J.R. v. Certas Home and Insurance Company, 2018 CanLII 13161

RECONSIDERATION DECISION

Before: Linda P. Lamoureux, Executive Chair

Date: February 26, 2018

File: 16-003921/AABS

Case Name: J.R. v. Certas Home and Insurance Company

Written Submissions By:

For the Applicant: Thomas R. Su and Ashu Ismail

For the Respondent: Stefania Sdao

Overview

1The applicant, J.R., argues that he needs certain benefits under the Statutory Accident Benefits Schedule – Effective September 1, 2010¹ (the “Schedule”) to address his chronic pain. His insurer, Certas Home and Insurance Company (“Certas”), disagrees. Certas denied him those benefits after multiple insurers’ examination reports concluded that J.R. reached maximum medical recovery. Ultimately, the Licence Appeal Tribunal (the “Tribunal”) found that J.R. failed to prove his claim. As explained below, that decision was based on multiple errors, particularly concerning the manner in which the Tribunal treated the parties’ evidence. Accordingly, I grant J.R.’s request for reconsideration and order that this matter be reheard.

The Facts

2The following are the facts based on the limited record before me. J.R. swore no affidavit in support of his case, and relies on no such evidence from anyone else. His story is told briefly through his counsel’s written submissions, only part of which are actually proven through a handful of documents. Moreover, both parties’ briefs reference several other documents that I would have thought relevant to their cases – e.g., disability certificates, reports or records from treating physicians, insurer’s assessment reports, various OCF-18s for which Certas provided or refused funding, and correspondence explaining those decisions – none of which they filed. Thus, what follows is the relevant background insofar as the parties offered it.

The accident

3On July 12, 2013, J.R was injured when the vehicle he was driving was rear-ended at a stoplight. The following day, he saw his family physician, Dr. L. Bernston. J.R. reported to Dr. Bernston that, as a result of the accident, his car’s rear window shattered, he hit his chest on the steering wheel and, because his door was jammed, he needed to climb into the back seat to attend to his infant daughter, who was bleeding from the mouth. J.R. reported soreness in his neck, shoulders, and chest. Three days later, he returned to Dr. Bernston’s office, complaining of excessive pain in his neck, upper back, and right shoulder. He also reported that he could not sleep and was having nightmares.²

4The next month, he began psychotherapy at Eastwood Psychologists, where he completed a total of 23 psychotherapy sessions over the next year and half.³ In addition, that same month he applied for benefits under the Schedule.

Dr. Muhlstock’s first report

5Six months later, in February 2014, he attended an insurer’s examination with Dr. J. Muhlstock (Physiatrist), who conducted a physiatry assessment. The purpose of this assessment was to determine whether J.R.’s injuries fell within the Minor Injury Guideline (“MIG”). Dr. Muhlstock’s report of February 26, 2014 provides the following information:

• J.R. reported suffering generally from constant neck and low back pain, as well as intermittent right shoulder and mid-to-upper back pain;⁴
• J.R. reported neck and low back pain while performing certain movements during his examination;⁵
• J.R. reported receiving weekly counselling at Eastwood Psychologists and that within a week of the accident he also began attending physiotherapy at CBI Physiotherapy Clinic (“CBI”).⁶ (With respect to this later claim, the record discloses that indeed J.R. received physiotherapy, including treatment at CBI, though the earliest of these records are from July 2015 and, in total, evidence fewer than 15 sessions between then and March 2017.⁷ I note, however, that Dr. Bernston’s clinical records immediately after the accident provide “start massage therapy” and “CBI”, presumably a recommenced course of therapy and referral, respectively);⁸
• Dr. Muhlstock opined that J.R.’s injuries “would be consistent with soft tissue (musculoskeletal ligamentous sprain/strain) injuries to the cervical spine, WAD I or at most WAD II, possibly the thoracolumbar spine and the right shoulder girdle.” According to him, J.R.’s prognosis was “excellent, given that all injuries sustained in the accident have essentially resolved with no objective findings of any ongoing physical impairments relatable to the subject motor vehicle accident.” Further, he concluded that J.R. had reached pre-injury status and maximal medical improvement, and that his injuries were within the MIG.⁹

6The parties’ submissions make clear that Certas initially treated J.R. within the MIG. However, they also make clear that, by no later than July 4, 2014, Certas agreed that the MIG did not apply.¹⁰ The parties filed no evidence explaining why Certas changed its position.

