Financial Services Commission des

Commission services financiers

of Ontario de l’Ontario

Neutral Citation: 2015 ONFSCDRS 267

FSCO A14-003818

BETWEEN:

QIN NIKKI CHEN

Applicant

and

TD GENERAL INSURANCE COMPANY

Insurer

REASONS FOR DECISION

Before:

Arbitrator Lynda Tanaka

Heard:

In person at ADR Chambers on August 10, 11, 12 and 13, 2015 and by written submissions due October 19, 2015

Appearances:

Ms. Tania Shaheen participated for Ms. Qin Nikki Chen

Mr. J. Jason Kerr and Mr. Rabjeet Wallia participated for TD General Insurance Company

Issues:

The Applicant, Ms. Qin Nikki Chen, has claimed statutory accident benefits from TD General Insurance Company (“TD”) arising from an automobile accident on April 2, 2012 in which the automobile in which she was a passenger was struck by another automobile. She suffered injuries and applied for and received benefits under the Schedule.¹ The parties were unable to resolve their disputes through mediation, and Ms. Qin Nikki Chen applied for arbitration at the Financial Services Commission of Ontario under the Insurance Act, R.S.O. 1990, c.I.8, as amended (“the Insurance Act”).

The evidence was heard over four days and, instead of oral closing submissions, the parties filed written submissions including a book of authorities submitted by TD. The closing submissions included the transcript of the evidence of two doctors called by TD to testify as to their assessments of the Applicant’s injuries.

The issues in this Hearing are:

1. Is the Applicant entitled to medical benefits claimed in a) a treatment plan, dated April 12, 2012, by Mon Sheong Court Physio & Rehab Centre (“Mon Sheong”) (Dr. Peter Counti) outstanding totaling $1,518.98, and b) a treatment plan, dated June 18, 2012, by Mon Sheong (physiotherapist Elli Luy) outstanding totalling $690.84?

2. Is the Applicant entitled to costs of examination benefits for a) a treatment plan, dated May 29, 2012, by Dr. Andrew Shaul totalling $1,979.36, and b) a Disability Certificate, dated July 27, 2013, by Mon Sheong (chiropractor Dr. Georgia Palantzas) totaling $200.00?

3. Is the Applicant entitled to interest on overdue payment in accordance with the Schedule? It was previously agreed on consent by both parties that interest on any benefit ruling at Arbitration would be calculated only up until March 1, 2015.

4. Is TD liable to pay the Applicant her expenses in respect of this Arbitration?

5. Is the Applicant liable to pay TD its expenses in respect of this Arbitration?

Result:

1. The Applicant is not entitled to the medical benefits claimed in a) a treatment plan, dated April 12, 2012, by Mon Sheong Court Physio & Rehab Centre (“Mon Sheong”) (Dr. Peter Counti) outstanding totaling $1,518.98, and b) a treatment plan, dated June 18, 201, by Mon Sheong (physiotherapist Elli Luy) outstanding totalling $690.84.

2. The Applicant is not entitled to costs of examination benefits for a) a treatment plan, dated May 29, 2012, by Dr. Andrew Shaul totalling $1,979.36, and b) a Disability Certificate, dated July 27, 2013, by Mon Sheong (chiropractor Dr. Georgia Palantzas) totaling $200.00.

3. The Applicant is not entitled to interest as there are no benefit rulings in her favour.

4. In the event that the parties are unable to agree on the matter of expenses, any party claiming expenses shall provide its submissions to me within 30 days of release of this decision. The responding party shall provide its response within 20 days of receipt of the expense claim submissions. Reply material shall be provided within 10 days of receipt of the response.

EVIDENCE AND ANALYSIS:

The Applicant disputes the partial denial of two treatment plans by TD which would have provided her with additional physiotherapy treatment as well as a psychological assessment to determine if she required psychological treatment as a result of the automobile accident. TD denied the treatment plans and assessment on the basis that she had already received $3,500.00 in treatment and her injuries were predominantly minor in nature as described by the Minor Injury Guideline (“the MIG”). TD also denied payment of a Disability Certificate issued some fifteen months after the accident on the same grounds.

