Joslin-Mielke v. Pembridge, 2022 CanLII 57402

Licence Appeal Tribunal

Citation: Joslin-Mielke v. Pembridge, 2022 ONLAT 19-012118/AABS Licence Appeal Tribunal File Number: 19-012118/AABS

In the matter of an Application pursuant to subsection 280(2) of the Insurance Act, RSO 1990, c I.8., in relation to statutory accident benefits.

Between: Kimberley Joslin-Mielke, Applicant and Pembridge Insurance Company, Respondent

DECISION

ADJUDICATOR: Thérèse Reilly

APPEARANCES: For the Applicant: Kimberley Joslin-Mielke, Applicant Gordon Harris, Counsel

For the Respondent: Stefanie Schone, Representative Jennifer Griffiths, Counsel

HEARD: By way of written submissions

OVERVIEW

1The applicant was injured as a result of a motor vehicle accident on May 23, 2016. She applied for and sought an attendant care benefit (ACB) from December 20, 2016 to May 23, 2018 pursuant to the Statutory Accident Benefits Schedule – Effective September 1, 2010 (''Schedule''). The respondent agrees the applicant is entitled to an attendant care benefit but states the parties disagree on the monthly amount of the ACB.¹

2The applicant’s main argument is that due to the applicant’s complex leg injuries she may need help in an emergency at night as she needs mobility aids to walk, has reduced range of motion and identified safety hazards in her rental home. The applicant maintains her Form 1 addresses safety and emergency needs at night while sleeping whereas the respondent’s Form 1 did not address this safety issue. The failure to do so she submits is support that the applicant needs this assistance ² and as such the evidence is uncontested.³

3The respondent paid for attendant care expenses between December 20, 2016 and May 23, 2018 ⁴ but denies the ACB was incurred or deemed incurred beyond the amounts already paid and as such no additional amounts are payable.⁵ Moreover, the respondent submits the attendant care needs for basic supervisory care with respect to a safety issue in the event of an emergency at night is not reasonable and necessary.⁶ The respondent states the applicant is not entitled to an attendant care benefit in the monthly amount of $3,527.67 from December 20, 2016 to May 23, 2018.⁷

ISSUES:

4The following are the issues ⁸ to be decided:

a. Is the applicant entitled to an attendant care benefit in the monthly amount of $3,527.67 from December 20, 2016 to May 23, 2018?

b. Is the applicant entitled to interest on any overdue payment of benefits?

RESULT

5The applicant is entitled up to $984.52 as of January 1, 2017 and up to $509.86 as of May 1, 2017 for attendant care services. However, she is not entitled to payment for any ACB expenses over and above the amounts already paid from December 20, 2016 to May 23, 2018 as the amounts do not meet the definition of an “incurred expense” within the meaning of section 3(7)(e) of the Schedule, nor can they be deemed incurred under section 3(8) of the Schedule. Interest is not payable as there are no overdue payment of benefits.

BACKGROUND

The Applicant’s Impairments

6The applicant was a passenger on a motor cycle that was involved in a motor vehicle accident. She sustained severe orthopaedic injuries which included a fracture of the hip, femur, two toes and ribs on the left side. She was airlifted to the hospital where she had orthopaedic surgery to address the fractures. She was hospitalized following the accident and discharged from the hospital on June 20, 2016.⁹ The applicant maintains she had ongoing pain complaints and had mobility issues for a long time after the accident as she was not able to weight-bear on her right leg without the assistance of a walker, a wheel chair, a cane or crutches. She submits her home is not safe for her disabilities at any time of day and she is not safe with her mobility.¹⁰

7On release from the hospital, the applicant submitted a claim for and received ACBs from the respondent.

8On release from the hospital, the applicant also received numerous assistive devices such as a hospital bed, a bath bench, a ramp outside the home at the main entrance, a two wheeled walker and a rollator walker and a motorized wheelchair to assist with her recovery and rehabilitation.¹¹ The discharge planning report prepared by Ms. Chawla, occupational therapist (OT) dated June 23, 2016 noted the applicant’s access to the front of the home had stairs which Ms. Chawla stated was at that time not accessible by wheelchair or a walker. One of the assistive devices is a ramp outside the home at the main entrance to address access to the home.

