OLAT 2021

The applicant sought statutory accident benefits for chiropractic and psychological treatment plans following a 2016 motor vehicle accident.

The respondent denied the benefits on the basis that they were not reasonable and necessary.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to provide compelling medical evidence supporting the treatment plans and noting that the plans were largely recommended after a subsequent 2018 accident.

As no benefits were payable, the claim for interest was also dismissed.

The appellant appealed the 45-day impoundment of her vehicle, which was seized after her daughter was caught driving it with a suspended licence.

The appellant argued she exercised due diligence by relying on her daughter's assurances and a brief glimpse of a licence card.

The Tribunal found that the appellant failed to meet the high standard of due diligence, noting she was aware of her daughter's previous driving incidents and court matters but failed to make independent inquiries with the Ministry of Transportation.

The appeal was dismissed and the impoundment order was confirmed.

The appellant's vehicle was impounded for 45 days after she allowed an unlicenced friend to drive it.

She appealed the impoundment on the ground of exceptional hardship under section 50.2 of the Highway Traffic Act.

The Licence Appeal Tribunal dismissed the appeal, finding that the appellant failed to establish that there was no reasonable alternative to the impounded vehicle, as she had been successfully using public transit and walking for work, medical appointments, and groceries.

The applicant sought a determination of catastrophic impairment under the Statutory Accident Benefits Schedule following a motor vehicle accident.

The central issue was whether the applicant's traumatic brain injury resulted in a Severe Disability or Lower Moderate Disability under the Extended Glasgow Outcome Scale (GOS-E).

The Tribunal found that the GOS-E assessment must be conducted by a physician or neuropsychologist, not an occupational therapist, and must isolate the effects of the brain injury from other physical or psychological injuries.

Preferring the evidence of the respondent's neuropsychologist, the Tribunal concluded the applicant sustained only a mild traumatic brain injury and did not meet the threshold for catastrophic impairment.

The application was dismissed.

The appellant entered into an agreement to purchase a new home, but the transaction failed to close after multiple occupancy delays and the appellant's inability to secure financing.

The appellant sought a deposit refund from Tarion, which was denied.

On appeal to the Licence Appeal Tribunal, the appellant argued she had exercised a statutory right to rescind and that the vendor fundamentally breached the contract by changing the locks and providing insufficient notice of closing.

The Tribunal found no evidence of a statutory rescission and held that the vendor's actions did not amount to a fundamental breach, as the home was substantially complete and the vendor was ready to close.

The appeal was dismissed and Tarion's denial of the deposit refund was confirmed.

The applicant requested a reconsideration of a decision denying him non-earner benefits.

He argued the Tribunal erred in fact and law by rejecting certain medical evidence, including a letter from Dr. Galley, and by accepting the evidence of Dr. Dessouki despite alleged procedural flaws.

The Adjudicator dismissed the request, finding that the Tribunal properly weighed the evidence, including the applicant's own testimony and family evidence, and correctly applied the legal test for non-earner benefits.

No error of law or fact was established.

The applicant was injured in a motor vehicle accident and sought various medical and rehabilitation benefits, which the respondent insurer denied.

The applicant applied to the Licence Appeal Tribunal.

The adjudicator found that the applicant was entitled to a psychological assessment and psychological services, as the evidence supported that she suffered from accident-related psychological impairments warranting removal from the Minor Injury Guideline (MIG).

However, the adjudicator denied the claims for physical treatments, functional abilities evaluation, and chronic pain programs, finding insufficient objective medical evidence to establish they were reasonable and necessary.

The adjudicator also awarded a 5% special award under s. 10 of O. Reg. 664 and $200 in costs against the respondent due to its unreasonable 16-month delay in removing the applicant from the MIG after its own assessor recommended it.

The applicant sought statutory accident benefits, claiming that a motor vehicle accident caused her to subsequently develop meningitis and an empyema.

The applicant's expert theorized that the accident caused a rupture in the dura mater, allowing a middle ear infection to migrate to the brain.

The Tribunal found the expert's theory to be overly speculative and concluded that the applicant failed to prove on a balance of probabilities that the accident was a necessary cause of her meningitis.

The preliminary issue was answered in the negative.

The applicant, an international student, was injured in a motor vehicle accident and sought visitor's expenses for her mother's travel from China to Canada, claiming the visits were necessary for her recovery.

The respondent denied the benefits.

The Licence Appeal Tribunal found numerous inconsistencies in the applicant's evidence regarding her injuries, employment, and when she informed her family about the accident.

The Tribunal concluded that the applicant failed to prove on a balance of probabilities that the visitor's expenses were reasonable, necessary, or incurred as a result of the accident.

The application was dismissed.

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

The insurer paid benefits up to the Minor Injury Guideline (MIG) limit and denied further treatment plans.

The applicant argued she should be removed from the MIG due to a pre-existing fibromyalgia condition, physical injuries including a partial shoulder tear, and psychological injuries.

The Tribunal found insufficient evidence of a documented pre-existing condition that precluded recovery within the MIG.

The Tribunal also found the physical injuries met the definition of minor injuries and rejected the applicant's psychological evidence due to inconsistencies and omissions in self-reporting.

As the applicant remained within the MIG and its limits were exhausted, the disputed treatment plans were not payable.

The Tribunal also found the insurer's denial letters complied with the notice requirements under the Schedule.

