Ian Drong

The applicant sought statutory accident benefits following a motor vehicle accident, specifically claiming costs for medical cannabis and a social work assessment.

The Tribunal denied the claims for medical cannabis, finding it was not reasonable and necessary as the applicant reported deriving little benefit from it compared to other pharmaceuticals.

However, the Tribunal ordered the respondent to pay for the social work assessment because the respondent's denial letter relied on boilerplate language and failed to provide sufficient medical reasons, violating s. 38(8) of the Schedule.

Claims for an award under s. 10 of Reg. 664 were dismissed, but interest was awarded on the overdue payment for the social work assessment.

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

The Tribunal found the applicant should be removed from the Minor Injury Guideline (MIG) due to an accident-related psychological impairment (anxiety).

The applicant was awarded one treatment plan for physiotherapy because the insurer failed to provide sufficient medical reasons for its denial under s. 38(8) of the Schedule.

However, claims for non-earner benefits, an occupational therapy assessment, and assistive devices were dismissed.

The Tribunal found the applicant did not suffer a complete inability to carry on a normal life, noting significant pre-existing limitations, and the occupational therapy expense was incurred before the treatment plan was submitted.

The applicant sought various statutory accident benefits following a 2019 motor vehicle accident.

The respondent denied the claims.

The Tribunal considered procedural issues regarding late expert reports and submissions, ultimately admitting them to ensure procedural fairness.

On the merits, the Tribunal found the applicant was not entitled to the disputed physiotherapy, assistive devices, personal training, or psychological therapy, as she failed to prove they were reasonable and necessary, or they were barred by the Schedule's timing provisions.

However, the Tribunal granted entitlement to a $2,200 psychological assessment, finding it was submitted within the five-year limitation period and supported by medical evidence.

The applicant sought statutory accident benefits following a 2017 motor vehicle accident, specifically claiming the balance of a treatment plan for a hot tub and attendant care benefits.

The Tribunal found the hot tub was reasonable and necessary to address the applicant's accident-related chronic back pain and mobility limitations, preferring the evidence of the applicant's treating occupational therapist over the insurer's assessors.

However, the claim for attendant care benefits was dismissed because the applicant failed to provide evidence that the expenses were actually incurred, as required by the Schedule.

The applicant requested a reconsideration of a Tribunal decision that denied his entitlement to a post-104 week Income Replacement Benefit (IRB) and found that the quantum for his pre-104 week IRB could not be determined.

The Vice-Chair dismissed the request to admit new tax documents to determine the IRB quantum, finding the applicant failed to show the evidence could not have been obtained previously.

However, the Vice-Chair found the original adjudicator committed an error of law by failing to explicitly engage with the expert evidence regarding the post-104 week IRB test.

Upon reviewing the evidence, the Vice-Chair concluded the applicant suffers from a complete inability to engage in reasonably suited employment due to chronic pain and cognitive struggles.

The decision was varied to find entitlement to the post-104 week IRB, though no benefit is currently payable as the quantum remains undetermined.

The applicant sought income replacement benefits (IRBs) following a motor vehicle accident.

The Tribunal found that while the applicant met the medical test for pre-104 week IRBs due to chronic pain and adjustment disorder, they failed to provide the necessary financial documents, such as tax returns, to determine the quantum of the benefit.

The Tribunal also found that the applicant did not meet the more stringent post-104 week test of a complete inability to engage in suitable employment.

As no quantum could be determined, the application for IRBs and interest was dismissed.

The applicant sought statutory accident benefits following a 2016 motor vehicle accident.

The respondent denied several expenses and treatment plans.

The adjudicator found the applicant was entitled to medication expenses as they do not require a prior treatment plan.

The claim for a left knee brace was dismissed because the expense was incurred before a treatment plan was submitted, contrary to s. 38(2) of the Schedule.

The adjudicator granted the treatment plans for a chronic pain assessment and an attendant care assessment because the respondent failed to provide proper notice under s. 38(8) after the applicant was removed from the Minor Injury Guideline.

The treatment plans for an occupational therapy assessment, occupational therapy services, and an OT jobsite analysis were found to be reasonable and necessary based on the applicant's functional limitations and supporting medical evidence.

Interest was awarded on all overdue benefits.

The applicant requested a reconsideration of a preliminary issue decision that struck her claim for non-earner benefits because she failed to attend properly scheduled insurer's examinations.

The applicant argued that attending the examinations on the eve of a case conference would be counterproductive and that the Tribunal erred in its application of the Statutory Accident Benefits Schedule.

The Tribunal dismissed the request for reconsideration, finding no error of law or fact and no breach of procedural fairness, as the applicant was in breach of section 44 of the Schedule, which barred her from proceeding under section 55.