The Applicant was 22 years old at the time of the accident. She is petite, unmarried with no children, and has almost two years of university education. She immigrated from China in 2005 and her facility in English, while sufficient for her to gain entrance to university, required that she be assisted by an interpreter for her evidence. Because of her inability to take another day from her current employment in the fast food service industry, her evidence was taken on the first day of the Hearing and she was unable to attend the Hearing after that. She lives with her extended family including her sister’s small children. During her evidence, she appeared to be struggling to remain attentive. She had to be prompted from time to time by the interpreter to respond to a question as the day wore on. No request for an adjournment or other accommodation for her was made.

The accident description is recorded in various places including the assessment reports prepared following the Insurer Examinations that will be discussed later in this decision. In summary, the accident occurred on Highway 407 when the Applicant and members of her family were going to Pearson Airport at about 8:00 p.m. on April 4, 2012. They were travelling at or over 80 km/h when another automobile hit their automobile from the right side, pushing their automobile sideways to the left and off balance so it “tilted on wheels before coming to rest”.² She testified that she was sitting in the rear passenger seat behind the driver, wearing her seatbelt. The description of the accident is recorded in the assessment reports from the Insurer Examinations. It is noted there that the air bags did not deploy and the estimated value of the damage to the vehicle, a Toyota Corolla, was less than $10,000.00.

She testified that immediately after the accident, she felt a cramp in her stomach and nausea. There is some dispute as to whether or not she complained at the time of the accident about pain in her neck and back, or if those pain sites arose in the next two days. She did not need to go to the hospital, either on her own later or by ambulance after the accident. She testified at the Hearing that she was not dying or bleeding so she did not need an ambulance.

She testified that her sister convinced her to go for treatment about two weeks after the accident, and she also retained a lawyer. She received chiropractic and physiotherapy treatment two or three times a week and it was helpful. After the treatment stopped, she had pain here and there and she described in her evidence that her bones would dislocate. She still has limitations in that she still feels pain and she cannot carry heavy loads.

The Applicant testified that she had been a student at the University of Toronto registered in Economics and Statistics until January 2012, the middle of her second year. She did “okay” in her first year but did not pass her second year. She has had considerable conflict with her mother who wants her to go to university while she wants to become a hair stylist.

After the accident, she was unable to hold or lift and carry her sister’s children and she said that this caused a big problem. She testified to ongoing pain and anxiety, her fear of driving, and her irritability. She tried to return to her university program following the accident but withdrew because she could not do the work – she had difficulty concentrating, little energy, sensitivity to loud noises, and pain sitting in class. She says that, since the accident, her memory is poor and the school environment is too noisy. She told Dr. Nikolaos Harmantas in August 2012 (4 months after the accident) that she had pain in her neck and shoulder and that she had headaches. She testified that she went to the psychologist because she was not sleeping well and she was bothered by loud sounds; in her testimony she referred to examples like the sound of metal coming together as bothersome. She is not sure what the benefit would be of the psychological treatment because the major issue is sleeping. She has gone to her family doctor over the sleeping issues and he has tried to address her concerns, albeit not to her satisfaction. There is some suggestion that she may return to her university program eventually.

Dr. Peter Counti, a chiropractor at Mon Sheong, completed a treatment plan, dated April 12, 2012,³ which proposed 16 treatment sessions. Exhibit 13, which proposed $3,718.98 for treatment, was partially approved for $2,200.00 and the Applicant underwent the treatment. The outstanding amount of $1,518.98 is what is in dispute in this Arbitration.

