OLAT 2021

The applicant sought medical and rehabilitation benefits for physiotherapy and psychological treatment following a 2015 motor vehicle accident.

The respondent denied the claims, and the applicant applied to the Licence Appeal Tribunal.

The Tribunal found that the applicant had significant pre-existing physical and psychological conditions, and the medical evidence did not establish that the proposed treatments were reasonable and necessary as a result of the accident.

The Tribunal also dismissed the applicant's claim for an award under Regulation 664, finding no evidence that the respondent's conduct was excessive or imprudent.

The application was dismissed in its entirety.

The applicant sought entitlement to four treatment plans for injuries sustained in a motor vehicle accident.

The Tribunal found that the applicant failed to prove the reasonableness and necessity of the treatment plans for driving instructor travel time, physiotherapy, and chiropractic services, noting a lack of compelling contemporaneous evidence and that driving instructor travel time is not an authorized transportation expense.

However, the Tribunal approved the treatment plan for psychological services, finding it reasonable and necessary based on the unrefuted opinion of the applicant's psychologist and corroborating neuropsychological assessments.

The applicant was also awarded interest on the approved psychological treatment plan.

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

The respondent denied medical benefits beyond the $3,500 Minor Injury Guideline limit.

The applicant argued for removal from the guideline based on psychological impairment and chronic pain.

The Tribunal found the applicant's injuries were predominantly minor soft tissue injuries and their clinically associated sequelae.

The Tribunal preferred the evidence of the applicant's family physician and the respondent's psychological assessor over the applicant's expert reports, which were either based solely on self-reporting or outside the assessor's scope of practice.

The application was dismissed.

The appellant appealed the suspension of his driver's licence by the Registrar of Motor Vehicles for medical reasons, specifically Alcohol Use Disorder (AUD).

The appellant did not attend the hearing.

The Tribunal found that the appellant suffers from AUD and that the Registrar met the burden of establishing that the condition is likely to significantly interfere with his ability to drive safely.

The Tribunal confirmed the Registrar's decision to suspend the licence, noting the lack of evidence of recent continuous abstinence and the absence of a supportive recommendation from a treating health care practitioner.

The appellant appealed the Registrar of Motor Vehicles' decision to suspend his driver's licence on medical grounds due to cognitive impairment.

The Registrar based the suspension on medical reports and a functional driving assessment indicating deficits in the appellant's driving skills.

The Licence Appeal Tribunal found that the appellant suffers from cognitive impairment that is likely to significantly interfere with his ability to drive safely, and confirmed the Registrar's decision to suspend the licence.

The applicant brought a motion seeking an order to refer the matter to the Divisional Court for a contempt hearing after the respondent's occupational therapist failed to attend the hearing despite being served with a summons.

The respondent took no position.

The adjudicator found that the witness was properly served and failed to attend without providing reasons.

Given the importance of the witness's evidence to the catastrophic impairment determination, the motion was granted and the matter was referred to the Divisional Court.

The applicant was injured in a motor vehicle accident and sought income replacement benefits, which the respondent insurer denied.

The respondent raised a preliminary issue that the applicant's dispute was statute-barred under section 56 of the Statutory Accident Benefits Schedule.

The Tribunal found that the two-year limitation period did not begin to run until the respondent properly delivered the denial notice to the applicant's counsel under section 64, which occurred years after the initial denial.

The preliminary issue was dismissed, allowing the applicant's claim to proceed.

The applicant sought medical benefits for injuries sustained in a motor vehicle accident.

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

The applicant argued he suffered from chronic pain and had pre-existing conditions that justified removal from the MIG.

The Tribunal found the medical evidence established only minor, soft tissue injuries.

The Tribunal rejected the applicant's chronic pain assessment as it was conducted virtually and unsupported by objective evidence.

The applicant also failed to provide compelling evidence that his pre-existing conditions would prevent his recovery within the MIG.

The application was dismissed.

The applicant was injured in a motor vehicle accident and submitted an application for accident benefits indicating potential entitlement to both an income replacement benefit and a non-earner benefit.

The insurer requested that the applicant complete an election of benefits form (OCF-10) and attend an insurer's examination before initiating payments.

The applicant argued this was not in accordance with s. 36 of the Statutory Accident Benefits Schedule.

The Tribunal held that because the application indicated possible entitlement to more than one specified benefit, s. 35 required an election, making the application incomplete until the OCF-10 was submitted.

Therefore, the insurer's requests were in accordance with the Schedule.

The applicant sought payment for a chiropractic treatment plan in the amount of $2,822.90 following a motor vehicle accident.

The respondent denied the plan based on an insurer's examination report which concluded the treatment was not reasonable and necessary.

The Tribunal found that the applicant suffered from uncomplicated soft-tissue injuries and had already received a year of similar treatment with limited progress.

The Tribunal preferred the respondent's medical evidence and dismissed the application, finding the treatment plan was not reasonable and necessary.

The applicant was injured in a motor vehicle accident and sought medical and rehabilitation benefits.

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

The Tribunal found that the applicant suffered from chronic pain, removing him from the MIG.

