7 total
Applicant awarded post-104 week income replacement benefits; chronic pain and opioid use precluded competitive employment.
The applicant was injured in a motor vehicle accident and received income replacement benefits (IRBs) for approximately 13 years before the respondent insurer terminated them.
The applicant sought post-104 week IRBs, arguing that his chronic pain, reliance on opioids, and resulting cognitive issues prevented him from working.
The respondent relied on independent medical examinations and video surveillance to argue the applicant could perform light duties.
The Tribunal found that the applicant's pain and medication use severely limited his functionality, rendering him unable to sustain competitive employment.
The Tribunal held that the applicant met the test for post-104 week IRBs and awarded the benefits with interest.
The respondent's request for costs was denied.
Appeal to set aside administrative dismissal denied due to self-represented lawyers' prolonged and unexplained delay.
The appellants, who are self-represented lawyers, appealed a Master's order dismissing their motion to set aside a Registrar's dismissal of their action for delay.
The Divisional Court upheld the Master's decision, finding that the appellants failed to meet any branch of the test to set aside the dismissal.
The court noted the appellants' near total abdication of their responsibility to move the case forward for many years, their failure to provide a reasonable explanation for the delay, and their failure to rebut the presumption of prejudice.
Procedural directions issued for a virtual appeal hearing, including electronic filing and Zoom protocols.
A case management endorsement setting out the procedural and technological directions for an upcoming virtual appeal hearing before the Divisional Court.
The court provided instructions on the use of Zoom, electronic document filing via a drop box, hyperlinking in factums, and time allocations for oral argument.
Claim for accident benefits dismissed as applicant failed to prove accident trauma triggered her Multiple Sclerosis.
The applicant was injured when her bicycle was struck by a parked car's door.
She was later diagnosed with Multiple Sclerosis (MS) and claimed statutory accident benefits, arguing the trauma from the accident triggered her MS.
The arbitrator reviewed expert neurological evidence on the theory that trauma can disrupt the blood-brain barrier and trigger latent MS.
The arbitrator found the theory speculative and concluded the applicant failed to prove the accident triggered her MS, noting she had pre-accident neurological symptoms and lacked evidence of serious trauma.
The claims for income replacement benefits, medical benefits, and a special award were dismissed.
Applicant awarded $2,998.61 in expenses after successfully opposing insurer's unnecessary motion for medical examination.
The applicant was injured in a motor vehicle accident and successfully opposed the insurer's motion to compel her attendance at a medical examination.
In this subsequent hearing on expenses, the arbitrator applied the criteria under section 12(2) of Ontario Regulation 664.
Finding that the applicant was completely successful and that the insurer's motion was unnecessary, the arbitrator awarded the applicant her expenses of the motion, assessed at $2,998.61.
Applicant permitted to withdraw medical benefits claim; Insurer awarded costs for preliminary issue hearing preparation.
The Applicant sought to withdraw her claim for medical benefits shortly before a scheduled preliminary issue hearing.
The Insurer opposed the withdrawal without an order for costs, arguing the late withdrawal caused unnecessary expenses.
The Arbitrator permitted the withdrawal of the claim and awarded the Insurer its reasonable expenses for preparing for the preliminary issue hearing, capped at Legal Aid rates, totaling $334.59.
Insurer's request for a medical examination denied due to delay, improper purpose, and deficient notice.
The insurer brought a motion for a preliminary issue seeking an order that the insured attend a medical examination under s. 42 of the Statutory Accident Benefits Schedule, and to stay the arbitration proceedings until she did so.
The arbitrator found that the requested examination was not reasonably necessary because the insurer had delayed its request for over a year after learning of the insured's multiple sclerosis, suggesting the examination was sought to bolster its case for arbitration rather than to adjust the claim.
Furthermore, the notice of examination was deficient.
The arbitrator also noted a lack of jurisdiction to order attendance at a medical examination.
The motion was dismissed and the arbitration was not stayed.