OLAT 2021

The appellant appealed a Notice of Proposal to refuse a cannabis retail operator licence.

The parties reached a settlement and applied for a consent order under s. 4.1 of the Statutory Powers Procedure Act to dispose of the matter without a hearing.

The Tribunal granted the consent order, directing that the appellant be bound by the terms of the settlement agreement, which imposed a condition on the licence requiring notification of any charges or convictions.

The Registrar proposed to revoke the appellant's registration as a real estate salesperson.

The appellant appealed the proposal to the Licence Appeal Tribunal.

Prior to a hearing, the parties reached a settlement and requested a consent order.

The Tribunal ordered the Registrar to carry out the proposal with a six-month suspension instead of revocation, and required the appellant to complete mandatory continuing education courses on compliance and ethics.

The appellant brought a motion to extend the time to appeal the 90-day impoundment of her motor vehicle under the Highway Traffic Act.

The vehicle was impounded after her boyfriend was caught driving it with a suspended licence.

The appellant filed the appeal 24 days late, arguing she initially feared retribution from her abusive boyfriend if she reported the vehicle as stolen, but decided to appeal when she learned the impoundment was for 90 days rather than 45.

The Tribunal applied the Manuel factors and found that, although the delay was significant and there was no initial intention to appeal, the appellant's explanation was reasonable and her claim that the vehicle was taken without consent had merit.

The motion to extend the time for filing the appeal was granted.

The appellant's vehicle was impounded after being driven by an individual with a suspended licence.

The appellant filed an appeal of the impoundment approximately 20 days after the 15-day statutory deadline had expired.

The appellant brought a motion for an extension of time to file the appeal.

The Licence Appeal Tribunal applied the four-part test for extending time and found that the appellant lacked a bona fide intention to appeal within the time limit, the delay was significant, the respondent would suffer prejudice, and the merits of the appeal were weak.

The motion for an extension of time was dismissed.

The appellant appealed a Notice of Proposal by the Registrar to refuse his application for registration as a motor vehicle salesperson.

After three days of hearing, the parties reached an agreement to grant the registration subject to conditions, including a five-year prohibition on being a partner or director of a dealer, and a requirement to repay $37,000 to the Motor Vehicle Dealers Compensation Fund.

The Licence Appeal Tribunal issued a consent order reflecting the agreement and disposing of the appeal without further hearing.

The applicant requested a reconsideration of a decision that denied payment for various medical expenses under the Statutory Accident Benefits Schedule.

The applicant argued the adjudicator erred in law and fact by failing to consider his unique circumstances.

The Licence Appeal Tribunal dismissed the request, finding that the applicant was attempting to re-litigate unsuccessful arguments and failed to identify an articulable error of law or fact that would have changed the outcome.

The Registrar issued a Notice of Proposal to revoke the registrations of the appellants as a motor vehicle dealer and salesperson, and to refuse the registration of an added party as a salesperson.

The parties reached a settlement and waived the requirement of a hearing.

The Licence Appeal Tribunal issued a consent order maintaining the registrations subject to extensive terms and conditions regarding compliance, premises, books and records, disclosure, financial responsibility, and course requirements.

The respondent insurer requested a reconsideration of a LAT decision that found the applicant entitled to two treatment plans due to the insurer's failure to provide compliant denial notices under ss. 38(8) and 38(9) of the SABS.

The insurer argued the adjudicator breached procedural fairness by citing case law not raised by the parties, erred in finding the insurer could no longer cure its defective notices, and misapplied s. 38(11) by ordering payment for unincurred expenses.

The adjudicator dismissed the procedural fairness and right-to-cure arguments, finding no error of law.

However, the adjudicator granted the reconsideration in part to clarify that while the treatment plans were payable without first being incurred, the funds are only payable 30 days after the applicant submits an invoice for services rendered, in accordance with s. 38(15).

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

The insurer denied claims for physiotherapy and a psychological assessment, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found the applicant sustained a psychological impairment, removing her from the MIG.

The Tribunal denied the physiotherapy claims for lack of evidence but granted the psychological assessment and interest on overdue payments.

The applicant was struck by a vehicle while crossing the street and sought statutory accident benefits.

The insurer determined her injuries fell within the Minor Injury Guideline (MIG) and refused to fund several treatment plans.

The applicant argued that pre-existing conditions, psychological injuries, and chronic pain precluded her recovery within the MIG.

The Tribunal found no evidence that the accident exacerbated her pre-existing conditions or caused psychological injuries or chronic pain.

The Tribunal concluded the applicant sustained minor soft-tissue injuries, was subject to the $3,500 MIG limit, and dismissed the application as the funding limit had been exhausted.