In Exhibit 13, Dr. Counti noted the injury and sequelae directly resulting from the accident as strains and sprains of the shoulder joint and region, wrist, ribs and sternum, lumbar spine, and sacroiliac joint, injury to the muscles and tendon at neck level, tension-type headache, vertigo of central origin, malaise and fatigue, inappropriate diet and eating habits, other effects of heat and light, insomnias, and unspecified anxiety disorder. The treatment plan proposed the goal of pain reduction, increase in strength, increased range of motion and promotion of tissue repair/remodelling.

Dr. Counti also noted under “Additional Comments” as follows:

Based on evidence of more severe accident mechanism and subsequent injury, as well as accompanying psychosocial issues and decreased ADL capacity, Ms. Chen’s condition is not presently considered to be minor. More involved multi-disciplinary treatment outside a minor injury framework (according to appropriate biopsychosocial models) is recommended in order to avoid chronicity.⁴

He noted the barriers to her recovery as the severity of the collision (high force side impact), insufficient capacity for physically demanding ADLs and psychological issues.

In its response, dated May 2, 2012, and included in Exhibit 13, TD waived the completion of a Treatment Confirmation Form and agreed to make payments within the MIG on the assumption that the impairment was a minor injury. TD requested submission of an application for accident benefits which the Applicant did on May 1, 2012.⁵

A treatment plan, dated June 18, 2012, was submitted for the Applicant’s treatment by one Elli Luy, a physiotherapist at Mon Sheong.⁶ The treatment plan proposed $2,070.00 in twelve physiotherapy sessions. This treatment plan also was partially approved, this time to a total of $1,300.00 and the Applicant underwent this treatment. The goals included pain reduction, increase in strength, increased range of motion and promotion of complete tissue repair/remodelling. The treatment plan notes its goal of the Applicant returning to pre-accident school activities. This treatment plan identified the same barriers to the Applicant’s recovery and also identified psychosocial issues, as was done in Exhibit 13, the treatment plan completed by Dr. Counti.

Neither Dr. Counti nor Ms. Luy identified any disease, condition or injury that could affect the Applicant’s response to treatment for the injuries identified.

In denying the balance of the treatment plan, dated June 18, 2012, TD explained in its letter of June 28, 2012⁷ to the Applicant that the injuries described appeared predominately minor in nature and that, on the completion of the April 12, 2012 treatment plan approved for Dr. Counti, there was only $1,300.00 left in the cap for medical and rehabilitation benefits payable under s. 18(1) of the Schedule. The letter noted the Applicant’s failure to attend an Insurer Examination which had been scheduled for May 16, 2012 to determine if the injuries were minor. TD indicated it would have the Insurer Examination rescheduled and would reconsider its position on receipt of a report under that examination or submission of objective medical documentation indicating the injuries were not minor.

Dr. Georgia Palantza is a chiropractor also with Mon Sheong. She testified concerning the Disability Certificate that she signed July 27, 2013, some 15 months after the accident. She also noted the injury and sequelae directly resulting from the accident as strains and sprains but provided more detail as to which shoulder and which wrist were injured, and gave clearer information on the diet issue. She described the effects of heat and light as “light sensitivity” and she added “unspecified disorder of psychological development” to the list. She was clear that she did not have the qualifications to diagnose psychological disorder but she was obligated to include what the Applicant reported to her as the injuries and sequelae that were the direct result of the accident. Unlike Dr. Counti, she notes that the Applicant had a substantial inability to perform her housekeeping and home maintenance services even though her examination occurred over a year after the accident and Dr. Counti had not made such a note. Dr. Palantzas also noted no disease, condition or injury that affected her ability to perform housekeeping, attending school, etc.

