Jason Goodman

The applicant sought statutory accident benefits following a motor vehicle accident, including chiropractic services and a chronic pain assessment.

The respondent denied the treatment plans.

The applicant argued the denials were improper under s. 38(8) of the Schedule, but the Tribunal found the respondent replied within the required 10 business days.

The Tribunal held the applicant failed to prove the treatment plans were reasonable and necessary, noting significant gaps in seeking medical attention and a failure to link the reported pain directly to the accident.

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

The appellant appealed a Licence Appeal Tribunal decision finding she did not sustain a catastrophic impairment from a motor vehicle accident.

The appellant argued the adjudicator misapplied the 'but for' test for causation regarding her psychological and behavioural impairments.

The Divisional Court dismissed the appeal, holding that the adjudicator correctly applied the legal test for causation and that her conclusions were factual findings supported by the evidence.

The court also upheld the adjudicator's finding that the appellant failed to prove a marked impairment in three spheres of functioning.

The appellant, who was deemed catastrophically impaired following a motor vehicle accident, appealed a Licence Appeal Tribunal (LAT) decision dismissing his claim for attendant care benefits.

The Divisional Court found that the LAT Vice-Chair erred in law by providing inadequate, conclusory reasons and conflating the test for 'reasonable and necessary' expenses with procedural non-compliance.

The court set aside the LAT decision and remitted the matter for a fresh hearing before a differently constituted tribunal.

The applicant sought statutory accident benefits following a motorcycle accident.

The respondent denied benefits, arguing the applicant's policy was cancelled prior to the accident and he was excluded under s. 31(1)(a)(i) of the Schedule for driving without insurance.

The Tribunal found the respondent validly terminated the policy by registered mail and the applicant ought reasonably to have known he was uninsured.

Furthermore, the Tribunal dismissed the applicant's claims for various medical benefits and treatment plans, finding the applicant failed to provide sufficient medical evidence to prove the plans were reasonable and necessary.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision which found she did not sustain a catastrophic impairment as a result of a motor vehicle accident.

The applicant argued the adjudicator erred in law or fact by incorrectly applying the 'but for' test for causation regarding her psychological impairments.

The adjudicator dismissed the request, finding that the correct legal test for causation was applied and that the applicant failed to meet her burden of proof to show the accident was a necessary cause of her psychological impairments.

The adjudicator also found no error in the assessment of the applicant's impairments under the AMA Guides.

The applicant sought judicial review of a Licence Appeal Tribunal decision regarding statutory accident benefits.

The Divisional Court declined to exercise its discretion to hear the application, finding that the applicant ought to have pursued a statutory appeal under s. 11(6) of the Licence Appeal Tribunal Act, 1999, which limits appeals to questions of law.

The court held there were no exceptional circumstances to justify bypassing the statutory appeal mechanism and declined to convert the application into an appeal.

The application was dismissed without prejudice to the applicant seeking an extension of time to pursue a statutory appeal.

The applicant was involved in a motor vehicle accident and applied for accident benefits 14 months later.

The respondent denied the claim, arguing the applicant was precluded from bringing a claim due to the delay.

The Tribunal found that the applicant had a reasonable explanation for the delay under section 34 of the Statutory Accident Benefits Schedule, as the respondent failed to provide the applicant with an application for benefits (OCF-1) and there was confusion regarding the applicable policy and coverage.

The applicant is not precluded from bringing a claim.

The applicant sought a determination that she sustained a catastrophic impairment due to mental and behavioural disorders following a 2016 motor vehicle accident.

The adjudicator found inconsistencies in the applicant's self-reporting to various assessors, including failing to disclose a post-accident trip to Hawaii, criminal charges, and a subsequent motor vehicle accident.

The adjudicator concluded the applicant failed to prove she suffered a marked impairment in three spheres of functioning.

Furthermore, the applicant failed to satisfy the 'but for' causation test, as the evidence did not establish the 2016 accident was a necessary cause of her psychological impairments.

The application was dismissed.

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

The insurer denied several claims and requested the applicant attend Insurer's Examinations under section 44 of the Statutory Accident Benefits Schedule.

The applicant refused to attend, arguing the requests were made in bad faith and lacked sufficient medical reasons.

The Tribunal found that the insurer's notices complied with the Schedule and provided clear, comprehensible rationales.

Because the applicant failed to attend the properly requested examinations, section 55 of the Schedule barred her from commencing a proceeding before the Tribunal.

The application was dismissed without costs.

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

The respondent denied several treatment plans for chiropractic and psychological care on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Licence Appeal Tribunal found that the applicant sustained predominantly minor soft tissue injuries and failed to establish that he suffered from chronic pain or a psychological impairment that would remove him from the MIG.

As the $3,500 MIG funding limit had been exhausted, the claims for additional medical benefits were dismissed, along with claims for interest and an award for unreasonable withholding of benefits.

The applicant sought statutory accident benefits for injuries sustained in a motor vehicle accident, including treatment plans for occupational therapy, physiotherapy, and psychological assessments.

The respondent insurer denied the benefits, relying in part on surveillance evidence.

The Tribunal gave little weight to the surveillance evidence, finding it unreliable and not contradictory to the applicant's self-reported limitations.