Dr. Tavazzani’s report

7In November 2014, J.R. then saw Dr. F. Tavazzani (Orthopaedic Surgeon). It appears that J.R.’s former counsel asked Dr. Tavazzani to determine, among other things, J.R.’s diagnosis and prognosis. Dr. Tavazzani’s report following the assessment – a complete copy of which was not included in J.R.’s hearing submissions but which his counsel filed separately – details the following:

• J.R. reported suffering generally from persistent neck and lower back pain, and that this pain was exacerbated by certain movements. He also reported suffering from anxiety, depression, and an inability to sleep at night;¹¹
• Dr. Tavazzani opined that J.R. was “presenting with clinical signs and symptoms that are indicative of the development of chronic pain syndrome,” and that his impairments were also related to “post-accident anxiety and depression;”¹² and
• Dr. Tavazzani recommended that J.R. “continue indefinitely with a multidisciplinary rehabilitation program in order to prevent deconditioning and deterioration of his injuries.” He also recommended “a particular focus on active conditioning with a physical therapist or personal trainer and on manual treatments with a chiropractor or massage therapist.”¹³

Drs. R. Zatzman and Husnani’s Report

8Shortly after, on January 30 2015, J.R. also saw Drs. R. Zatzman (Physician) and Husnani (Chiropractor) at All Health Medical Centre. The purpose of their assessment was to determine whether J.R. presented with the typical symptoms and characteristic behaviour of a “chronic pain profile,” and whether J.R. needed to “be enrolled in a chronic pain treatment protocol.”¹⁴ In their Chronic Pain Examination Report following the assessment, Drs. Zatzman and Husnani outline the following:

• J.R. reported suffering generally from constant neck and low back pain, along with headaches and insomnia due to nightmares;¹⁵
• J.R. reported moderate pain while having his cervical and shoulder ranges of motion tested, as well as several lumber pain during the same test;¹⁶
• the authors opined that J.R. had “shifted from an acute pain state to a chronic pain state,”¹⁷ and that his condition fit “the classical picture of a Chronic Pain Syndrome secondary to unresolved residual pain;”¹⁸
• they also opined that J.R.’s “chronic pain symptoms may be mitigated, though not resolved, through his participation in an interdisciplinary treatment program,”¹⁹ which they later describe as combining exercise, psychological, medical and rehabilitation services, treatment and education to improve functional abilities and reduce pain;²⁰ and
• the report ends with the authors confirming that J.R. is a good candidate to be enrolled in “an interdisciplinary chronic pain treatment protocol for a 10-week program,” and that “[a]n OCF-18 treatment plan for chronic pain protocol was submitted to [J.R.’s insurer] for their review and approval.”²¹

9As the report mentioned, Dr. Husnani did indeed submit an OCF-18 on J.R.’s behalf. Unfortunately, J.R.’s counsel did not file a complete version of that document, dated January 30, 2015, before the hearing. Instead, when filing J.R.’s application to the Tribunal, he included only the Insurer Fax Back portion, which, in turn, was appended to one of Certas’s Explanation of Benefits denying the plan. Nevertheless, the OCF-18’s Insurer Fax Back portion makes clear that Dr. Husnani recommended that J.R. receive a variety of interdisciplinary services – exercise and therapy for multiple regions, education, acupuncture, and mental health therapy – totalling $9,464.40.²²

10In response, J.R. was required to attend two insurer examinations.

