Michael Brill

The applicant sought judicial review of a Licence Appeal Tribunal decision that found she had not sustained a catastrophic impairment following a motor vehicle collision.

The applicant argued the Tribunal unreasonably rejected expert evidence that her accident-related sleep impairments resulted in a 9% whole person impairment rating.

The Divisional Court dismissed the application, finding the Tribunal reasonably concluded there was a lack of causal evidence linking the sleep impairment to the accident and that the Tribunal's reasons were justified, transparent, and intelligible.

The court approved the settlement of a motor vehicle accident claim involving a party under disability.

The plaintiff, represented by a litigation guardian, had settled both an accident benefits claim for $500,000 and a tort claim for $390,000.

The primary issue concerned the reasonableness of legal fees charged by plaintiff's counsel under a contingency fee agreement.

The court reduced the combined fees from $295,115 to $211,500, finding that a 35% contingency fee on the accident benefits claim was excessive and not in the best interests of the party under disability.

The court approved 15% of the accident benefits settlement as reasonable fees and directed that remaining funds be placed in a structured settlement.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that found she had not sustained a catastrophic impairment.

The applicant argued the Tribunal made errors of law and fact, including typographical errors regarding medical reports and errors in assessing a 9% whole person impairment rating for sleep impairment provided by a neurologist.

The Tribunal dismissed the request, finding that the typographical errors were inconsequential and would not have changed the result.

Furthermore, the Tribunal held it did not err in rejecting the sleep impairment rating, as the rejection was based on inconsistent reporting and a lack of causal evidence linking the impairment to the accident.

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

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

The applicant applied to the Licence Appeal Tribunal, arguing for removal from the MIG due to chronic pain and psychological impairments.

The Tribunal found that the applicant failed to meet the burden of proving chronic pain with a functional impairment under the AMA Guidelines, noting normal physical exams and lack of compelling evidence of functional decline.

The Tribunal also found insufficient evidence of a psychological condition, citing multiple assessments indicating symptom exaggeration and malingering.

The application was dismissed, and the applicant remained subject to the $3,500 MIG limit.

The applicant sought a determination that she sustained a catastrophic impairment as a result of a 2018 motor vehicle accident, along with entitlement to various treatment plans.

The Tribunal found the applicant did not meet the threshold for catastrophic impairment under either criterion 7 (whole person impairment) or criterion 8 (mental or behavioural impairment), rejecting the impairment ratings proposed by her assessors due to a lack of objective evidence and causal connection to the accident.

However, the Tribunal concluded that a $13,386.90 multidisciplinary chronic pain program was reasonable and necessary to address the applicant's ongoing pain-related complaints.

The claims for psychological services, a neuropsychology assessment, and transportation expenses were dismissed as the applicant failed to provide submissions or meet her evidentiary burden.

The applicant sought reconsideration of a decision denying entitlement to a neuropsychological assessment, multidisciplinary catastrophic impairment assessment, and SPECT scan.

The applicant argued procedural unfairness, errors of law and fact, and sought to introduce new evidence.

The Adjudicator dismissed the request, finding no procedural unfairness, no errors in weighing the medical and surveillance evidence, and that the applicant failed to explain why the new evidence could not have been obtained prior to the hearing.

The applicant was involved in a motor vehicle accident and sought statutory accident benefits, claiming she sustained a catastrophic impairment due to a mental or behavioural disorder.

The Tribunal applied the Pastore test and found that the applicant suffered from class 4 (marked) impairments in activities of daily living, social functioning, and adaptation, meeting the threshold for catastrophic impairment.

The Tribunal also awarded $4,077.72 in attendant care benefits with interest, but dismissed the claim for a special award under s. 10 of Regulation 664, finding the insurer did not unreasonably withhold payments.

The applicant was injured in a motor vehicle accident and sought various statutory accident benefits, including treatment plans for occupational therapy, a chronic pain program, and assessments for neuropsychological, chronic pain, functional cognitive, and catastrophic impairment, as well as a SPECT scan.

The insurer denied the claims.

The Licence Appeal Tribunal dismissed the application in its entirety, finding that the applicant failed to demonstrate on a balance of probabilities that the proposed plans were reasonable and necessary.

The Tribunal relied on insurer examination reports and surveillance evidence showing the applicant engaging in normal activities, which contradicted the applicant's self-reported functional limitations and the opinions of his assessors.

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

The respondent argued the applicant was barred from proceeding under section 55(1) of the Statutory Accident Benefits Schedule because he failed to submit a completed disability certificate (OCF-3) for the subject accident.

The Tribunal found that the applicant's initial OCF-3 was unclear as it contained information relating to a previous accident, and the applicant subsequently withdrew it without submitting a new one for the subject accident.

As the applicant failed to submit a completed OCF-3, he was barred from proceeding with his application for an income replacement benefit.