9The evidence indicates that by November 2016, the two wheeled walker had been returned as it was no longer required or used by the applicant. By November 2016, the Attendant Care Assessment Form 1 completed by Ms. Bertolo, occupational therapist ¹² indicated the applicant still required the use of the power wheel chair, the portable ramp and a rollator walker for support. By April 20, 2017, these items had been returned as the applicant no longer required them. This included the wheelchair, rollator walker and ramp. Ms. Bertolo noted in her assessment of April 5, 2017 and report dated April 20, 2017,¹³ all assistive devices had been returned as the applicant no longer required them. This included the wheelchair, rollator walker and ramp.

10In November 2016, the applicant was receiving PSW support with meal preparation, accessing her closet, toenail care, and bathroom and bedroom hygiene. She received this service about three times a week, for three hours per visit.¹⁴ By April 2017, the applicant was still receiving PSW support with meal preparation, foot care, bathroom cleaning, linen changes, and housecleaning tasks such as vacuuming and laundry. The frequency had decreased to twice a week.

11Dr. Henry Ahn, orthopaedic surgeon, noted in his report of July 6, 2017 that the applicant’s right hip and femur fractures had healed. Dr. Ahn encouraged the applicant to increase her activity level and to continue with physiotherapy as part of her ongoing rehabilitation.¹⁵ The applicant had a follow up appointment on October 31, 2017 ¹⁶ after she had had a fall on her knee in her home. Dr. Ahn did not note any safety concerns and noted her pain was improving and she had full range of motion in her knee. Imaging taken at the time indicated the fractures remained fully healed.¹⁷ She had osteoarthritis in her right knee. Dr. Ahn recommended the applicant take Tylenol as needed.

12Physiotherapy records from July 2017 indicate the applicant was approximately "80% better with physio."¹⁸

13In January 2017, the applicant returned to her pre-accident employment as a bookkeeper for Peak Property Management and Xact Machinery Inc.¹⁹

Attendant Care Needs Assessments – the Form 1s

14The Form 1 is used to determine the amount of a monthly attendant care benefit. It is divided into three categories of assistance, represented by levels. According to the descriptions indicated on the Form 1, Level 1 attendant care is for routine personal care. Level 2 attendant care is for basic supervisory functions. Level 3 attendant care is for complex health/care and hygiene functions.

15In June 2016, the applicant submitted an Assessment of Attendant Care Needs (“Form 1”) dated June 23, 2018 completed by Ms. Sharat Chawla (OT) and recommended a monthly ACBs in the amount of $8,708.08.²⁰ In response, the respondent agreed to fund a monthly ACB of incurred expenses up to $3,000.00.²¹ On November 2, 2016, Ms. Chawla submitted an updated Attendant Care Form 1 Reassessment Report dated November 2, 2016. The new Form 1 recommended a monthly ACB in the amount of $4,476.19.²²

16In her OT assessment of November 2, 2016, Ms. Chawla, noted the applicant was unable to weight bear on her right leg without external support. She stated the applicant had reduced range of motion in her leg, left shoulder, and low back. She had reduced walking and standing tolerances, her right foot was swelling and often numb, she had reduced standing and walking balance, and suffered from pain, reduced sleep (fatigue) and anxiety. She could not walk without a walker and external supports and needed a power wheelchair to get about the community. She could not access stairs.

17The Form 1 reassessment report of Ms. Chawla assigned 630 minutes required weekly for meal preparation in Level 1 and a further 630 minutes weekly for assistance with walking noting the applicant relies on a walker inside the home. Ms. Chawla assigned in Level 2 of the Form 1, 3,360 minutes to the category of “applicant lacks ability to respond to an emergency.” The comments state the applicant would not be self sufficient in an event of an emergency when she is asleep at night.” ²³ Ms. Chawla in the Form 1 under basic supervisory care stated this as “applicant lacks ability to independently get in and out of a wheel chair or to be self sufficient in an emergency.²⁴ In her assessment summary Ms. Chawla noted the applicant was unable to access stairs, was completely limited with housekeeping (she stated the applicant could benefit from 15 hours/a week of housekeeping assistance), leisure and work and she was partially limited with personal care.²⁵ Ms. Chawla in her reassessment report noted she did not formally assess balance, climbing stairs, or sleeping.²⁶ She noted the applicant was able to walk a few steps without a walker²⁷, uses a wheelchair to mobilise outdoors and goes out in the power wheelchair to the strip mall close to her home.²⁸

The Respondents Form 1

18The respondent referred the ACB issue to a section 44 assessment with Ms. Angela Bertolo, occupational therapist (OT), who concluded in her OT assessment completed November 30, 2016 and dated December 19, 2016 that the applicant’s ongoing monthly attendant care needs were $984.52.²⁹ The benefit was reduced effective January 1, 2017.

