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Tribunal approves psychotherapy at psychologist rates and various assessments, but denies chronic pain program.
The applicant sought statutory accident benefits following a motor vehicle accident.
The Tribunal found the applicant entitled to outstanding amounts for psychological and psychotherapy services, accepting that a registered psychotherapist could reasonably bill at a rate comparable to a psychologist when providing structured cognitive behavioural therapy under clinical supervision.
The Tribunal also approved a chiropractic treatment plan and assessments for neurology and chronic pain, finding them reasonable and necessary based on ongoing symptoms.
However, a comprehensive chronic pain program was denied due to insufficient evidence of severity and functional decline.
The applicant's claim for a special award was dismissed.
Application for accident benefits dismissed; PRP injections and chronic pain program deemed not reasonable and necessary.
The applicant sought statutory accident benefits following a motor vehicle accident, specifically claiming entitlement to Platelet-Rich Plasma (PRP) injections and the outstanding balance of a chronic pain program.
The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to prove the treatments were reasonable and necessary.
The Tribunal accepted the respondent's medical evidence that the applicant sustained only soft tissue injuries and that PRP injections lacked sufficient clinical evidence for such injuries.
As no benefits were payable, claims for interest and a special award were also dismissed.
Application for catastrophic impairment and non-earner benefits dismissed due to extensive pre-existing psychological conditions.
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.
Insurer ordered to pay 50% special award for unreasonably splitting minor injury determination.
The applicant was injured in a motor vehicle accident and sought statutory accident benefits.
The respondent insurer split the determination of her injuries, subjecting her physical injuries to the Minor Injury Guideline (MIG) limits while accepting her psychological injuries were non-minor.
The applicant applied to the Licence Appeal Tribunal.
At the case conference, the respondent agreed to pay the disputed benefits.
The Tribunal held a written hearing to determine if the applicant was entitled to an award under section 10 of Regulation 664.
The Tribunal found the respondent's position to split the determination was contrary to settled law and constituted unreasonable withholding of benefits.
The applicant was awarded $3,194.41, representing 50% of the amounts withheld based on the split determination.
E-scooter is not an automobile; pedestrian struck by e-scooter denied statutory accident benefits.
The applicant, a pedestrian making a delivery for Uber Eats, was struck by an e-scooter and sought statutory accident benefits.
The respondent denied the claim on the basis that an e-scooter is not an 'automobile' and therefore the incident was not an 'accident' under s. 3(1) of the Schedule.
The Tribunal applied the Adams test and found that the applicant failed to provide sufficient evidence regarding the e-scooter's features to prove it was an automobile in ordinary parlance.
The application was dismissed.
Applicant entitled to chronic pain program and physiotherapy; claims for special award and costs dismissed.
The applicant, who was struck by a vehicle as a pedestrian at age 11, sought entitlement to a chronic pain management program and six physiotherapy treatment plans under the Statutory Accident Benefits Schedule.
The respondent insurer denied the benefits based on insurer's examinations.
The Tribunal found that the applicant met her burden of proving the treatment plans were reasonable and necessary, relying on the reports of her treating practitioners which documented ongoing pain and functional limitations.
The Tribunal ordered the respondent to pay the treatment plans and interest on overdue benefits.
The applicant's claims for a special award under s. 10 of Regulation 664 and for costs were dismissed.
Motion for further production order denied as duplicative; costs issue deferred to hearing.
The applicant brought a motion seeking a further production order for documents the respondent was previously ordered to produce in a Case Conference Report and Order.
The Tribunal denied the motion, finding that a further order would be duplicative and redundant, as the original order remained in force and non-compliance could be addressed by the hearing adjudicator.
The applicant's request for costs was added as an issue in dispute for the upcoming hearing.
The request for an adjournment was not considered as it was not properly filed using the required form.
Insurer's motion to bar application dismissed because notices of examination failed to comply with statutory requirements.
The respondent insurer brought a preliminary issue motion arguing that the applicant was barred from proceeding with her application for statutory accident benefits because she failed to attend scheduled insurer examinations.
The Tribunal reviewed the notices of examination provided by the insurer and found that they did not comply with the strict requirements of section 44(5) of the Statutory Accident Benefits Schedule, as they failed to adequately set out the medical reasons or the specific provisions of the Schedule relied upon.
Because the notices were deficient, the insurer could not rely on section 55 to bar the application.
The preliminary issue motion was dismissed.
Appeal dismissed; supply of medical assessment reports by non-hospital facility is not an exempt institutional health care service.
The appellant appealed GST/HST assessments for reporting periods between 2009 and 2012.
The appellant argued that its supply of independent medical assessment reports to insurance companies was an exempt supply of an 'institutional health care service' made by the operator of a 'health care facility'.
The Tax Court of Canada held that the appellant did not operate a health care facility because it did not provide medical or hospital care, and the individuals assessed were not patients of the facility.
The Court also upheld gross negligence penalties for the appellant's failure to charge and remit HST, finding the appellant was recklessly indifferent to its tax obligations.
Finally, the Court denied additional input tax credits due to a lack of prescribed supporting documentation.
The appeal was dismissed.
Appeal to set aside default judgment dismissed due to appellants' delay and evasion of service.
The appellants appealed an order dismissing their motion to set aside a default judgment in a slip and fall action.
The appellants claimed they only learned of the action when enforcement proceedings began, 12 years after the incident.
The Court of Appeal upheld the motion judge's finding that the appellants had evaded service, failed to act promptly, lacked a plausible explanation for their delay, and presented a defence of dubious merit.
Appeal allowed and Master's order setting aside registrar's dismissal reinstated due to required deference.
The plaintiff's action was dismissed for delay by the Registrar.
The Master set aside the dismissal, finding the delay was inadvertent and there was no actual prejudice to the defendants.
On appeal, the Superior Court judge reinstated the dismissal, finding the Master misapprehended the evidence and failed to consider the public interest in finality.
The Court of Appeal allowed the plaintiff's appeal and reinstated the Master's order, holding that the Master's discretionary decision was entitled to significant deference and his findings were reasonable.
Appeal allowed; administrative dismissal reinstated due to counsel’s negligence and prolonged litigation delay.
The defendants appealed a master's order setting aside an administrative dismissal of a personal injury action.
The motion judge found that the master misapprehended the evidence regarding the explanation for extensive litigation delay and improperly characterized counsel’s conduct as mere inadvertence.
The court held that the plaintiff’s counsel had effectively abandoned the file through poor organization, lack of supervision, and failure to monitor service of the statement of claim.
Applying the contextual approach from Scaini and the Reid factors, the court emphasized the public interest in finality of litigation.
The appeal was allowed and the administrative dismissal was reinstated.