The applicant sought $789.39 for physiotherapy and an assistive vacuum following a motor vehicle accident, along with an award for unreasonable delay and interest.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to submit the required treatment and assessment plan under s. 38(2) of the Schedule and provided no evidentiary basis for the claimed expenses.

Claims for an award and interest were also dismissed as there were no overdue benefits and insufficient evidence of unreasonable conduct by the insurer.

The applicant sought various medical and rehabilitation benefits following a motor vehicle accident, including natural supplements, medical marijuana, Platelet Rich Plasma (PRP) therapy, physiotherapy, psychological services, and a visual assessment.

The Licence Appeal Tribunal dismissed the application in its entirety.

The Tribunal found that medical marijuana was contraindicated due to the applicant's pre-existing conditions, and that PRP therapy was experimental and thus excluded under s. 15(2)(a) of the Schedule.

Relying on independent medical examinations, the Tribunal concluded that the remaining physical and psychological treatment plans were not reasonable and necessary.

The applicant sought income replacement benefits (IRB) following a 2016 motor vehicle accident.

The insurer denied the IRB in June 2016, and the applicant returned to work.

In 2022, the applicant went on medical leave and submitted an updated disability certificate, which the insurer denied based on the 2016 denial.

The Tribunal found the applicant failed to dispute the denial within the two-year limitation period under section 56 of the Schedule.

Applying the Manuel factors under section 7 of the LAT Act, the Tribunal declined to extend the limitation period, finding no bona fide intention to appeal, significant unexplained delay, prejudice to the insurer, and lack of merit.

The applicant was injured in a motor vehicle accident and sought income replacement benefits (IRBs) from the respondent insurer.

The insurer denied the IRBs and brought a preliminary motion arguing that the applicant's subsequent application to the Tribunal was statute-barred for missing the two-year limitation period under section 56 of the Statutory Accident Benefits Schedule.

The Tribunal found that the limitation period expired on a Saturday, meaning it was deemed to expire on the next business day.

Because the applicant filed her application on that next business day, the application was within the limitation period and she was permitted to proceed with her claim.

The applicant was involved in a motor vehicle accident and failed to submit his application for accident benefits (OCF-1) within the 30-day time limit prescribed by section 32(5) of the Statutory Accident Benefits Schedule, submitting it over two years late.

The applicant argued that his delay was reasonable due to emotional distress from an abusive relationship and confusion regarding the insurance system.

The Tribunal found that the applicant failed to provide a reasonable explanation for the delay under section 34, noting a lack of evidence connecting his emotional state to his inability to submit the form, especially given he had filed other insurance claims during the same period.

Consequently, the applicant was found to be statute-barred from proceeding with his application.

The applicant was injured in a motor vehicle accident as a pedestrian and sought non-earner benefits.

The respondent requested the applicant attend insurer's examinations, which the applicant failed to attend, arguing it was unreasonable to schedule them close to a case conference.

The Tribunal found the applicant failed to attend properly scheduled insurer's examinations without a valid exemption.

Consequently, the applicant is barred from disputing her entitlement to non-earner benefits, and the issue was struck from the application, though she may proceed with her claim for medical benefits.

The plaintiff brought a motion to validate service of the Statement of Claim and to extend the time to set the action down for trial.

The defendant brought a cross-motion to dismiss the action for delay, arguing prejudice due to the five-year delay between issuance and service.

The court found the plaintiff's explanation for the delay acceptable, noting the plaintiff was pursuing a WSIB claim and attempting to consolidate discoveries with companion actions.

The court also found no non-compensable prejudice to the defendant, as his counsel had been involved in companion actions arising from the same accident.

The plaintiff's motions were granted, and the defendant's motion to dismiss was dismissed.

The defendant, Irina Campos, brought a motion under Rule 21.01(1)(a) of the Rules of Civil Procedure to dismiss the plaintiff's action as statute-barred, arguing the limitation period had expired.

The plaintiff, Miano, was injured in a hit-and-run in May 2015 and only identified Campos as the probable owner of the truck in February 2018 after obtaining police records.

The court dismissed the defendant's motion, holding that a limitation period defence based on discoverability is a question of mixed fact and law, not suitable for determination under Rule 21.01(1)(a) unless facts are undisputed.

The court further clarified that a claim for damages from an automobile accident is not discovered until the plaintiff knows or ought to know the identity of the owner or operator of the automobile, rendering it unnecessary to commence an action against "Jane Doe" to preserve a limitation period.

The defendant brought a motion to compel the plaintiff to answer questions refused on cross-examination.

The plaintiff had sworn an affidavit in support of a pending motion to remove the defendant's counsel for a conflict of interest, alleging he previously shared confidential information with lawyers at that firm.

The plaintiff refused to disclose the contents of those conversations, claiming solicitor-client privilege.

The court granted the motion to compel, finding that the defendant needed the details of the communications to test whether a solicitor-client relationship existed, whether the information was confidential, and whether there was a risk of prejudice.