Dr. Muhlstock’s second report

11The first was with Dr. Muhlstock, who conducted another physiatry assessment. The purpose of this assessment was to determine whether J.R. was able to return to his pre-accident activity levels, as well as whether the January 30, 2015 OCF-18 was appropriate given J.R.’s condition.²³ Dr. Muhlstock’s report following the examination details as follows:

• J.R. reported again that he began attending CBI for physiotherapy within a week of the accident, and that he had attended two or three times per month with no interruption for approximately 20 months;²⁴
• J.R. reported suffering generally from mostly constant neck pain, intermittent mid-back pain, constant low back pain, and poor sleep;²⁵
• J.R. reported neck and low back pain during his physical examination;²⁶
• Dr. Muhlstock found that there were “no objective findings off any clinical impairment;”²⁷ and
• ultimately, Dr. Muhlstock opined that J.R.’s soft tissue injuries have “long since resolved and achieved maximum medical recovery” and, thus, “no further formal treatment [was] warranted.”²⁸

Dr. Hines’s report

12The second examination was with Dr. R. Hines (Psychiatrist), who performed a psychological assessment. Like Dr. Muhlstock’s assessment, the purpose of Dr. Hines’s assessment was to determine whether J.R. was able to return to his pre-accident activity levels, as well as whether the January 30, 2015 OCF-18 was appropriate given J.R.’s condition.²⁹ In his report following the assessment, Dr. Hines concluded that, although J.R. developed Adjustment Disorder with Mixed Anxiety and Depressed Mood following the accident, this was now in “full remission.”³⁰ He further opined that from a psychiatric perspective, J.R. had reached pre-injury status and that his prognosis was excellent.³¹

13Based on these two reports, Certas denied the January 30, 2015 OCF-18 by Explanation of Benefits dated May 22, 2015.³²

14In September 2015, Certas received a further OCF-18. In that OCF-18, dated September 8, 2015, CBI recommended that J.R. receive physiotherapy and massage therapy services totalling $1,312.63. (This recommendation appears further to a hand-written clinical note on CBI letterhead whose author is unknown. The note indicates that J.R. reported “intermittent increases in cervical and lumbar irritation” with prolonged sitting and stress at work.³³)

15Certas denied the plan by Explanation of Benefits dated September 14, 2015 based on Dr. Muhlstock’s first and second reports.³⁴ Unfortunately, as with the January 30, 2015 OCF-18, J.R.’s counsel did not file a complete version of this OCF-18 either before the hearing. Again, when filing J.R.’s application to the Tribunal, he included only the Insurer Fax Back portion appended to Certas’s Explanation of Benefits denying the plan.

J.R.’s application to the Tribunal

16In November 2015, J.R. applied to the Tribunal. He disputes his entitlement to the following benefits:

• the $9,464.40 cost of the services included in the January 30, 2015 OCF-18 completed by Dr. Husnani;
• the $1,800 cost of his chronic pain assessment by Dr. Husnani; and
• the $1,312.63 cost of the physiotherapy and massage therapy services included in the September 8, 2015 OCF-18 completed by CBI.

The Tribunal’s decision

17The Tribunal dismissed J.R.’s application. In the Tribunal’s view, there was “a lack of information and insufficient evidence” supporting J.R.’s claim, and the medical evidence supported the conclusion that he had reached maximum medical improvement: see para. 9. The Tribunal based its decision, in part, on the observations included in Drs. Muhlstock and Hines’s reports, in particular their conclusions that J.R.’s injuries had resolved and that no further treatment was necessary. The Tribunal also explained that J.R.’s evidence raised several concerns resulting in the Tribunal giving it “limited weight:” see para. 19. For those reasons, it found that the OCF-18s of January 30 and September 8, 2015 were not reasonable or necessary. Additionally, the Tribunal held that J.R. was not entitled to the $1,800 cost of the chronic pain assessment given his failure to comply with s. 38(2) of the Schedule by filing the relevant OCF-18 before having the assessment performed.

18J.R. now asks that I reconsider the Tribunal’s decision.