The applicant was involved in a motor vehicle accident and sought statutory accident benefits, including a determination of catastrophic impairment.

The central issue was whether the accident caused the rapid progression of the applicant's pre-existing peripheral arterial disease, which ultimately required an above-the-knee amputation.

The Tribunal applied the 'but for' test and found that the applicant's accident-related lack of mobility was a necessary cause of the disease's progression and the resulting amputation, thereby meeting the criteria for catastrophic impairment.

The Tribunal also awarded non-earner benefits, partial attendant care benefits, costs for chiropractic treatment and catastrophic impairment assessments, and interest on overdue payments, while dismissing a claim for a home exercise program.

The applicant sought accident benefits following a 2017 motor vehicle accident, claiming catastrophic impairment due to mental and behavioural disorders, non-earner benefits, and various treatment plans.

The Tribunal found that the applicant had significant pre-existing conditions from a 2009 workplace injury and failed to prove on a balance of probabilities that the motor vehicle accident was a necessary cause of his psychological impairments.

Consequently, the catastrophic impairment claim and non-earner benefits were denied.

However, the Tribunal approved treatment plans for a chronic pain program, an attendant care assessment, and a driving reintegration assessment, finding them reasonable and necessary to address exacerbations of physical pain and new driving anxiety caused by the accident.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including attendant care benefits and physiotherapy treatment plans, which the respondent insurer denied.

The respondent raised a preliminary issue that the applicant's disputes were statute-barred by the two-year limitation period under s. 56 of the Schedule.

The Tribunal found that the attendant care benefit dispute was commenced within the limitation period because the initial denial was not clear and unequivocal.

For the $3,500.10 physiotherapy treatment plan, the Tribunal found the dispute was filed 45 business days late but granted an extension of time under s. 7 of the LAT Act, finding no prejudice to the respondent and some merit to the claim.

On the merits, the Tribunal found the $3,500.10 physiotherapy treatment plan was reasonable and necessary, but dismissed the claims for the $1,540.10 treatment plan and the remaining attendant care benefits for lack of evidence.

The applicant was injured in a motor vehicle accident and sought income replacement benefits.

The insurer denied the benefits on November 8, 2016.

The applicant filed an application to dispute the denial on May 29, 2019, beyond the two-year limitation period.

The applicant argued that a subsequent letter from the insurer on July 28, 2017, which provided an accounting report and payment for past benefits, restarted the limitation period.

The Tribunal found that the November 2016 letter was a clear and unequivocal denial that started the limitation clock, and the July 2017 letter did not alter this denial.

The Tribunal also declined to extend the limitation period under section 7 of the Licence Appeal Tribunal Act, finding no bona fide intention to appeal within the time limit and a significant delay of six months.

The applicant was barred from proceeding with the claim.

The applicant sought payment for two physiotherapy treatment plans and an award for unreasonable delay following a motor vehicle accident.

The Licence Appeal Tribunal found that the first treatment plan for $3,609.60 had already been paid in full by the insurer.

For the second treatment plan of $425.73, the Tribunal held it would be payable once the applicant submitted an invoice, which had not yet occurred.

The claim for an award under section 10 of Regulation 664 was dismissed as there was no evidence the insurer unreasonably withheld or delayed payment.

The applicant filed a Request for Reconsideration of a Tribunal decision that denied her entitlement to non-earner benefits (NEBs), medical benefits, and interest following a motor vehicle accident.

The applicant argued the Tribunal erred in law by failing to properly apply the legal test for NEBs and erred in fact by failing to properly consider medical evidence.

The Vice Chair found that the Tribunal correctly applied the test for NEBs as set out in the Schedule and the principles from Heath and Galdamez.

The Vice Chair also found no error in the Tribunal's weighing of the medical evidence.

The Request for Reconsideration was dismissed.

The respondent insurer requested a reconsideration of a Tribunal decision that removed the applicant from the Minor Injury Guideline (MIG) due to spinal injuries and a chronic pain disorder.

The insurer argued the Tribunal erred in fact by finding a diagnosis of chronic pain syndrome and erred in law regarding the definition of minor injury and causation.

The Vice Chair found that while the Tribunal technically erred in stating there was a specific diagnosis of chronic pain syndrome, the error was not significant enough to alter the decision, as the removal from the MIG was primarily based on objective evidence of spinal injuries.

The Tribunal also made no errors in law regarding the definition of minor injury or causation.

The request for reconsideration was dismissed.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits beyond the $3,500 Minor Injury Guideline (MIG) limit.

The respondent denied the benefits, arguing the injuries were minor.

The Tribunal found that the applicant's injuries, which included disc bulges, central canal stenosis, and chronic pain syndrome, were not minor and removed him from the MIG.

The Tribunal approved the chronic pain assessment, chronic pain treatment program, and psychological assessment as reasonable and necessary, but denied the orthopaedic assessment.

The applicant was also awarded interest on the overdue benefits.