Karen Klaiman

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

Prior to the hearing, the respondent paid the outstanding IRBs with interest up to July 29, 2025, and subsequently terminated the benefit.

The Tribunal found the post-July 2025 termination was not properly in dispute.

The Tribunal dismissed the applicant's claim for a special award under s. 10 of O. Reg. 664, finding the respondent's delay in payment was not unreasonable as it was awaiting necessary Employment Insurance documentation.

Both parties' requests for costs were denied.

The applicant sought an income replacement benefit (IRB) following a motor vehicle accident.

The respondent denied the benefit, relying on insurer's examinations.

The Tribunal found the applicant met the test for an IRB, preferring the evidence of the applicant's treating physicians and the respondent's own kinesiologist, who found the applicant demonstrated functional limitations below the physical demands of his pre-accident job as a café supervisor.

The Tribunal rejected the respondent's other experts, noting inconsistencies in their reasoning.

The applicant was awarded the IRB with interest, but his claim for an award for unreasonable delay was dismissed due to lack of evidence.

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

The respondent denied various treatment plans, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant argued for removal from the MIG based on chronic pain and psychological injuries.

The Tribunal found the applicant failed to prove chronic pain with a functional limitation.

Regarding psychological injuries, the Tribunal preferred the respondent's expert evidence, which relied on objective testing, over the applicant's expert, who used primarily subjective self-reporting tools.

The application was dismissed, and the applicant was held to the MIG.

The applicant sought accident benefits following a motor vehicle accident, claiming she sustained a catastrophic impairment due to psychological issues.

The Tribunal found that the applicant's extensive pre-existing psychological conditions were the primary cause of her impairments, and the accident was not a necessary cause.

The Tribunal preferred the respondent's medical evidence, noting the applicant's self-reports were inconsistent with her medical records, which showed improvement post-accident.

The application for catastrophic impairment, non-earner benefits, and other medical benefits was dismissed.

The applicant requested a reconsideration of a Tribunal decision that found her entitled to income replacement benefits (IRBs) but quantified them at nil.

The applicant argued the Tribunal breached procedural fairness by admitting late-filed expert reports from the insurer's examination (IE) assessors regarding medical entitlement, and erred in law by finding she was self-employed and excluding her prior year's employment income.

The Tribunal granted the reconsideration in part, varying the decision to vacate all findings related to medical entitlement due to the respondent's breach of expert disclosure rules.

However, the Tribunal dismissed the request regarding the quantum of IRBs, finding no error in the determination that the applicant was self-employed and that her IRBs were correctly calculated at nil under the Schedule.

The respondent raised a preliminary issue arguing that the applicant should be barred from proceeding to a hearing for failing to attend insurer's examinations (IEs) under s. 44 of the Schedule.

The Tribunal found that the applicant was not barred from proceeding with claims for pre-104-week income replacement benefits (IRBs) and a treatment plan, as the applicant either attended the relevant IEs or was not provided with proper notice.

However, the applicant was barred from proceeding with the claim for post-104-week IRBs because he refused to attend the newly scheduled IEs required to assess entitlement under the distinct post-104-week test.

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

The central issue was whether the applicant, a personal support worker who had recently registered a business at the behest of a staffing agency, was 'employed' or 'self-employed' under the Statutory Accident Benefits Schedule.

The Tribunal found that the applicant suffered a substantial inability to perform the essential tasks of her employment for a closed period.

However, applying the Schedule's definitions, the Tribunal determined she was solely self-employed at the time of the accident.

Because her business reported no income in the prior fiscal year, and she could not rely on her previous employment income, the quantum of her IRBs was calculated as nil.

The application was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, including an income replacement benefit (IRB) and chiropractic treatment.

The respondent denied the benefits and sought repayment of past IRBs, alleging wilful misrepresentation regarding the applicant's receipt of long-term disability benefits.

The Tribunal found that the applicant failed to prove entitlement to the IRB and chiropractic treatment, as the medical evidence did not establish a substantial inability to perform the essential tasks of his employment or that the treatment was reasonable and necessary.

However, the Tribunal dismissed the respondent's claim for repayment, finding that the overpayment was due to an adjuster error rather than wilful misrepresentation, and the notice of repayment was provided outside the 12-month limitation period.

Claims for interest and a special award were also dismissed.

The applicant was injured in a motor vehicle accident and sought payment for three medical assessments (neurological, chronic pain, and physiatry) under the Statutory Accident Benefits Schedule.

The respondent denied the benefits on the basis that they were not reasonable and necessary.

The Tribunal found that the applicant failed to meet his burden of establishing that the assessments were reasonable and necessary, noting a lack of objective medical evidence and inconsistencies in the applicant's self-reported functionality compared to pre-accident records and independent assessments.

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

The applicant sought statutory accident benefits after slipping and falling on ice in a parking lot while walking around her vehicle to enter the driver's side.

The respondent denied benefits on the basis that the incident was not an 'accident' under s. 3(1) of the Statutory Accident Benefits Schedule.

The Licence Appeal Tribunal applied the purpose and causation tests, finding that while the purpose test was met, the causation test failed.

The ice on the ground was an intervening cause and the dominant feature of the injuries, not the use or operation of the vehicle.

The application was dismissed.

The applicant sought statutory accident benefits following a rear-end collision, claiming his injuries fell outside the Minor Injury Guideline (MIG) due to chronic pain syndrome and psychological impairments.

The Licence Appeal Tribunal found that the applicant's injuries were predominantly minor, relying on insurer examinations that concluded his physical and psychological symptoms did not warrant removal from the MIG.

The Tribunal gave little weight to the applicant's pain specialist report, finding it relied entirely on self-reporting and contradicted objective evidence.

The applicant's claims for a $13,667.32 chronic pain program, an award for unreasonable delay, interest, and costs were all dismissed.

The applicant sought funding for an in-home attendant care assessment more than 104 weeks after a motor vehicle accident.

The respondent denied the treatment plan because the applicant had not been designated catastrophically impaired, barring entitlement to attendant care benefits beyond the 104-week mark under s. 20(2)(a) of the Schedule.

The Tribunal agreed with the respondent, finding that absent a catastrophic impairment designation, the Tribunal lacks jurisdiction to award attendant care benefits post-104 weeks, rendering the assessment premature and not reasonable or necessary.

The application was dismissed.

The appellant, Toronto Hydro, appealed a Master's decision granting the respondent leave to amend a third-party claim to add Toronto Hydro as a party after the apparent expiry of the limitation period.

The underlying action involved a motor vehicle collision at an intersection where the traffic lights were not functioning due to a power outage.

The appellant argued the Master erred in applying the discoverability principle under the Limitations Act and misapprehended evidence regarding the respondent's due diligence.

The Superior Court of Justice dismissed the appeal, finding no error in the Master's interpretation of the law and holding that her factual findings on discoverability were owed deference and supported by the evidence.