Decision and Reasons

19It is trite law that, as the trier of fact, the Tribunal is entitled to weigh the parties’ evidence as it sees fit. Citing this very proposition, I have repeatedly refused to interfere with the Tribunal’s decisions.³⁵ That said, the Tribunal’s discretion is subject to important limits. Not the least of these is that it must be exercised in a manner that is procedurally fair and rationally cogent. In this case, the Tribunal erred in both respects.

The partial OCF-18s

20To begin, the Tribunal erred by failing to request complete copies of the January 30 and September 8, 2015 OCF-18s at issue. For whatever reason, J.R.’s counsel did not file them before the hearing. This was a serious disservice to his client. J.R. applied to the Tribunal to dispute his entitlement to the treatment included in those OCF-18s. One would naturally expect, therefore, that his counsel would file complete versions of those documents in order to advance J.R.’s claim. However, he filed only the Insurer Fax Back portions appended to Certas’s correspondence. What is the difference?

21The Insurer Fax Back portion is undoubtedly important. It details the recommended goods or services for which an insured person requests funding and, for that reason, is usually the substantive focal point of an OCF-18. However, an OCF-18 also includes an “Additional Comments” section. Sometimes that section is included in the form’s Insurer Fax Back portion. Other times, like in this case, it appears at the end of the document. In either event, the section invites the health professional completing the form to explain why the insured requires the goods or services being recommended. For those reasons, a complete OCF-18, including any additional comments justifying the request therein, is central to not only the claims process but also the Tribunal’s adjudicative function. Just as an insurer reviews a complete OCF-18 in order to properly decide whether to fund the insured’s request, the Tribunal generally requires the same document in order to properly understand both the insured’s request and the insurer’s response. Put simply, the Tribunal cannot fairly adjudicate an application in most cases without a complete copy of the very document giving rise to the parties’ dispute.

22Applicants to the Tribunal are obligated to make their own case. As part of that obligation, applicants must adduce all evidence upon which they need or intend to rely. The Tribunal will not satisfy their evidentiary onus for them. However, that does not mean that the Tribunal is bound in all cases to remain silent pending its decision. Questions will arise. The Tribunal may need further assistance. For instance, an adjudicator may need to ask the parties to confirm a fact or their positions on a particular issue,³⁶ or may need a document upon which a party clearly intended to rely but never filed.³⁷ In such circumstances, the Tribunal should ask for that assistance. Indeed, Rule 9.1 of the Rules of Practice and Procedure contemplates this very possibility, providing that the Tribunal may request additional particulars or documentation from a party “at any stage in a proceeding” as it considers “necessary for a full and satisfactory understanding of the issues in the proceeding.”

23In this case, the Tribunal sought that very assistance. On May 24, 2016, it wrote to J.R.’s counsel to note that he filed only a partial copy of Dr. Tavazzani’s report, asking for a complete copy by the end of the following day. When that request went unanswered, the Tribunal wrote again on May 29, following which J.R.’s counsel obliged. Presumably, the Tribunal requested a complete copy of Dr. Tavazzani’s report given its importance to J.R.’s case, along with the Tribunal’s general obligation to ensure that every application receives a fair and just determination on its merits. Obviously, it would have been unfair for the Tribunal to remain silent about receiving the partial copy only to then find that the report failed to establish J.R.’s claim. The Tribunal was right to ask for a complete copy.

24It should have taken the same approach to the January 30 and September 8, 2015 OCF-18s. Both formed the basis of the parties’ dispute and the J.R.’s resulting application. Moreover, while the Insurer Fax Back portion of those documents allowed the Tribunal to see what benefits were requested, they did not explain why, something typically addressed in the Additional Comments section. For these reasons, and given that the contents of both OCF-18s were beyond dispute, the Tribunal should have asked for complete copies. It did not. That failure, in my view, was a breach of procedural fairness, one that materially affected the Tribunal’s decision. The Tribunal went on to raise multiple concerns about J.R.’s claim, in particular about the link between, on one hand, the medical reports upon which he relied and, on the other, the treatment recommended in the OCF-18s. As explained below, that link was addressed unsurprisingly in the Additional Comments sections of both OCF-18s.