19In her October 30, 2016, Attendant Care Assessment Form 1 Ms. Bertolo,³⁰ indicated the applicant still required the use of the power wheel chair, the portable ramp and a rollator walker for support. Ms. Bertolo noted the applicant was observed being able to access the main level of her home with the use of a walker for support. She was observed being able to access her bathroom without her walker and using the counter for support. She noted the applicant demonstrated safety and independence with all transfers. In level 1 she assigned the applicant 630 minutes for meal preparation but only assigned the applicant with 60 minutes of assistance with walking. Ms. Bertolo also reported that the applicant uses a power wheelchair and had a bus pass for travel in the community. The applicant used a rollator walker for support in the home. She noted the applicant’s poor balance and recommended assistance with respect to her mobility (i.e. while outdoors). Ms. Bertolo stated the applicant was independent under ‘basic supervisory care’, stating, she demonstrated adequate mobility in order to exit her home in case of an emergency. Assistance was not required with respect to that activity.

20On April 5, 2017, the applicant was re-assessed by Ms. Bertolo, who recommended an ongoing monthly ACB benefit but reduced it to $509.86 a month effective May 1, 2017. In her assessment Ms. Bertolo noted the applicant needed assistance primarily with meal preparation and help with some bedroom and personal hygiene. The applicant she noted had reported significant improvement with her symptoms. Ms. Bertolo observed the applicant being able to sit to stand, and bed, toilet and bathtub transfers were performed safely and independently. The applicant demonstrated the ability to lift up to five pounds with each hand. It was noted the applicant was observed accessing the main level in her home with the use of a cane for support.³¹ She reported that equipment received from the hospital such as the bed, rollator and two wheeled walkers, power wheelchair and the portable ramp had been retuned and as such she did not assign any assistance needed for maintenance in equipment under Level 3.³²

21In her April 5, 2017 assessment, Ms. Bertolo (OT) noted the applicant was observed climbing the 4 steps in front of her home safely and independently. Ms. Bertolo did not assign any assistance for walking. The applicant was observed climbing the stairs in her home.

22The respondent summarized the Form 1s as follows³³:

Attendant Care Needs	Form 1 dated October 23, 2016 by Ms. Chawla	Form 1 dated November 30, 2016 by Ms. Bertolo	Form 1 dated April 5, 2017 by Ms. Bertolo
Level 1 Routine Personal Care Needs	1275 mins per week • Grooming (15) • Feeding (630) • Mobility (630)	700 mins per week • Grooming (10) • Feeding (630) • Mobility (60)	420 mins per week • Feeding (420)
Level 2 Basic Supervisory Functions	3570 mins per week • Hygiene (310) • Basic Supervisory Care including emergency assistance at night while sleeping (3360)	280 mins per week • Hygiene (280)	140 mins per week • Hygiene (140)
Level 3 Complex Healthcare and Hygiene Functions	225 mins per week • Medication (15) • Bathing (140) • Maintenance of Supplies and Equipment (70)	70 mins per week • Maintenance of Supplies and Equipment (70)	0 mins per week

23The respondent lists in its submissions the invoices submitted to it by the applicant totalling $11,961.39 for PSW/attendant care services from Apex Health Care/Qualicare Family Homecare between December 2016 and May 2018. The respondent paid $9,587.45 of these expenses as set out in the chart below. The difference between the amount claimed and the amount paid is $2,373.94.

Invoice No.	Period of Service	Amount Payable	Amount Claimed	Amount Paid
1253, 1202	December 2016	$3,000.00	$1,357.92	$1,357.92
1328	January 2017	$984.52	$1,087.64	$948.52
1333	February 2017	$984.52	$1,008.55	$948.52
1446	March 2017	$984.52	$1,122.98	$948.52
1474	April 2017	$984.52	$780.26	$780.26
1537	May 2017	$509.86	$950.92	$509.86
1588	June 2017	$509.86	$1,210.72	$509.86
1665	July 2017	$509.86	$593.25	$509.86
1699, 1719	August 2017	$509.86	$771.23	$509.86
1772	September 2017	$509.86	$632.80	$509.86
1814	October 2017	$509.86	$632.41	$509.86
N/A	November 2017	$509.86	$0.00	$0.00
N/A	December 2017	$509.86	$0.00	$0.00
N/A	January 2018	$509.86	$0.00	$0.00
2080	February 2018	$509.86	$369.13	$369.13
2100	March 2018	$509.86	$362.56	$362.56
2163	April 2018	$509.86	$461.41	$461.41
2208	May 2018	$509.86	$619.61	$351.45
TOTAL:		$13,566.26	$11,961.39	$9,587.45