The Tribunal found the applicant was entitled to the costs of an attendant care assessment and occupational therapy, as well as physiotherapy, finding them reasonable and necessary.

The claim for a second psychological assessment was dismissed as it exceeded the statutory cap for a single assessment.

The Tribunal also awarded the applicant a 35% special award under O. Reg. 664, finding the respondent unreasonably withheld approval of the attendant care assessment after the applicant was removed from the Minor Injury Guideline.

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

The Licence Appeal Tribunal found that the insurer failed to provide adequate medical reasons in its notices denying certain treatment plans under s. 38(8) of the Schedule, entitling the applicant to incurred costs until proper notice is given.

The Tribunal also found three chiropractic treatment plans and one psychological treatment plan to be reasonable and necessary.

However, a second psychological treatment plan, a chronic pain assessment, and a cognitive assessment were deemed not reasonable and necessary.

The applicant's claim for an award under Regulation 664 was dismissed.

This endorsement addresses multiple motions in a family law proceeding.

The court reviewed the continuation of a temporary spousal support order for a personal care assistant (PCA) and decided on two Form 14B motions for leave to bring further motions.

The Respondent sought leave to compel production of the Applicant's entire medical file, which was denied due to disproportionality and lack of necessity.

The Applicant sought leave for several reliefs, including striking affidavits, a restraining order, and interim disbursements.

The court dismissed most of the Applicant's requests for leave but granted leave for a motion for interim costs, recognizing the complexity of the Respondent's financial affairs and the need to "level the playing field." The court also clarified its ongoing case management role.

The applicant brought a motion for interim child support, seeking imputation of $200,000 income to the respondent, increased life insurance, disclosure orders, and costs.

The respondent, claiming unemployment and disability, opposed the imputation and other requests.

The court imputed an income of $74,977 to the respondent, ordered child support of $700 per month, and a 67/33 split for section 7 expenses.

The existing $100,000 life insurance policy was maintained, and the respondent was ordered to provide outstanding disclosure.

Costs for previous conferences were fixed at $10,000, to be apportioned by the trial judge, and the applicant was awarded $5,000 in costs for the motion.

The applicant sought an order addressing the income tax consequences of a temporary spousal support order previously made.

The court ordered the respondent to pay a lump sum equal to the applicant's tax liability on the periodic spousal support received in 2018.

The court also directed a review of the ongoing necessity and cost of the applicant's 24/7 personal care assistant.

Following an arbitration where the insurer successfully defended all claims for statutory accident benefits, the insurer sought its expenses.

The arbitrator found that the applicant's conduct, including the late production of a voluminous ODSP file and changing the structure of the case mid-hearing, unnecessarily prolonged and hindered the proceedings.

Applying the principle of fairness and noting the consumer protection nature of the legislation, the arbitrator applied a 25% discount to the insurer's legal fees and excluded surveillance costs from disbursements.

The applicant was ordered to pay the insurer's expenses fixed at $52,167.11.

The Applicant sought statutory accident benefits following a motor vehicle accident, claiming catastrophic impairment, attendant care benefits, and medical benefits.

The Insurer denied the claims, arguing the Applicant's ongoing issues were related to pre-existing conditions and that he was malingering.

The Arbitrator found the Applicant and his family members lacked credibility, noting significant inconsistencies between their testimony, the Applicant's pre-accident medical history, his receipt of ODSP benefits, and surveillance evidence showing him performing normal daily activities.

The Arbitrator preferred the evidence of the Insurer's medical experts, who found the Applicant was malingering and that his impairments were not caused by the accident.

The claims for catastrophic impairment, attendant care benefits, and medical benefits were dismissed.

Following an arbitration where the applicant was found catastrophically impaired but was largely unsuccessful on the quantum of attendant care benefits, the parties disputed the entitlement to and quantum of expenses.

The arbitrator awarded the applicant his reasonable expenses but reduced them by one-third to reflect the insurer's success on the significant issue of attendant care quantum.

After assessing the claimed legal fees and disbursements, the arbitrator ordered the insurer to pay the applicant $41,039.34 for expenses.

The applicant was injured in a motorcycle accident and sought statutory accident benefits.

The Licence Appeal Tribunal found the applicant suffered a complete inability to engage in any employment for which he was reasonably suited, entitling him to a post-104 week income replacement benefit.

The Tribunal also determined the applicant sustained a catastrophic impairment, as his combined physical, neurocognitive, and mental/behavioural impairments met the 55% whole person impairment threshold under the AMA Guides.

However, the applicant's claims for specific medical and rehabilitation benefits were dismissed for lack of evidence proving they were reasonable and necessary.

The applicant was injured in a motor vehicle accident and sought accident benefits, claiming he sustained a catastrophic impairment.

The insurer denied the claim, arguing that any catastrophic impairment was the result of a stroke the applicant suffered two years after the accident.

The arbitrator found that the applicant's psychological impairments resulting from the accident met the threshold for catastrophic impairment, and that the accident materially contributed to the stroke.

The arbitrator awarded attendant care benefits for incurred professional services but denied them for family-provided care due to a lack of evidence of economic loss.

A special award was granted against the insurer for unreasonably withholding payments.