25Before leaving this issue, I make one additional point. It appears that J.R.’s counsel recognized his disservice to his client when he received the Tribunal’s decision. In filing J.R.’s request for reconsideration, he included complete copies of both OCF-18s. Certas argues that the OCF-18s do not qualify as “new evidence” within the meaning of Rule 18.2(d) and, thus, should not be considered. I view the matter differently. Based on the nature of J.R.’s claim and, more particularly, given the concerns about his evidence that the Tribunal raised, the Tribunal erred in not asking for these copies earlier. Accepting them now simply cures the Tribunal’s earlier mistake.

Dr. Tavazzani’s report

26The Tribunal also committed a number of errors in the manner in which evaluated J.R.’s evidence. In my view, these errors would have, if corrected, likely resulted in the Tribunal deciding this matter differently. Thus, putting aside the issue of procedural fairness, I would have granted this reconsideration based on the following errors alone.

27To begin, I highlight the Tribunal’s comments at paras. 19-20 concerning Dr. Tavazzani’s report:

In contrast to the evidence of Dr. Muhlstock and Dr. Hines, the applicant’s medical reports predate the treatment plans and do not link how the proposed treatment will achieve the applicant’s goal of alleviating his pain, anxiety, and increasing his strength and range of motion. I find they have limited weight with respect to the reasonableness and necessity of the treatment plans.

For example, Dr. Tavazani [sic] who is an orthopaedic surgeon prepared a report in November 2014. Therefore, it does not in any way address the proposed treatment plans that were created in 2015.

28Based on this sole concern, the Tribunal appears to have refused to consider the substance of Dr. Tavazzani’s report altogether – it made no further mention of the report. That was a mistake.

29Dr. Tavazzani issued his report in November 2014, less than three months before the January 30, 2015 OCF-18 and some ten months before the September 8, 2015 OCF-18. As a result, his report does not directly reference either. Nevertheless, the Tribunal erred in suggesting that Dr. Tavazzani’s report does not “in any way” address those plans.

30As outlined above, Dr. Tavazzani opined that J.R. was “presenting with clinical signs and symptoms that are indicative of the development of chronic pain syndrome.” For that reason, he recommended that J.R. “continue indefinitely with a multidisciplinary rehabilitation program,” arguably the very same course of treatment that was later included in the January 30, 2015 OCF-18. On this view, Dr. Tavazzani’s report is far from irrelevant. It appears to lay the foundation for J.R.’s claim that he suffers from chronic pain – the essence of his case – and, in so doing, appears to explain his need for the benefits included in both the January 30 and September 8, 2015 OCF-18s. This same connection is drawn in the Additional Comments section of the January 30, 2015 OCF-18, which provides as follows:

This treatment plan was designed and proposed as per Dr. Franco Tavazzani’s (Orthopaedic Surgeon) report recommendations, Dr. Ray Zatzman’s (MD) and Dr. Nasim Husnani’s (DC) physical examination and in accordance to the most recent medical research literature related to the non-systemic chronic pain condition, within a interdisciplinary treatment protocol approach for the chronic pain patient. This evidence based plan is goal oriented, patient centered and comprehensive in scope.

31One might also draw the same connection between Dr. Tavazzani’s report and the September 8, 2015 OCF-15, which provides as follows in the Additional Comments section:

Goal of this treatment plan will be to decrease current pain levels and restore functional ROM [i.e., range of motion], while concurrently increasing strength and endurance of the affected areas to facilitate return to pre-MVA [i.e., motor vehicle accident] function in the near future.

32Fundamentally, the Tribunal’s error was in requiring Dr. Tavazzani’s report to explicitly “link how the proposed treatment will achieve the applicant’s goal of alleviating his pain, anxiety, and increasing his strength and range of motion.” That was the Tribunal’s role. It alone was required to determine the nature of J.R.’s condition based on the parties’ evidence and whether, based on that condition, the benefits included in the OCF-18s were reasonable and necessary. In some cases, a medical report may directly answer this question. In other cases, it may not. In either event, the Tribunal is ultimately responsible for answering that question.