The respondent insurer requested a reconsideration of a decision finding two treatment plans reasonable and necessary but not payable due to missing signatures under s. 38(3) of the Schedule.

The insurer argued the Tribunal exceeded its jurisdiction by allowing the applicant to remedy the deficiency at a future date.

During the reconsideration process, the applicant provided the signed treatment plans.

The Tribunal found that accepting the signed plans promoted fairness, efficiency, and the consumer protection mandate of the Schedule.

The reconsideration request was denied, and the benefits were deemed payable once incurred.

The applicant sought statutory accident benefits following a 2016 motor vehicle accident.

The respondent determined the applicant's injuries fell within the Minor Injury Guideline (MIG) and denied claims for a non-earner benefit, chiropractic treatment beyond the MIG limit, and prescription medications.

The Tribunal found that the applicant failed to provide compelling evidence that pre-existing conditions prevented maximal recovery within the MIG, thus capping treatment at $3,500.

The Tribunal approved the disputed chiropractic treatment plan up to the remaining MIG limit, finding it reasonable and necessary for pain reduction.

The claim for a non-earner benefit was dismissed as the applicant did not suffer a complete inability to carry on a normal life, having resumed personal care and university studies shortly after the accident.

Claims for prescription medication reimbursement and a special award were also dismissed, though interest was awarded on the approved treatment plan.

The applicant sought a loss of earning capacity benefit (LECB) offer from the respondent following a 1994 motor vehicle accident.

The respondent argued the claim was barred under s. 20.1 of the Statutory Accident Benefits Schedule because the applicant had not commenced a mediation, arbitration, or court proceeding prior to March 1, 2006.

The applicant contended that s. 20.1 did not apply because the respondent never issued a proper written denial of her income replacement benefits.

The Tribunal held that regardless of whether a proper denial was issued, the failure to commence a proceeding before the March 1, 2006 deadline meant the applicant was not entitled to an LECB offer.

The preliminary issue was resolved in favour of the respondent.

The applicant and respondent both requested reconsideration of a Tribunal decision finding the applicant sustained predominantly minor injuries.

The applicant sought reconsideration based on new evidence, specifically a chronic pain report and an MRI.

The adjudicator dismissed the applicant's request, finding the new evidence could have reasonably been obtained prior to the hearing.

The respondent requested reconsideration because the original decision failed to address its request for costs.

The adjudicator granted the respondent's reconsideration request to address the costs issue, but ultimately declined to award costs, finding the applicant's conduct was not vexatious, frivolous, or in bad faith.

The applicant requested a reconsideration of a decision finding him statute-barred from disputing the respondent's denial of income replacement and medical benefits.

The applicant argued the adjudicator made errors of law and fact, and sought to introduce new case law.

The Tribunal dismissed the request, finding the applicant was improperly attempting to advance new arguments not raised at the initial hearing.

While the adjudicator acknowledged an error in grouping the denials together when analyzing the Manuel factors for a limitation extension, he concluded this error would not have changed the outcome.

The respondent's request for costs was also dismissed.

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

The respondent denied the claims.

The Tribunal found that the applicant failed to prove she suffered a complete inability to carry on a normal life, noting inconsistencies in her self-reporting and preferring the evidence of the respondent's assessors.

The Tribunal also found the disputed treatment plans were not reasonable and necessary.

The application was dismissed, and no award or costs were granted.

The applicant sought an extension of time to file a request for reconsideration of a preliminary issue decision that barred his claim for attendant care benefits.

The applicant's former counsel had removed herself from the record the day before submissions were due, leaving the applicant unrepresented and unaware of the decision.

The Tribunal granted the motion, finding that the applicant had a bona fide intention to appeal and that denying the extension would result in a denial of procedural fairness.

The applicant requested a reconsideration of a decision denying him income replacement benefits and a treatment plan.

He argued the adjudicator misapprehended expert evidence, breached procedural fairness, and made errors of fact and law regarding causation and expert qualifications.

The Vice Chair dismissed the request, finding no errors of law or fact and no breach of procedural fairness, noting the applicant was attempting to re-litigate the case.

The respondent's request for costs was also dismissed, as the applicant's conduct did not rise to the level of being unreasonable, frivolous, or vexatious.

The appellant appealed the suspension of his driver's licence by the Registrar of Motor Vehicles under s. 47(1) of the Highway Traffic Act.

The suspension was based on medical reports indicating the appellant suffered an alcohol withdrawal seizure and had severe Alcohol Use Disorder (AUD).

The appellant denied having AUD or a seizure.

The Tribunal found that the medical evidence supported the diagnosis of AUD.

While the appellant had remained abstinent for over five months and completed a substance use program, he lacked a supportive recommendation from his treating health care provider for licence reinstatement, as required by the CCMTA Standards.

The Tribunal concluded the Registrar met the burden of proving the appellant's condition was likely to significantly interfere with his ability to drive safely.

The suspension was confirmed.

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

In a supplementary decision following a reconsideration order, the adjudicator redetermined whether the applicant's injuries fell within the Minor Injury Guideline (MIG) and whether she was entitled to income replacement benefits (IRBs).

The adjudicator found that the applicant's chronic pain did not affect her functionality, relying on surveillance evidence, Ontario Works applications indicating no work restrictions, and the respondent's medical assessments.

The evidence of the applicant's occupational therapist was rejected as unreliable.

Consequently, the adjudicator concluded the injuries fell within the MIG and dismissed the claims for IRBs, medical benefits, and interest.