12 total
Application for accident benefits dismissed as applicant achieved maximal recovery and returned to full-time work.
The applicant sought statutory accident benefits following a motor vehicle accident, specifically claiming entitlement to chiropractic treatments, an in-home assessment, and in-home treatments.
The Licence Appeal Tribunal dismissed the application, finding that the applicant had achieved maximal recovery and functional range of motion.
The Tribunal preferred the respondent's insurer's examinations, noting the applicant had returned to full-time employment as a nurse and was able to participate in activities such as hiking, cycling, and yoga.
As no benefits were payable, the claim for interest was also dismissed.
Applicant found catastrophically impaired under criterion 8 due to marked psychological and behavioural impairments.
The applicant, a self-employed bicycle delivery person, was injured in a motor vehicle accident and sought a determination of catastrophic impairment under criterion 8 of the Statutory Accident Benefits Schedule.
The Licence Appeal Tribunal assessed the applicant's mental and behavioural impairments across four spheres of function.
Preferring the evidence of the applicant's experts, the Tribunal found the applicant sustained marked impairments in activities of daily living, social functioning, concentration, persistence and pace, and adaptation.
The Tribunal concluded the applicant suffered a catastrophic impairment.
Occupational therapy plan partially approved for injured cyclist; chiropractic plan and special award denied.
The applicant, a cyclist intentionally struck by a vehicle, sought statutory accident benefits for occupational therapy and chiropractic services, as well as a special award for unreasonable delay.
The Licence Appeal Tribunal partially approved the occupational therapy plan, finding it reasonable and necessary based on a contemporaneous psychiatric report diagnosing severe PTSD and depression.
The chiropractic plan was denied due to a lack of corroborating contemporaneous medical evidence.
The claim for a special award was dismissed as the insurer's denial was not found to be unreasonable.
Attendant care benefits denied, but insurer ordered to pay 25% award for unreasonably delaying treatment plans.
The applicant was injured in a bicycle/motor vehicle collision and sought attendant care benefits and an award for unreasonably delayed treatment plans.
The Tribunal found the applicant was not entitled to attendant care benefits as she had regained independence in her activities of daily living.
However, the Tribunal found the insurer unreasonably delayed approving four treatment plans by keeping the applicant in the Minor Injury Guideline despite receiving a neurologist's report diagnosing a concussion.
The Tribunal awarded 25% of the value of the delayed plans ($2,657.54) plus interest.
Judicial review and motion to set aside dismissed; applicant failed to exhaust statutory review process.
The applicant sought judicial review of a decision by the Office of the Independent Police Review Director (now LECA) denying his request for a review of a police investigation into his complaints of excessive force during encampment clearings.
The applicant also moved to set aside a single judge's order quashing his judicial review application against the Toronto Police Service.
The Divisional Court dismissed the motion, finding the motion judge correctly applied the 'plain and obvious' test and properly concluded that the applicant had to exhaust the statutory review process under section 71 of the Police Services Act before seeking judicial review.
The Court also dismissed the judicial review application against LECA, holding that the Director's decision to deny the late request for review was reasonable and did not breach procedural fairness.
Motion to quash judicial review granted; applicant failed to exhaust administrative remedies under Police Services Act.
The applicant filed a complaint regarding police conduct during encampment clearings.
After the Toronto Police Service investigated and substantiated only one minor allegation, the applicant sought judicial review of the investigation's adequacy.
The Toronto Police Service brought a motion to quash the application.
The Divisional Court granted the motion, finding that the application was bound to fail because the applicant had not exhausted the mandatory administrative review process under section 71 of the Police Services Act, which requires seeking a review by the OIPRD before applying for judicial review.
Application for catastrophic impairment designation and treatment plans dismissed; applicant failed to meet Criterion 8 threshold.
The applicant, a law student who was struck by a vehicle while riding a bicycle, sought a determination of catastrophic impairment under Criterion 8 (mental and behavioural disorders) and entitlement to various treatment plans.
The Tribunal found that the applicant did not meet the threshold for catastrophic impairment, as he did not demonstrate a marked impairment in three of four functional domains.
Despite accident-related challenges, the applicant successfully completed law school, passed the bar, and maintained employment as a lawyer.
The Tribunal also dismissed the claims for the disputed treatment plans, finding that the applicant failed to prove they were reasonable and necessary.
Reconsideration request dismissed; no errors of law or breaches of procedural fairness found.
The applicant requested a reconsideration of a Licence Appeal Tribunal decision that denied her claims for provider travel time, a higher hourly rate for psychological services, and an award under Regulation 664.
The applicant argued the Tribunal heard false evidence, erred in its interpretation of the Schedule regarding travel time, and erred in its findings on the hourly rate and the Regulation 664 award.
The Vice-Chair dismissed the request, finding no breach of procedural fairness, no error of law or fact, and no new evidence that would have affected the outcome.
Claims for unapproved treatment plans, unreasonable delay award, and costs dismissed.
The applicant sought payment for unapproved portions of chiropractic and psychological treatment plans, an award for unreasonable delay, and costs following a motor vehicle accident.
The Licence Appeal Tribunal found the applicant failed to prove the unapproved portions were reasonable and necessary.
Specifically, provider travel time was not payable, and the psychotherapist's hourly rate was appropriately reduced based on her credentials and experience.
The Tribunal also found no jurisdiction to order an award under Regulation 664 as no benefits were awarded, and the insurer's conduct did not meet the threshold for an award.
Both parties' claims for costs were dismissed as neither party's conduct was unreasonable, frivolous, vexatious, or in bad faith.
Physical therapy treatment plan approved due to complex pre-accident medical history; special award denied.
The applicant was injured in a 2011 motor vehicle accident and sought payment for a $2,362.00 physical therapy treatment plan, a special award, and interest.
The insurer denied the treatment plan based on an independent physiotherapy assessment concluding the applicant had reached maximum therapeutic benefit.
The arbitrator found the treatment plan was reasonable and necessary, noting the applicant's complex pre-accident medical history and chronic pain, which required a longer course of treatment.
The arbitrator relied on credible testimony from the applicant, his mother, and treating practitioners showing functional deterioration when treatment ceased.
The claim for a special award was dismissed as the insurer relied on an expert opinion and did not act imprudently or inflexibly.
Interest was awarded on the overdue benefits.
Motion to add defendants dismissed as statute-barred due to plaintiffs' failure to exercise reasonable diligence.
The plaintiffs brought a motion to add several parties, including Watts and Gayton, as defendants in an action arising from a fatal scalding incident in a retirement home bathtub.
Watts and Gayton opposed the motion, arguing the limitation period had expired and they would suffer non-compensable prejudice because the plumbing apparatus was no longer available for inspection.
The court found that the plaintiffs failed to exercise reasonable diligence to discover the identities of the proposed defendants within the limitation period, as they could have obtained this information by requiring timely delivery of the original defendants' statements of defence.
The motion to add Watts and Gayton was dismissed.
Application for accident benefits dismissed due to applicant's repeated failure to attend pre-hearing discussions.
The applicant sought statutory accident benefits following a motor vehicle accident.
After the applicant failed to attend multiple pre-hearing discussions, the insurer brought a motion to dismiss the proceeding under Rule 68 of the Dispute Resolution Practice Code.
The applicant's counsel argued that the applicant's non-attendance was due to a traumatic brain injury, addiction issues, and incarceration.
The arbitrator found that the applicant had been given sufficient notice and failed to respect the tribunal's jurisdiction.
The proceeding was dismissed, but no expenses were awarded to the insurer due to the applicant's health and social challenges.