33To help illustrate the point, consider a situation in which an injured person adduces a wealth of medical evidence suggesting that he suffers from accident-related psychological trauma. Now imagine that none of the medical reports on which he relies mentions the sole OCF-18 at issue, which recommends counselling to deal with that same psychological trauma. Would it be reasonable for the Tribunal to discredit the injured person’s medical evidence simply because it made no mention of the OCF-18? I think not. The Tribunal must itself evaluate whether, based on the person’s condition, the treatment at issue is reasonable and necessary. That is part of the duty that the legislature assigned to it through the Schedule.

Drs. Zatzman and Husnani’s report

34The same applies to the Tribunal’s comments about Drs. Zatzman and Husnani’s report. At paras. 21-2, the Tribunal reasons as follows:

The Chronic Pain Examination Report of Dr. Zatzman, a family physician, and Dr. Husnani, a chiropractor, is dated January 30, 2015. This is the same date as the first treatment plan and pre-dates the second treatment plan of September 8, 2015. Although, this report recommends that it would be prudent for the applicant to receive “appropriate treatment for his post-traumatic symptoms” there is no specific proposal for this treatment and the report does not reference either of the treatment plans. As such, I am unable to determine if the proposed treatment plans would in fact alleviate the applicant’s pain, increase strength and range of motion. Will the chiropractic massage, physiotherapy, or acupuncture, sought by the applicant achieve the goal of relieving his headaches or pain to his back and neck thereby improve function? If so, this could make the treatment plans necessary but there is no evidence indicating this to be the case.

With respect, the very general language used by the doctors in their report that the chronic pain symptoms “may be mitigated, though not resolved through his participation on an interdisciplinary treatment program”, in my view, is indeterminate and uncertain. It is not specific enough. It does not address if there is a ceiling for effectiveness through the recommended interdisciplinary treatment program. More is required to allow the applicant to meet his evidentiary burden. [emphasis in original]

35I have a number of difficulties with these comments.

36First, the Tribunal inappropriately faulted the report for containing “no specific proposal” for the treatment recommended therein. That specific proposal was obviously included in the OCF-18 that Dr. Husnani completed on the same day that he and Dr. Zatzman completed the report, January 30, 2015. Indeed, the authors conclude the report by stating that “[a]n OCF-18 treatment plan for chronic pain protocol was submitted to [J.R.’s insurer] for their review and approval.”³⁸ Thus, the Tribunal should have read the report, which clearly outlined the purposes of J.R.’s recommended treatment,³⁹ in conjunction with the contemporaneous OCF-18, which further detailed the nature of this treatment.

37Second, and again, the Tribunal erred in suggesting the report was required to reference any particular OCF-18. As explained above, the Tribunal alone was required to determine whether, based on J.R.’s condition, the benefits included in any OCF-18 were reasonable and necessary.

38Third, the Tribunal erred in requiring the report to opine on whether the recommended interdisciplinary treatment program has a “ceiling for effectiveness.” That requires too much. Such an opinion may, if offered, be relevant to whether the treatment is reasonable and necessary. However, one is not strictly necessary to make that determination, especially given that, as the Tribunal recognized, pain relief in and of itself can be a legitimate medical and rehabilitative goal.⁴⁰

The IEs

39Lastly, I find that the Tribunal also erred in failing to consider the limits of Drs. Muhlstock and Hines’s reports. The Tribunal placed considerable weight on the findings in those reports that J.R.’s injuries had resolved and that no further treatment was necessary, findings based on what both doctors viewed as a lack of objective evidence of J.R.’s physical impairment. However, neither report opined specifically on the possibility of J.R. suffering from chronic pain, a condition which, by its very nature, cannot be supported by objective findings.⁴¹ In this respect, Drs. Muhlstock and Hines’s reports may be accurate insofar as they are based on objective findings. Nevertheless, the accuracy of those reports does not necessarily mean that J.R.’s evidence should be rejected. The Tribunal should have considered more carefully the uses to which the parties’ evidence could have been put.

