Joshua Meshack

The applicant sought various medical and rehabilitation benefits following a 2020 motor vehicle accident.

The adjudicator found the applicant was not subject to the Minor Injury Guideline, as the insurer had previously removed her from it.

The applicant was awarded a chronic pain assessment based on her family doctor's records, and the balance of a mental health assessment due to a non-compliant denial notice by the insurer.

Claims for psychological, physiatry, and neurological assessments were dismissed, as was the claim for a special award under s. 10 of Regulation 664.

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

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

The Tribunal found the applicant failed to prove on a balance of probabilities that he suffered from chronic pain with functional impairment or a psychological condition warranting removal from the MIG.

Furthermore, the Tribunal held that the respondent's denial notices complied with s. 38(8) of the Schedule by adequately identifying the applicant's condition as minor and requesting necessary medical information.

The application was dismissed.

The applicant sought statutory accident benefits following a 2018 motor vehicle accident.

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

The applicant argued that a psychological condition removed him from the MIG and that the treatment plans were payable under s. 38 of the Schedule due to late and insufficient denials.

The Tribunal found that the applicant failed to provide sufficient medical evidence linking his psychological symptoms to the accident, keeping him within the MIG limits.

The Tribunal also found that the respondent's denial notices were timely and compliant with s. 38(8).

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

The applicant sought various statutory accident benefits, including treatment plans and attendant care benefits, following a motor vehicle accident.

At the start of the videoconference hearing, both parties requested to convert the proceeding to a written hearing as they were unprepared to proceed.

The adjudicator denied the request, noting the file's age and proper notice, and ordered a brief recess for preparation.

Following the recess, the parties advised that they had settled all issues in dispute, resulting in the closure of the Tribunal's file.

The applicant sought accident benefits following a motor vehicle accident.

The Tribunal found the applicant's injuries fell within the Minor Injury Guideline (MIG), as he failed to establish chronic pain with functional impairment or a psychological impairment.

The applicant was denied an income replacement benefit due to lack of evidence.

However, the Tribunal ordered the respondent to pay for two chiropractic treatment plans because its denial letters failed to provide specific medical reasons as required by section 38(8) of the Schedule.

Claims for other treatment plans and an award under Regulation 664 were dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, disputing the respondent's determination that his injuries fell within the Minor Injury Guideline (MIG) and the denial of several treatment plans for chiropractic services.

The Tribunal found that the applicant failed to provide submissions or evidence to warrant removal from the MIG.

Furthermore, the Tribunal determined that the respondent provided proper notice of denial for the disputed treatment plans under s. 38(8) of the Schedule, albeit some were late.

Because the applicant provided no evidence of incurred expenses during any period of non-compliance, the treatment plans were not payable, and claims for interest and an award were dismissed.

The applicant requested a reconsideration of a preliminary issue decision that found his application for accident benefits was statute-barred due to a failure to submit it within the timelines under section 32 of the Schedule without a reasonable explanation.

The applicant argued the Tribunal breached procedural fairness and misapplied the law, including the principles in Tomec and the Horvath factors.

The Tribunal dismissed the request, finding the applicant was attempting to re-litigate his position and had failed to provide a reasonable explanation for the delay in his original submissions.

The applicant was involved in a motor vehicle accident and subsequently assaulted.

He notified the insurer but failed to submit his application for accident benefits (OCF-1) within the 30-day time limit prescribed by section 32(5) of the Statutory Accident Benefits Schedule, submitting it approximately seven months late.

The Licence Appeal Tribunal held a preliminary issue hearing to determine if the application was statute-barred.

Applying the Horvath factors, the Tribunal found the applicant's explanations—limited English proficiency and ignorance of the claims process—were not reasonable explanations for the delay under section 34.

As the delay prejudiced the insurer's ability to conduct contemporaneous assessments, the Tribunal dismissed the application pursuant to section 55(1)1 of the Schedule.

The applicant sought statutory accident benefits for chiropractic treatment following a 2018 motor vehicle accident.

The respondent denied the treatment plan, arguing it was not reasonable and necessary and was related to a subsequent 2021 accident.

The Tribunal found that the applicant failed to prove the treatment was reasonable and necessary, noting a lack of contemporaneous medical evidence of ongoing impairment from the 2018 accident and relying on an insurer's examination which concluded the injuries had healed.

The application for benefits and interest was dismissed.

The applicant was involved in a motor vehicle accident and sought statutory accident benefits.

The respondent denied the benefits because the applicant failed to notify them of her intention to apply until 137 days after the accident, well beyond the seven-day limit under section 32(1) of the Schedule.

The Tribunal found that the applicant did not provide a credible or reasonable explanation for the delay under section 34, noting her lack of corroborating medical evidence for claimed latent injuries and her admission of knowing about the claims process from her sister.

The application was dismissed as statute-barred.

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

The Respondent denied claims for attendant care benefits, an accounting report, various treatment plans, and prescription cannabis.

The Tribunal found that the attendant care benefits were not incurred and the accounting report was not reasonably required.

The disputed treatment plans were found not reasonable and necessary, largely based on uncontroverted insurer's examination reports indicating the Applicant had reached maximum medical recovery or that further facility-based treatment was not supported.

The Respondent agreed to pay for one treatment plan and the incurred prescription cannabis expenses.

The claim for an award for unreasonable delay was dismissed.

The applicant sought statutory accident benefits after fracturing her hip in a fall on Bay Street.

She had just exited an Uber vehicle and was crossing the street to reach a GO Station.

The respondent denied benefits, arguing the incident was not an "accident" under s. 3(1) of the Statutory Accident Benefits Schedule.

The Tribunal applied the two-part Greenhalgh framework.

While the incident met the purpose test, it failed the causation test.

The Tribunal found that the dominant feature of the incident was the applicant slipping and falling on the street, and the operation of the Uber vehicle was merely ancillary.

The application was dismissed.