Mikolaj T. Grodzki

The applicant requested a reconsideration of a Tribunal decision that dismissed her second application for a catastrophic impairment determination on the basis of res judicata.

The applicant argued the Tribunal breached procedural fairness by failing to address her arguments regarding the insurer's statutory obligations under Roy and the fairness exception to res judicata under CUPE.

The Adjudicator granted the reconsideration, finding that the original decision lacked adequate reasons on these central arguments, constituting a material breach of procedural fairness.

The original decision was cancelled and a written rehearing before a different adjudicator was ordered.

The applicant sought a determination that she sustained a catastrophic impairment (Criterion 8) following a motor vehicle accident.

The respondent argued the application was barred by res judicata, as the Tribunal had previously dismissed an identical claim by the applicant.

The applicant contended that res judicata should be waived based on fresh evidence, including updated medical and occupational therapy reports, and an ODSP approval.

The Tribunal found that the three preconditions for res judicata were met and that the new reports did not constitute fresh evidence that would conclusively impeach the prior decision.

The application was dismissed.

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

The applicant argued the adjudicator breached procedural fairness by demonstrating a reasonable apprehension of bias against her psychiatric assessor and by failing to consider all expert reports.

She also alleged errors of law and fact regarding the assessment of her pain and adaptation to work-like settings under the AMA Guides.

The Vice-Chair dismissed the request, finding no evidence of bias, noting the adjudicator properly weighed the evidence, and concluding there were no errors in the application of the catastrophic impairment criteria.

The applicant sought a determination of catastrophic impairment following a motor vehicle accident, claiming a class 5 extreme mental and behavioural impairment.

The applicant moved to exclude the respondent's insurer's examination report by a psychologist, which the Tribunal denied, finding that the restrictions in section 45(2) of the Schedule apply to insured persons, not insurers.

On the merits, the Tribunal found the applicant did not sustain a catastrophic impairment, giving no weight to her psychiatric expert's report due to methodological deficiencies, lack of an occupational therapy assessment, and over-reliance on the applicant's inconsistent self-reporting.

The application for benefits and an award was dismissed.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that denied her entitlement to an income replacement benefit.

She argued the Tribunal breached procedural fairness by allowing the respondent's late motion to strike her reply evidence, made errors of fact regarding her pre-accident employment, and sought to introduce new adjuster log notes.

The adjudicator dismissed the request, finding no breach of procedural fairness as the applicant had ample opportunity to respond to the motion.

The adjudicator also found no errors of fact based on the admitted evidence and declined to admit the new log notes because the applicant failed to demonstrate they could not have been obtained previously.

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

The respondent brought a motion to strike new evidence introduced in the applicant's reply submissions, which the Tribunal granted, finding the late introduction prejudicial.

On the merits, the Tribunal dismissed the application for IRBs, finding the applicant failed to prove she was employed at the time of the accident or establish the essential tasks of her alleged employment.

The Tribunal also found insufficient evidence to support a complete inability to work post-104 weeks.

The claims for interest and a special award were dismissed.

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

The applicant argued the adjudicator committed a material breach of procedural fairness by failing to qualify her expert as a chronic pain expert, placing little weight on uncontested reports, and incorrectly interpreting the AMA Guides.

The applicant also alleged errors of law regarding the consideration of pain-based limitations and the application of the multidisciplinary approach.

The adjudicator dismissed the request, finding no breach of procedural fairness or errors of law, noting that the original decision properly weighed the evidence and correctly applied the relevant legal principles.

The moving parties brought a motion for leave to appeal the decision of J.S. Richard J. dated April 5, 2024.

The Divisional Court dismissed the motion for leave to appeal without costs.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that found her application for non-earner benefits was statute-barred by the two-year limitation period.

The applicant argued the Tribunal breached procedural fairness, acted outside its jurisdiction, and made errors of law and fact, including misinterpreting the Schedule and substituting its own medical opinion.

The Vice-Chair dismissed the request, finding the applicant was attempting to re-litigate the case and failed to meet the strict criteria for reconsideration under Rule 18.2.

The applicant sought a determination that she sustained a catastrophic impairment under Criterion 8 (mental and behavioural disorders) following a 2012 motor vehicle accident.

The Tribunal first dismissed the applicant's preliminary motion for summary judgment, finding no jurisdiction to dispose of substantive issues without a hearing.

On the merits, the Tribunal preferred the evidence of the respondent's psychiatric expert over the applicant's expert, finding that the applicant's functional impairments were primarily caused by physical chronic pain rather than an accident-related mental or behavioural disorder.

The Tribunal concluded the applicant did not suffer a marked or extreme impairment in any of the four areas of functioning.

The application was dismissed, and the applicant was ordered to pay $250 in costs for unreasonable delays in producing disclosures.

The plaintiff sued two physicians for medical malpractice, alleging they negligently failed to diagnose and treat him for Lyme disease following a suspected tick bite in April 2010.

The emergency room physician diagnosed cellulitis and prescribed antibiotics, while the family physician later treated the plaintiff for various ongoing symptoms but did not diagnose Lyme disease.