The Applicant acknowledged that she was better after the physiotherapy treatment that she did obtain, at least 50% according to what she told Dr. Harmantas in August 2012.⁸

A treatment and assessment plan for a psychological assessment was submitted by Dr. Andrew Shaul, Psychologist, on May 29, 2012. The injury and sequelae identified as the direct result of the accident were described as “Mixed anxiety and depressive disorder”. Dr. Shaul indicated as unknown whether, prior to the accident, the Applicant had any disease, condition or injury that could affect her response to the treatment for this injury. The treatment plan goals were pain reduction and “reduce depression, anxiety, disturbed sleep; via CBT treatment”.⁹ Dr. Shaul proposed a mental health assessment and documentation at a cost of $1,929.20. Additional comments were provided in this treatment plan as a report of a “pre-screening interview conducted under the supervision of Dr. Shaul”, by an unidentified person described in the Additional Comments as:

an experiences (sic) Master?s (sic) Level Mandarin-speaking associate of the Andrew Shaul Psychology Professional Corporation.¹⁰

Dr. Shaul submitted a treatment plan for mental health counselling on September 20, 2013 in the amount of $2,919.04. The goals of the treatment plan were “pain reduction, increase in strength and increase pain and tress (sic) management skills. Address anxiety”.¹¹ This treatment plan is not the subject of this Arbitration but was referred to in the assessments done by other witnesses.

TD denied approval of this plan on the basis that the impairment only entitled the Applicant to receive services under the MIG. It requested that the Applicant attend assessments by Dr. Irina Safir and Dr. Gerry Dancyger to determine if the impairment came within the MIG.

Dr. Counti and Dr. Shaul did not testify to provide evidence in support of the treatment plans which they had proposed. Neither did Ms. Luy, nor the unidentified individual who did the screening interview referred to above.

The Insurer Examinations originally scheduled for May 2012 were rescheduled and the Applicant was assessed by Dr. Nikolaos Harmantas, M.D., C.C.F.P., D.O.H.S, on August 17, 2012¹² and Dr. Gerry Dancyger, psychologist, on August 10, 2012.¹³ Dr. Dancyger reassessed the Applicant on April 7, 2014¹⁴ and Dr. Irina Safir conducted a medical examination on April 2, 2014.¹⁵ The physical assessments were conducted to determine if the Applicant sustained a “minor injury” under the Schedule. In the case of Dr. Safir’s assessment, she described in her report that the purpose was also to determine if the proposed treatment plan or mental health counselling, submitted by Dr. Andrew Shaul on September 20, 2013, was reasonable and necessary.¹⁶ Dr. Safir stated in her report that she was confining herself to the physical components of the proposed treatment plan and that the issues of a mental health nature were to be dealt with by Dr. Dancyger.¹⁷

Both Dr. Harmantas and Dr. Dancyger indicated on the first page of their reports, Exhibit 8 (“Harmantas Report”) and Exhibit 5 (“Dancyger Report 1”) that the reason for the assessment was an OCF-18 by Dr. Andrew Shaul. Dr. Harmantas was clear that he was not a psychologist or qualified to make diagnoses that Dr. Shaul was qualified to make. He described the purpose of the assessment as being to determine “if the claimant’s impairment fall (sic) within the definition of a predominantly minor injury…or is there compelling evidence of a pre-existing condition that would prevent the claimant from achieving maximal recovery from the [MIG]”.¹⁸

Dr. Harmantas and Dr. Safir concluded that the physical injuries suffered by the Applicant fall within the MIG. Both reported that the Applicant exaggerated her injuries and Dr. Dancyger concluded in 2012 that none of the psychological issues reported in the OCF-18 submitted by Dr. Shaul¹⁹ were supported by the testing he did.

Dr. Dancyger concluded in his 2012 assessment that from a psychological perspective there was no objective evidence to suggest that the Applicant had suffered any injury as a direct result of the accident. In his 2014 report,²⁰ Dr. Dancyger concluded that an OCF-18 submitted by Dr. Shaul, dated September 20, 2013, was not reasonable and necessary as a result of the subject accident and that:

From a psychological perspective there is no valid or objective evidence to suggest that [the Applicant] reaches criterion for any DSM-5 diagnosis as a result of the April 2, 2012 motor vehicle accident.²¹

