Jennifer M. Cosentino

The 79-year-old applicant sought non-earner benefits following a motor vehicle accident.

The insurer paid benefits until January 28, 2017, but terminated them based on multidisciplinary assessments indicating the applicant no longer suffered a complete inability to carry on a normal life.

The Tribunal applied the Heath framework and found that, due to successful physiotherapy and psychotherapy, the applicant had recovered sufficiently to engage in substantially all of his pre-accident activities.

The Tribunal also found the applicant non-compliant for failing to attend a scheduled insurer examination in September 2018, providing an independent basis for termination.

The application was dismissed.

The applicant sought reconsideration of a Licence Appeal Tribunal decision that denied her claim for a non-earner benefit following a motor vehicle accident.

The applicant argued the Tribunal violated procedural fairness and erred in law by excluding the testimony and clinical notes of a medical witness, and by failing to consider other psychological evidence.

The Tribunal dismissed the request, finding that the medical witness was properly excluded due to the applicant's failure to provide prior notice, and that the original decision reasonably considered all relevant evidence in determining the applicant did not suffer a complete inability to carry on a normal life.

The applicant sought various statutory accident benefits following a motor vehicle accident, including ongoing income replacement benefits (IRBs), the cost of an accountant's report, and medical benefits for assistive devices and psychological treatment.

The Tribunal found that the applicant was not entitled to ongoing IRBs because she had returned to full-time work and was paid her normal salary.

The cost of the accountant's report was deemed unreasonable due to the applicant's failure to provide accurate information regarding collateral benefits.

The claims for assistive devices and further psychological treatment were also dismissed, as the Tribunal preferred the evidence of the insurer's examiners, who concluded the items and treatments were not reasonable and necessary given the applicant's functional recovery.

The applicant was injured in a rear-end motor vehicle accident and sought a social worker assessment under the Statutory Accident Benefits Schedule.

The respondent denied the assessment, arguing it was not recommended by the applicant's psychiatrist and was a duplication of already approved psychotherapy services.

The Tribunal found that the assessment was not reasonable or necessary, as there was no medical need for it and it duplicated ongoing psychotherapy treatments.

The application was dismissed.

The applicant requested a reconsideration of a Tribunal decision that denied her claim for a non-earner benefit.

The applicant argued that the adjudicator made significant errors of law and fact by failing to properly interpret the evidence, including medical reports, clinical notes, and video surveillance, and by misapplying the Heath principles.

The adjudicator reviewing the reconsideration request found that the original decision provided a well-reasoned analysis of the evidence and submissions.

The adjudicator concluded that there was no significant error of law or fact that would have led to a different outcome, and dismissed the request for reconsideration.

The applicant sought a non-earner benefit following a motor vehicle accident, claiming a complete inability to carry on a normal life due to physical and psychological injuries.

The adjudicator dismissed the claim, preferring the respondent's independent medical examinations and video surveillance evidence over the applicant's expert reports.

The surveillance showed the applicant engaging in pre-accident activities such as shopping and walking without assistance, contradicting her self-reported limitations.

Claims for an award under Ontario Regulation 664 and interest were also dismissed.

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

The adjudicator found that the applicant was not continuously prevented from engaging in substantially all of her pre-accident activities, as she had reported to the respondent's medical assessors that she could still perform self-care, housekeeping, and caregiving tasks, albeit with pain.

The application for the non-earner benefit was dismissed, and neither party was awarded costs.

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

The insurer denied benefits and requested the applicant attend a section 44 insurer's examination.

The applicant refused to attend, arguing the request was unreasonable.

The Tribunal found the insurer's request was reasonable and compliant with the Schedule, noting the applicant's own medical professionals recommended a neurological assessment.

Because the applicant failed to attend the properly scheduled examination, he was statute-barred from applying to the Tribunal under section 55(1)2 of the Schedule.

The application was dismissed.

The applicant, an elderly pedestrian who was struck by a motor vehicle in a parking lot, applied for statutory accident benefits including non-earner benefits, attendant care benefits, and medical/rehabilitation benefits.

The adjudicator dismissed the application in its entirety.

The adjudicator found that the applicant failed to prove she suffered a complete inability to carry on a normal life, noting inconsistencies in her self-reporting and relying on insurer's examinations that found no objective impairment preventing her pre-accident activities.

Claims for attendant care and medical benefits were similarly dismissed due to a lack of persuasive medical evidence and inconsistencies in the applicant's submitted treatment plans.