The court found that neither physician breached the standard of care.

Furthermore, the court concluded the plaintiff failed to prove on a balance of probabilities that he was bitten by a tick or that he actually contracted Lyme disease.

The action was dismissed.

The plaintiffs in the main action brought a motion to strike a jury notice in consolidated motor vehicle accident trials, arguing that the estimated 8-10 week trial duration could not be accommodated within the court's allotted 6-week jury trial period due to limited judicial resources and pandemic-related backlogs.

The defendants opposed, asserting the motion was premature.

The court granted leave to bring the motion, finding the delay justified by the pandemic's impact and judicial resource constraints.

The motion to strike the jury notice was granted, converting the main action to a judge-alone trial, emphasizing the necessity of ensuring timely justice given the case's age and the unlikelihood of completing a jury trial within the available time.

The applicant sought a medical benefit of $3,405.00 for 75 chiropractic sessions following a motor vehicle accident.

The respondent denied the treatment plan based on an insurer's examination by a physiatrist.

The Tribunal found the applicant failed to prove the treatment was reasonable and necessary, noting the lack of medical evidence explaining the need for the specific treatment and the applicant's own reports of only temporary relief.

The Tribunal also rejected the applicant's argument that an allegedly deficient denial notice under s. 38(14) of the Schedule triggered a mandatory payment obligation under s. 38(11).

The application for benefits, interest, and an award was dismissed.

The applicant sought a non-earner benefit following a 2011 motor vehicle accident.

The respondent denied the benefit in November 2013 based on an updated disability certificate completed by the applicant's treating occupational therapist, which indicated she no longer suffered a complete inability to carry on a normal life.

The applicant applied to the Tribunal in 2022, arguing the 2013 denial was invalid for failing to provide medical reasons under section 37(4) of the Schedule.

Applying Varriano, the Tribunal held the denial was valid as it relied on a non-medical ground (the disability certificate), triggering the two-year limitation period.

The application was dismissed as statute-barred.

The applicant requested a reconsideration of a decision finding she was not catastrophically impaired under Criterion 8 of the Schedule.

The applicant argued the adjudicator erred in law and fact by misapplying the Schedule, rejecting expert psychiatric opinions, misapplying the causation test, and ignoring evidence of deterioration.

The Tribunal dismissed the request, finding no errors of law or fact that would have changed the outcome.

The adjudicator noted that assigning weight to evidence and preferring certain evidence over expert opinions falls within the adjudicator's role and does not constitute an error of law.

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

The respondent insurer failed to pay the benefit, provide a notice of medical or other reasons for denial, or request further information directly from the applicant within 10 days of receiving the disability certificate, as required by s. 36(4) of the Statutory Accident Benefits Schedule.

The Licence Appeal Tribunal held that the respondent's failure to comply with s. 36(4) triggered s. 36(6), obligating the respondent to pay the IRB from the date the application was received until proper notice is given.

The applicant's claim for an award for unreasonable delay was dismissed due to a failure to disclose particulars.

The applicant sought an income replacement benefit following a motor vehicle accident, which the respondent insurer denied.

The respondent raised a preliminary issue arguing the applicant was statute-barred for failing to dispute the denial within the two-year limitation period.

The Tribunal found that the insurer's Explanation of Benefits was defective because it failed to provide clear medical reasons for the denial, as required by the principles in Smith v. Co-operators.

Consequently, the defective notice did not trigger the limitation period, and the applicant was permitted to proceed with her application.

The applicant sought a determination that she sustained a catastrophic impairment (CAT) under Criterion 8 of the Statutory Accident Benefits Schedule following a motor vehicle accident.

The respondent argued the application was barred by res judicata and abuse of process due to a prior Tribunal decision denying post-104-week income replacement benefits.

The Tribunal rejected the preliminary objections, finding the applicant relied on new medical evidence.

On the merits, the Tribunal found the applicant's impairments, including her psychological and chronic pain conditions, largely pre-dated the accident.

The Tribunal rejected the applicant's expert evidence as flawed and concluded she did not suffer a marked impairment in three of four domains of function.

The application was dismissed.

The applicant requested a reconsideration of a motion order that denied her request to extend the time to file a reconsideration of an earlier decision and struck portions of her reply submissions.

The Tribunal dismissed the request, finding that the motion order did not finally dispose of the appeal, making it ineligible for reconsideration under Rule 18.1.

Furthermore, the Tribunal found no error of law or fact in striking the improper reply submissions or in denying the extension of time.

The applicant was injured in a motor vehicle accident and deemed catastrophically impaired.

She sought attendant care benefits, which the respondent denied.

The Tribunal found that while the applicant required some attendant care services for feeding and hygiene, she was not entitled to payment because she failed to prove that the services were 'incurred' under s. 3(7) of the Schedule, as there was no evidence of economic loss by her husband or mother who provided the care.

The Tribunal also dismissed the applicant's claim for an award under s. 10 of Regulation 664, finding no evidence that the respondent unreasonably withheld or delayed benefits.

The application was dismissed.