Conclusion

40I order that this matter be re-determined in accordance with these reasons, and only with respect to J.R.’s entitlement to the January 30 and September 8, 2015 OCF-18s.

41As explained above, the Tribunal committed a number of errors that, if corrected, would likely have resulted in a different outcome. However, that is not to say that this matter should have necessarily been decided differently. I leave that to the Tribunal.

Linda P. Lamoureux

Executive Chair

Safety, Licensing Appeals and Standards Tribunals Ontario

Footnotes

1. 1O. Reg. 34/10.
2. 2Albany Medical Clinic Patient Encounter History; Applicant’s Submissions, Tab A.
3. 3Letter from M. Street and J. Eastwood (Eastwood Psychologists) dated March 25, 2017; Applicant’s Submissions, Tab I.
4. 4J. Muhlstock (AssessMed) Physiatry Assessment dated February 26, 2014; Respondent’s Submissions, Tab1A, p. 3. p. 7-8.
5. 5Ibid., p. 12.
6. 6Ibid., p. 6.
7. 7CBI Patient Ledger for July 2015 – November 2015, and Great West Life Explanation of Benefits from December 2016 – March 2017; Applicant’s Submissions, Tab B.
8. 8Supra note 1.
9. 9Supra note 6, p. 15-6.
10. 10Explanation of Benefits dated July 4, 2014; Applicant’s Submissions, Tab F.
11. 11F. Tavazzani (Cambridge Medical Assessments) Report (undated); Applicant’s Submissions, Tab G, p. 4-5.
12. 12Ibid., at p. 6-7.
13. 13Ibid., at p. 8.
14. 14Drs. R. Zatzman and N. Husnani (All Health Medical Centre) Chronic Pain Examination Report (undated); Applicant’s Submissions, Tab H, p. 2.
15. 15Ibid., at p. 4.
16. 16Ibid., at p. 5.
17. 17Ibid., at p. 8.
18. 18Ibid., at p. 9.
19. 19Ibid., at p. 8.
20. 20Ibid., at p. 9.
21. 21Ibid.
22. 22Appended to Certas’s Explanation of Benefits dated February 26, 2015, included in J.R.’s counsel’s correspondence of November 11, 2015 filing his application.
23. 23J. Muhlstock (AssessMed) Physiatry Assessment dated April 21, 2015; Applicant’s Submissions, Tab1K, p. 2.
24. 24Ibid., at p. 5.
25. 25Ibid., at p. 6.
26. 26Ibid., at p. 11-2.
27. 27Ibid., at p. 12, 14.
28. 28Ibid., at p. 14, 16.
29. 29R. Hines (AssessMed) Psychiatry Assessment dated April 24, 2015; Applicant’s Submissions, Tab J, p. 2.
30. 30Ibid., at p. 9.
31. 31Ibid., at p. 10.
32. 32J.R.’s counsel’s correspondence of November 11, 2015 filing his application.
33. 33Applicant’s Submissions, Tab 1E.
34. 34Supra note 32.
35. 35See, e.g., 16-001934 v Aviva Insurance Company of Canada, 2017 CanLII 59514 at para. 21; D.D.D. v RBC Insurance Company, 2017 CanLII 63631 at para. 26; 16-000098 v. Aviva Insurance Canada, 2017 CanLII 33657 at para. 10.
36. 36See, e.g., G.T. v. Unifund Assurance Company, 2017 CanLII 81567 at paras. 17-9.
37. 37See, e.g., Aviva Canada Inc. v. R.R., 2017 CanLII 81569.
38. 38Supra note 14 at p. 9.
39. 39Ibid., p. 3.
40. 4016-000536 v Co-operators General Insurance Company, 2016 CanLII 93133 at para. 11.
41. 41Nova Scotia (Workers' Compensation Board) v. Martin; Nova Scotia (Workers' Compensation Board) v. Laseur, 2003 SCC 54 at para. 1.