Dr. Dancyger could not discern how many of the symptoms that the Applicant complained of were the result of the Applicant’s personal family and academic issues versus the motor vehicle accident. He testified that he believed the Applicant was not forthright in her answers on his tests and therefore “it makes it very grey”.²² The validity measures in the psychological tests conducted by Dr. Dancyger satisfied him that the answers the Applicant gave indicated that she did not attend consistently or appropriately to the test item content. He suggested that such results could be due to carelessness, reading difficulties, confusion or not following the test instructions or, finally, that the subject was trying to manage the impression.²³ Her answers on the test for perception of pain produced a profile that was very dramatic and highly unusual, indicating that the responses were random or magnifying the symptoms.²⁴ On one of the tests conducted in 2014, she did very poorly compared to test results usually obtained testing people with dementia.²⁵

The onus is on the Applicant to prove that her injuries and impairments were the result of the automobile accident.

The Applicant says she is entitled to an award of the treatment plans which will provide her with treatment beyond the MIG cap because, in her words, you don’t stop halfway through. Her case rests on the identification of psychological issues by her chiropractors and Dr. Shaul, who is a psychologist who wishes to do an assessment. Her response to the assessments by Dr. Harmantas and Dr. Safir is that they are not psychologists and do not purport to be able to assess the psychological issues.

The Applicant says that Dr. Dancyger’s assessment cannot be relied on to reject the claim. She told him a lot more about her medical history and complaints than is noted in his assessments.

The Applicant relies on the evidence of Dr. Palantzas, another chiropractor who is not qualified to assess psychological impairments, that the impairment suffered is not predominantly a minor injury. Dr. Palantzas stated that premature termination of treatment can deter the patient’s progress and cause re-aggravation of injuries.

TD says that the Applicant is not entitled to the treatment plans award because of the conclusions reached by both Dr. Harmantas and Dr. Safir that the injuries were minor and they identified voluntary inhibition of effort and symptom amplification; that is, the Applicant was exaggerating her pain and limitations of movement. Dr. Dancyger’s tests provided no objective evidence to support the Applicant’s claims of impairment and no other psychologist was called to testify. Neither Dr. Counti nor Dr. Shaul were available to be cross-examined on the contents of their treatment plans.

TD also points out that the application for accident benefits²⁶ was not signed until May 1, 2012, almost a month after the accident. The Applicant did not go to see her family doctor for the first time after the accident until December 24, 2012,²⁷ and he notes that she is “better now”. She did not seek treatment on her own, but only when her sister pushed her into it and also once she had retained a lawyer. She allegedly lied on her application for accident benefits, saying that she was attending school and had been able to return to school after the accident, even though she had dropped out of school the previous January.

The MIG is a guideline issued pursuant to s. 268.3 of the Insurance Act. This section provides that a guideline shall be considered in any determination involving the interpretation of the Schedule. The Applicant’s position is that the MIG cannot be considered in this Arbitration as the issue of whether or not the Applicant’s injuries were predominantly minor in nature was not mediated as a separate issue. The MIG was the defence raised by TD in its responses to claims in dispute made under the Schedule and therefore it is a defence that must be considered in this Arbitration.

The MIG was developed in consultation with insurance industry stakeholders, health care professionals and legal representatives.²⁸ “Minor injury” is defined in s. 3(1) of the Schedule as a “sprain, strain, whiplash associated disorder, contusion, abrasion, laceration or subluxation and includes any clinically associated sequelae” to such an injury. The MIG limits or caps the funds available for medical and rehabilitation treatment to $3,500.00, but provides a process to speed up access to rehabilitation. It is “focussed on the application of a functional restoration approach, in addition to the provision of interventions to reduce or manage pain or disability”.²⁹

Under section 4 of the Guideline itself, “Impairments that do not come within this Guideline”, the MIG provides for more care if there is compelling evidence provided by a health practitioner that the person has a pre-existing medical condition that will prevent the insured person from achieving maximal recovery from the minor injury if he or she is subject to the cap. It is intended that the vast majority of pre-existing conditions will not exclude the person’s impairment from the MIG.