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

The respondent denied a physiotherapy treatment plan on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant failed to demonstrate that her physical or psychological impairments warranted removal from the MIG, noting a lack of objective evidence and preferring the respondent's medical assessments.

Consequently, the disputed treatment plan was deemed not reasonable and necessary, and the application was dismissed.

The applicant requested a reconsideration of a previous decision that denied a treatment plan for physiotherapy services.

The Tribunal found that it had committed a clear error of fact and law by relying on incorrect submissions that addressed a psychological treatment plan not in dispute.

Upon reviewing the correct submissions, the Tribunal found that the applicant had demonstrated on a balance of probabilities that the $2,486.45 physiotherapy treatment plan was reasonable and necessary to address her chronic pain and functional limitations.

The Tribunal preferred the evidence of the applicant's experts over the respondent's section 44 assessor, noting the latter failed to contemplate a chronic pain diagnosis.

The request for reconsideration was granted and the treatment plan was approved.

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

The respondent insurer denied a physiotherapy treatment plan on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant's physical injuries were predominantly sprains and strains, and he failed to provide sufficient medical evidence of chronic pain, a psychological condition, or a pre-existing condition that would preclude recovery within the MIG.

Consequently, the treatment plan was deemed not reasonable and necessary, and the application was dismissed.

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

The insurer denied a treatment plan for a chronic pain assessment, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant suffered from chronic pain syndrome and related psychological impairments, removing him from the MIG.

The Tribunal preferred the evidence of the applicant's chronic pain specialist over the insurer's physiatrist, who failed to address the psychological components of the pain.

The Tribunal also found the insurer failed to comply with the procedural requirements of section 38 of the Schedule by responding to the treatment plan almost a year late.

The applicant was awarded the cost of the assessment and interest.

The applicant sought medical benefits for chiropractic treatment, physiotherapy, an MRI, and an orthopaedic assessment following a motor vehicle accident.

The respondent denied the benefits, arguing the applicant's injuries were pre-existing.

The Licence Appeal Tribunal found that the applicant sustained a torn rotator cuff as a result of the accident.

The Tribunal held that the treatment plans for chiropractic and physiotherapy were reasonable and necessary, but the proposed MRI and orthopaedic assessment were not, as the injury had already been identified via ultrasound.

The applicant was also awarded interest on overdue payments.

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

The respondent scheduled insurer's examinations (IEs), which the applicant failed to attend.

The respondent raised a preliminary issue arguing the applicant was barred from proceeding under section 55 of the Statutory Accident Benefits Schedule.

The Tribunal found that the applicant failed to attend properly scheduled IEs without a reasonable excuse.

The Tribunal declined to exercise its discretion to permit the application to proceed, noting the respondent was prejudiced by the inability to obtain a contemporaneous medical opinion.

The application was dismissed.

The applicant sought medical and rehabilitation benefits following a motor vehicle accident.

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

The Tribunal found that the applicant failed to provide sufficient objective medical evidence to demonstrate that his physical or psychological impairments warranted removal from the MIG.

As the MIG limits had been exhausted, the disputed treatment plans were not reasonable and necessary, and no interest was payable.

The applicant sought statutory accident benefits following a motor vehicle accident, including an income replacement benefit and a treatment plan for massage and physiotherapy.

The respondent denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) and that he failed to provide sufficient information to support his IRB claim.

The Licence Appeal Tribunal found that the applicant failed to meet his burden of proof to warrant removal from the MIG, failed to prove the treatment plan was reasonable and necessary, and failed to demonstrate a substantial inability to perform the essential tasks of his employment for the IRB.

The application was dismissed.

The applicant requested a reconsideration of a Tribunal decision that denied payment for a $14,804.51 treatment plan.

The applicant argued the Tribunal erred in law and fact by finding the treatment plan was not reasonable and necessary, and by misapplying the notice requirements under s. 38 of the Schedule.

The Vice-Chair dismissed the request, finding no error in the adjudicator's determination that the insurer cured its defective notice and that the applicant failed to provide evidence of incurred treatment during the period of non-compliance.

The Tribunal's finding that the treatment plan was not reasonable and necessary was upheld.

The respondent insurer filed a request for reconsideration of a decision finding that the applicant was entitled to payment of an income replacement benefit that was improperly deducted due to her receipt of Employment Insurance sickness benefits.

The insurer argued the Tribunal erred in law by determining that EI sickness benefits were not deductible as gross employment income under s. 7(3) of the Statutory Accident Benefits Schedule.

The Tribunal dismissed the request, finding no error of law in its original interpretation that a genuine conflict exists in the Schedule and that EI sickness benefits fall within the temporary disability benefit exclusion under s. 47(3)(f)(i).