The Tribunal approved several treatment plans for chiropractic treatment, medical services, and an orthopaedic assessment as reasonable and necessary, but denied an expense for an MRI because no treatment plan was submitted prior to incurring the expense.

Interest was awarded on the overdue benefits.

The applicant sought statutory accident benefits following a motor vehicle accident, disputing the insurer's determination that his injuries fell within the Minor Injury Guideline (MIG).

The applicant claimed entitlement to a non-earner benefit, a psychological assessment, and removal from the MIG due to chronic pain and psychological impairments.

The Licence Appeal Tribunal found that the applicant failed to provide sufficient medical evidence to warrant removal from the MIG, noting the absence of a chronic pain diagnosis and preferring the insurer's objective psychological assessments.

Furthermore, the applicant did not demonstrate a complete inability to carry on a normal life, as he continued to work and engage in pre-accident activities.

The application was dismissed.

The applicant insurer sought repayment of $17,830.30 in income replacement and medical benefits paid to the respondent, alleging wilful misrepresentation.

The respondent claimed she was injured in a motor vehicle accident, but medical records revealed her injuries resulted from falling down a flight of stairs while intoxicated.

The respondent failed to participate in the hearing.

The Tribunal found that the respondent wilfully misrepresented the cause of her impairments and ordered her to repay the benefits in full, plus interest, pursuant to section 52 of the Statutory Accident Benefits Schedule.

The appellant appealed the Registrar of Motor Vehicles' decision to suspend his driver's licence under section 47(1) of the Highway Traffic Act due to a reported alcohol use disorder.

The Tribunal found that while the appellant suffered from mild to moderate alcohol use disorder, the Registrar failed to prove on a balance of probabilities that the disorder was likely to significantly interfere with his ability to drive safely.

The appellant had been abstinent for seven months, had an excellent driving record, and the initial medical report querying an alcohol withdrawal seizure was unsubstantiated.

The appeal was allowed and the licence suspension was set aside.

The respondent insurer requested reconsideration of a preliminary issue decision which found that it had requested Insurer's Examinations more often than reasonably necessary, meaning the applicant was not barred from proceeding with his income replacement benefit claim under s. 55 of the Schedule.

The Tribunal denied the reconsideration request, finding that the preliminary issue decision did not finally dispose of the appeal and therefore fell outside the scope of Rule 18.1.

Furthermore, the Tribunal found no procedural unfairness or error of law, as the insurer's requests for examinations were duplicative and unreasonable, and the applicant had no duty to explain his non-attendance at improperly requested examinations.

The applicant, a licensed establishment operating as a restaurant, applied to remove a condition on its liquor licence that prohibited amplified music or sound from emanating from within the premises or on the café.

The condition was originally imposed in 2005 due to objections from nearby residents when the establishment operated as a sports bar.

The applicant argued that it had pivoted to an upscale Greek restaurant due to the COVID-19 pandemic and that music was integral to the dining experience.

The Registrar took no position.

After the applicant attempted to contact the original objectors with minimal response, the Tribunal found a change in circumstances and ordered the removal of the condition.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming her physical and psychological impairments warranted removal from the Minor Injury Guideline (MIG).

The adjudicator found that the applicant's physical injuries were uncomplicated sprains and strains treatable within the MIG, and she failed to establish chronic pain with functional impairment.

Furthermore, the applicant did not prove that her psychological impairments were caused by the subject accident rather than other significant life stressors and previous accidents.

As the MIG limits were exhausted, the disputed treatment plans were deemed not reasonable and necessary, and the application was dismissed.

The applicants sought statutory accident benefits following their daughter's motor vehicle accident, claiming they were financially dependent on her.

The Tribunal excluded late-filed evidence and found the applicants failed to prove they were more than 50% dependent on their daughter at the time of the accident.

As they did not meet the definition of 'insured persons' under the Schedule, their claims for non-earner benefits and a psychological assessment were dismissed.

The appellant appealed a Notice of Proposal by the Registrar to revoke her registration as a real estate broker due to professional misconduct, including accepting cash gifts and mobile phones from a client and making misrepresentations to the Real Estate Council of Ontario.

Prior to the hearing, the parties reached a settlement.

The Licence Appeal Tribunal issued a consent order directing the Registrar to suspend the appellant's registration for 28 weeks instead of revoking it, subject to conditions including a five-year prohibition on acting as a broker of record, restrictions on accepting gifts or entering lending arrangements with clients, and an order to pay $17,000 in restitution to the client.

The appellant appealed the Registrar of Motor Vehicles' decision to suspend his driver's licence under section 47(1) of the Highway Traffic Act.

The suspension followed medical reports indicating the appellant suffered a traumatic brain injury and mild cognitive impairment, with recommendations for a functional driving assessment.

The appellant argued he was a safe driver and could not afford the assessment.

The Licence Appeal Tribunal confirmed the suspension, finding that the medical conditions were likely to significantly interfere with his ability to drive safely and that a functional assessment was necessary to demonstrate otherwise.