The Applicant is an intelligent woman. The evidence establishes that she has challenges within her family both from before and after the accident. I give little weight to TD’s argument that her injuries are minor because she did not take an ambulance at the time of the accident and did not go to see her family doctor immediately or sooner than December after the accident; nor do I give weight to the late submission of the benefits claim. Her evidence was clear and repeated to the assessors that her relationship with her family doctor was strained and she has clearly relied on Mon Sheong to take the matter through the Schedule process. Her sister’s urging could well have resulted from a sibling who is watching another push through the pain and hoping it will just go away. While it is attractive to say that if there was an injury or impairment, one would naturally go to see another medical doctor if you didn’t like the one you had, I reject that on the basis of the evidence here. The Applicant was receiving treatment which was effective to return her to at least 50% of where she had been before the accident from the chiropractor – absent other illness or issue, from a lay person’s perspective, what is the driving need to see a medical doctor when she is having success with another health care professional?

But in the end, the onus is on the Applicant to prove her case that these treatment plans are reasonable and necessary, and that her injuries are such that she is entitled to benefits outside the MIG. There is no objective evidence that the injuries suffered were other than minor injuries as defined in the Schedule, and there is no evidence of a pre-existing condition that will prevent her from achieving maximal recovery from the injury within the MIG cap. To get out of the MIG, on the basis of psych-social impairments, there must be objective evidence in support of that. There is none.

It is not up to TD to rebut an assumption that the treatment plans are reasonable and necessary – it is up to the Applicant to prove that they are. She provided insufficient evidence for me to draw the conclusion.

With respect to Dr. Palantzas’ Disability Certificate, I am not convinced that this certificate was reasonable or necessary, and the cost would bring the benefits over the MIG cap.

TD also relies on the Applicant’s refusal to attend the Insurer Examinations in the spring of 2012, as required under s. 44 of the Schedule. The correspondence from the Applicant’s representative³⁰ indicates that the refusal to attend was based on a position that has since been found to be invalid—i.e., that there was no Mandarin translator accredited by the Ministry of the Attorney General available to attend the examination. The Applicant was therefore not seen until the examinations were rescheduled for August 2012. It may well have been that, had she been seen more promptly by a medical doctor (as would have been the case if she had gone to the insurer’s examinations), her outcome might have been different. However, she did not, so the assessments were done at a time when she had healed physically at least 50% by her own admission, and more than that in the view of Dr. Harmantas.

I therefore find that the MIG cap is a complete answer to the claims that are brought in this Arbitration and I find that the Applicant is not entitled to the medical benefits or costs of examination claimed.

In refusing to grant the application here, I am not to be taken as dismissing the post-accident complaints of the Applicant as unfounded, which notably included symptoms of nausea immediately after the accident, vertigo, malaise and fatigue as well as headaches within two weeks of the accident, and later difficulties in concentrating and with memory, as well as sensitivity to noise. From the beginning of the process, Mon Sheong compartmentalized the Applicant’s complaints as strains and sprains to be addressed by physiotherapy and chiropractic care or as psychological issues; yet she herself says her real issue is her sleep and that she is unsure what the psychologist could do for her. The difficulties with concentration and memory and noise sensitivity prevent her from resuming her studies, whether at university or elsewhere. The evidence establishes that the Insurer Examinations by Dr. Harmantas and Dr. Safir focussed on range of motion and pain in movement, and Dr. Dancyger properly confined himself to psychological tests. Nor did the treatment plans submitted include in their goals anything to address directly these symptoms of difficulties in concentrating and with memory, as well as sensitivity to noise. I have not been provided with objective evidence in support of any impairment indicated by these symptoms nor a responding treatment plan. Therefore I have no basis for giving any remedy for this Applicant.

Interest

No interest is recoverable as I have refused to find that any of the treatment plans claimed or the costs of examination are reasonable and necessary.

