functional impairment as a direct result of the subject accident.

Consequently, the applicant's injuries were deemed predominantly minor.

The Tribunal ordered that the applicant is entitled to the disputed treatment plans only up to the remaining amount of the $3,500 MIG limit, as such benefits are deemed reasonable and necessary under s. 40(8) of the Schedule.

This ruling addresses the plaintiffs' motion for leave to call more than three medical experts in a personal injury trial, as permitted under Section 12 of the Evidence Act.

The court reviewed the proposed experts for both plaintiffs, Kenisha Desmond and Shian Henry, and found significant overlap and duplication in their anticipated testimony, particularly among medical specialists.

Applying the criteria for granting leave and emphasizing the court's gatekeeping function to prevent unnecessary trial length and disproportionate costs, the judge granted leave to call only one expert from each identified group of duplicative specialists for both plaintiffs, while allowing economic and occupational therapy experts.

The applicant sought payment for a treatment plan for window inserts and earplugs to address noise sensitivity following a motor vehicle accident.

The Licence Appeal Tribunal dismissed the application, finding the applicant failed to prove the items were reasonable and necessary.

The Tribunal noted that the applicant's own medical assessors did not identify noise sensitivity as the cause of her sleep disruption or limited productivity, and there was insufficient evidence that the proposed items would be effective or that their cost was proportionate.

The applicant sought non-earner benefits following a motor vehicle accident.

The respondent insurer denied the claim.

The Licence Appeal Tribunal found that the applicant failed to prove she suffered a complete inability to carry on a normal life.

The adjudicator preferred the respondent's multidisciplinary assessment reports, which found no objective physical or psychological impairment preventing the applicant from engaging in her pre-accident activities, and noted evidence of symptom exaggeration.

The applicant's failure to produce pre-accident disability records further undermined her claim.

The application was dismissed.

The applicant, a pedestrian struck by a vehicle, sought Income Replacement Benefits (IRBs) and funding for psychological and chronic pain assessments.

The insurer terminated IRBs after six months and denied the assessments, arguing the applicant's injuries fell within the Minor Injury Guidelines (MIG).

The Tribunal found the applicant did not suffer a substantial inability to perform his essential tasks for the first 104 weeks, nor a complete inability to engage in employment thereafter, relying on surveillance evidence showing him working and medical reports indicating symptom magnification.

The Tribunal also concluded the applicant's injuries were minor, dismissing the claims for the assessments.

Following an eleven-day jury trial where the jury awarded no damages, the defendant brought a motion for a declaration that the plaintiff's claim for non-pecuniary loss and health care expenses was barred by the threshold under the Insurance Act.

The plaintiff claimed to suffer from soft tissue injuries, headaches, and neck pain following a minor rear-end collision.

The court found that the plaintiff's impairments did not substantially interfere with her volunteer activities or usual activities of daily living, and preferred the medical evidence indicating no permanent impairment caused by the collision.

The motion was granted, barring the plaintiff's claims.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including income replacement, attendant care, and housekeeping benefits.

The arbitrator found the applicant's testimony lacked credibility due to inconsistencies and failure to disclose a subsequent accident to medical assessors.

However, relying on objective medical evidence, the arbitrator concluded the applicant suffered a substantial inability to perform his pre-accident employment as a cleaner for the first 104 weeks.

The applicant did not meet the complete inability test for the period after 104 weeks.

The arbitrator awarded income replacement benefits for the initial period, subject to deductions for post-accident earnings, and granted attendant care and housekeeping benefits for a limited period.

The applicant was injured in a motor vehicle accident and commenced a court action for certain accident benefits.

She later applied for arbitration to determine if she sustained a catastrophic impairment.

A priority dispute determined that Certas, not Dominion, was the priority insurer.

The applicant sought to add Certas to the arbitration, while Certas sought to stay the arbitration, arguing all issues should be heard in the existing court action.

Applying the pragmatic balancing of interests test from Mangat, the arbitrator found that allowing both proceedings would create an unacceptable risk of inconsistent results regarding causation and credibility.

However, the arbitrator permitted the applicant to consolidate all issues in the arbitration, provided she seeks leave to withdraw or discontinue her court action, as this would result in the most just, quickest, and least expensive resolution.

Certas was added as a party, and Dominion remained a party to respond to a special award claim.

The applicant sought ongoing statutory accident benefits following a motor vehicle accident, claiming physical and psychological disabilities prevented him from working as a superintendent.

The arbitrator found that the applicant suffered from chronic fatigue and psychological issues prior to the accident, stemming from previous torture in Turkey, which had already impaired his job performance.

Medical opinions supporting the applicant's claim were rejected because the experts were unaware of his pre-accident condition.

The arbitrator concluded the accident did not significantly contribute to the applicant's disability, denying further weekly benefits and the insurer's claim for repayment, but awarded reimbursement for a medical report.

The parties cross-appealed an arbitration decision regarding weekly income benefits and arbitration expenses following a motor vehicle accident.

The insured appealed the denial of weekly income benefits after September 5, 1994, and the refusal to adjourn the hearing to cross-examine the insurer's medical expert.

The insurer appealed the order requiring it to pay the insured's arbitration expenses, arguing that November 1996 amendments to the Insurance Act should have been applied.

The Director's Delegate dismissed both appeals, finding that the arbitrator's conclusions on benefits were supported by the evidence, the refusal to adjourn was a reasonable exercise of authority, and the new expense provisions did not apply retroactively to proceedings commenced before the amendments.

The insured was awarded $250 in appeal expenses for responding to the insurer's appeal.

The appellant was injured in a motor vehicle accident in December 1990 and received weekly income benefits until June 1991, when the insurer terminated them.

The appellant applied for arbitration, seeking ongoing weekly income benefits and rehabilitation expenses, arguing that his continuing back problems were caused by the accident.

The arbitrator dismissed the claims, finding that the appellant was no longer substantially unable to perform the essential tasks of his pre-accident occupation by June 1991, and that his ongoing back problems were primarily caused by factors other than the accident.

On appeal, the Director's Delegate confirmed the arbitrator's decision, finding no error in the assessment of the medical evidence or the application of the causation standard.

The appeal was dismissed with no expenses payable.

The applicant was injured in a motor vehicle accident in December 1990 and received weekly income benefits until June 1991.

He applied for arbitration, seeking ongoing weekly income benefits and supplementary medical and rehabilitation expenses, claiming he was substantially unable to perform his essential tasks as a home day care provider due to continuing back and leg pain.

The arbitrator found that the applicant's ongoing pain and disability after June 1991 were the result of a pre-existing degenerative disc disease process rather than the motor vehicle accident.

The claims for ongoing weekly income benefits and rehabilitation expenses were dismissed, though the applicant was awarded his arbitration expenses.

The Applicant was injured in a motor vehicle accident and received statutory accident benefits.

The Insurer terminated weekly income benefits on March 31, 1993.

The Applicant sought arbitration for further weekly income benefits, supplementary medical and rehabilitation expenses, and housekeeping and child care expenses.

The arbitrator found that the Applicant was not substantially unable to perform her essential tasks and dismissed the claim for further weekly income benefits.

The arbitrator awarded certain supplementary medical and rehabilitation expenses, including transportation and a club membership, but denied the claim for housekeeping and child care expenses due to insufficient evidence.