Nicholas Maida

The applicant sought statutory accident benefits after being assaulted and robbed while walking in a park.

During the assault, the applicant fled to his parked vehicle for shelter.

The respondent denied benefits on the basis that the incident was not an 'accident' under the Statutory Accident Benefits Schedule.

The Tribunal found that the incident did not meet the purpose or causation tests, as walking to a parked vehicle is not the use or operation of an automobile, and the assault was the dominant feature causing the injuries.

The application was dismissed.

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

The matter was scheduled for a videoconference hearing, but neither the applicant nor their paralegal attended.

The Tribunal proceeded in their absence pursuant to section 7(1) of the Statutory Powers and Procedure Act.

As the applicant failed to present any evidence to satisfy their burden of proof, the application was dismissed.

The applicant sought various statutory accident benefits following a 2019 motor vehicle accident, including non-earner benefits, attendant care benefits, and several treatment plans.

The Licence Appeal Tribunal dismissed all claims.

The adjudicator found the applicant failed to prove a complete inability to carry on a normal life, relying on s. 44 assessments and the applicant's self-reports of resuming most pre-accident activities.

Claims for attendant care and treatment plans were denied for lack of evidence establishing they were reasonable and necessary.

The Tribunal also dismissed claims for an award and interest.

The applicant sought entitlement to statutory accident benefits for various treatment and assessment plans following a motor vehicle accident.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to prove the plans were reasonable and necessary.

The Tribunal preferred the evidence of the respondent's independent medical examiners, who found no substantial impairment and concluded the applicant had reached maximum medical improvement, over the applicant's medical evidence which lacked contemporaneous support.

The applicant sought statutory accident benefits following a motor vehicle accident, specifically claiming entitlement to four treatment plans for chiropractic services and a chronic pain assessment.

The Licence Appeal Tribunal found that the chiropractic treatment plans were not reasonable or necessary, relying on insurer's examinations that showed normal ranges of motion and no functional impairment.

However, the Tribunal found the chronic pain assessment was reasonable and necessary because the applicant met at least three criteria for chronic pain syndrome under the AMA Guides, including emerging cannabis use disorder, fear-avoidance of physical activity, and development of psychological sequelae.

The applicant was awarded the cost of the chronic pain assessment with interest.

The appellant appealed a Licence Appeal Tribunal decision that dismissed her application for statutory accident benefits due to her failure to provide a reasonable explanation for notifying the insurer outside the prescribed timelines.

The Divisional Court found that the Tribunal erred in law by failing to consider the appellant's argument that section 32(10) of the Statutory Accident Benefits Schedule provides the only consequence for late delivery of an application without a reasonable excuse, and by incorrectly concluding this was a new issue on reconsideration.

The appeal was allowed and the matter remitted to the Tribunal for a new hearing.

The applicant requested a reconsideration of a preliminary issue decision which found she had not provided a reasonable excuse for the delay in reporting her intent to seek accident benefits.

The applicant argued the Tribunal made an error of law regarding the application of sections 32, 34, and 55 of the Schedule.

The Tribunal dismissed the request, finding that the applicant was attempting to re-litigate the issue and raise new arguments not presented at the initial hearing.

The Tribunal affirmed its original application of the Schedule.

The applicant was involved in a motor vehicle accident and retained counsel shortly after, but failed to notify the insurer of her intention to apply for statutory accident benefits until nearly a year later.

The insurer denied the claim due to non-compliance with the time limits in section 32 of the Schedule.

The Licence Appeal Tribunal found that the applicant's reliance on her former lawyer did not constitute a reasonable explanation for the delay.

Consequently, pursuant to section 55(1)1 of the Schedule, the applicant was barred from proceeding with her claim, and the application was dismissed.