EXPENSES:

In the event that the parties are unable to agree on the matter of expenses, the party requesting their expenses should contact me to request an Expense Hearing within 30 days of release of this decision, including their submissions as to expenses. The responding party shall provide its response within 20 days of receipt of the expense claim submissions. Reply material shall be provided within 10 days of receipt of the response.

December 14, 2015

Lynda Tanaka Arbitrator

Date

Financial Services Commission des

Commission services financiers

of Ontario de l’Ontario

Neutral Citation: 2015 ONFSCDRS 267

FSCO A14-003818

BETWEEN:

QIN NIKKI CHEN

Applicant

and

TD GENERAL INSURANCE COMPANY

Insurer

ARBITRATION ORDER

Under section 282 of the Insurance Act, R.S.O. 1990, c. I.8, as amended, it is ordered that:

1. The Applicant is not entitled to the medical benefits claimed in a) a treatment plan, dated April 12, 2012, by Mon Sheong Court Physio & Rehab Centre (“Mon Sheong”) (Dr. Peter Counti) outstanding totaling $1,518.98, and b) a treatment plan, dated June 18, 201, by Mon Sheong (physiotherapist Elli Luy) outstanding totalling $690.84.

2. The Applicant is not entitled to costs of examination benefits for a) a treatment plan, dated May 29, 2012, by Dr. Andrew Shaul totalling $1,979.36, and b) a Disability Certificate, dated July 27, 2013, by Mon Sheong (chiropractor Dr. Georgia Palantzas) totaling $200.00.

3. The Applicant is not entitled to interest as there are no benefit rulings in her favour.

4. In the event that the parties are unable to agree on the matter of expenses, the party requesting their expenses should contact me to request an Expense Hearing within 30 days of release of this decision, including their submissions as to expenses. The responding party shall provide its response within 20 days of receipt of the expense claim submissions. Reply material shall be provided within 10 days of receipt of the response.

December 14, 2015

Lynda Tanaka Arbitrator

Date

Footnotes

1. 1The Statutory Accident Benefits Schedule - Effective September 1, 2010, Ontario Regulation 34/10, as amended.
2. 2Exhibit 4, Notes of Mon Sheong.
3. 3Exhibit 13.
4. 4Ibid., p. 6.
5. 5Exhibit 7.
6. 6Exhibit 14.
7. 7Included in Exhibit 14.
8. 8Exhibit 8, page 3 of 8, last paragraph.
9. 9Exhibit 1, OCF-18 May 29, 2012, p. 3-4.
10. 10Ibid., p. 7.
11. 11Exhibit 22 Treatment and Assessment Plan, dated September 20, 2013.
12. 12Exhibit 8 General Practitioner Report, dated August 29, 2012.
13. 13Exhibit 5 Psychological Assessment Report, dated August 31, 2012.
14. 14Exhibit 10 Psychological Assessment Report by Dr. Gerry Dancyger, dated April 14, 2014.
15. 15Exhibit 9, Report of Dr. Irina Safir, dated April 13, 2014.
16. 16Ibid., p. 2.
17. 17Ibid., p. 3.
18. 18Exhibit 8, p. 2.
19. 19Exhibit 1.
20. 20Exhibit 10.
21. 21Exhibit 10, p. 8-9.
22. 22Transcript of the evidence of Dr. Gerald Dancyger provided August 12, 2015 (“Dancyger transcript”), p. 96 l. 20 – p. 97 l. 3.
23. 23Dancyger Transcript, p. 4, l. 10-18.
24. 24Ibid., p. 15, l. 11-25.
25. 25Ibid., p. 43, 45-46.
26. 26Exhibit 7.
27. 27Exhibit 2, page 3, clinical notes and records of Dr. Lawrence Lee.
28. 28Guideline 2/10 Minor Injury Guideline and Bulletin No. A-10/10.
29. 29Ibid.
30. 30Exhibits 24 and 25, correspondence from Yeung & Associates to TD, dated May 11, June 4, June 28 and July 24, 2012.