ANALYSIS

24The issues in this matter are whether the applicant is entitled to attendant care benefits for the period claimed and, if so, the quantum of her entitlement. A central issue is whether the attendant care expenses claimed by the applicant are an “incurred expense” pursuant to section 3(7)(e) of the Schedule or deemed incurred under section 3(8) of the Schedule. The onus is on the applicant to prove on a balance of probabilities that her entitlement and expenses are reasonable and necessary. Any expenses must be proven by the applicant to have been incurred or deemed to be incurred because the respondent unreasonably delayed or withheld payment of a benefit.

25Both parties agree the applicant is entitled to attendant care benefits, but they disagree on the monthly amount of ACB. The applicant submits the quantum should be above a monthly benefit of $3,000.00. However, section 19(3) of the Schedule limits the monthly amount of attendant care benefits payable to a maximum of $3,000.00 for non-catastrophic impairment. The applicant has not been determined to be catastrophically impaired and as there is no evidence of the purchase of optional benefits, I agree the respondent is not liable to pay any amounts in excess of this monthly maximum. The amount of any ACB awarded is limited to no more than $3,000.00 per month.

26As both parties agree the applicant is entitled to ACBs, I must determine the amount, if any, payable by the respondent.

27I prefer the Form 1s and Assessment Reports by Ms. Bertolo over the Form 1 of the applicant’s OT, Ms. Chawla, as the former are more reasonable and complete in their assessment of the ACB needs of the applicant for several reasons.

Emergency Needs at Night While Sleeping

28There are two main areas of divergence in the Form 1s. The first involves assistance with emergency needs at night when sleeping. The applicant maintains there is no substantial difference of opinion between the parties other than this issue, which explains most of the discrepancy in Form 1 calculations. Ms. Chawla allotted 3360 minutes towards this need. The applicant correctly identified some issues with safety and mobility especially in the months of June 2016 following release from the hospital however by November 2016 the evidence indicates that the applicant’s position improved to a point where she had returned to using the two wheeler walker. By April 2017 all assisted devices had been returned and were no longer needed by the applicant for mobility.

29The applicant maintains the respondent’s OT did not address the safety issue in her Form 1. I disagree. Ms. Bertolo stated the applicant demonstrated sufficient mobility to exit her home and as stated in her Form 1s that the applicant did not require assistance or supervision (in case of an emergency while asleep at night). Ms. Bertolo did not note any issue with mobility in the event of a potential night-time emergency. Ms. Bertolo found the applicant demonstrated adequate mobility in order to exit her home in case of an emergency, even with the use of a walker or cane for support.

30The applicant did not present any evidence to support the issue of needing assistance during an emergency at night. Further, there is no evidence to suggest any unique night-time challenges that would hinder the applicant’s ability to respond to an emergency. There is no indication in the Form 1 that Ms. Chawla conducted any assessment of the applicant’s specific night-time needs to support her recommendations. Further, Ms. Chawla noted in November 2016 the applicant was independent with bed transfers, bed mobility, as well as sit-stand-sit transfers with the support of her walker.

31The applicant referred in her submissions to a fall she had in October 2017 but when she saw Dr. Ahn, the doctor did not note any safety issues. Having a fall does not support a conclusion that the applicant cannot exit her home in the case of an emergency. As noted above, in the April 2017 assessment, Ms. Bertolo observed the applicant being able to climb the steps in front of her home safely and independently. The applicant was observed accessing the main level in her home with the use of a cane for support. She was observed climbing the stairs in her home and the four steps in front of her home.

32I agree with the respondent based on the totality of evidence that the attendant care needs for basic supervisory care with respect to a safety issue in the event of an emergency at night is not reasonable and necessary.

Mobility Issues

33The second area of divergence is Ms. Chawla assigning 630 minutes for assistance with mobility in her Form 1 of November 2016. I find the applicant has not presented evidence to support this. By November 2016, the evidence indicates the applicant had sufficient support and assistance with walking, through the use of devices such as her rollator walker, as well as a power wheelchair when travelling in the community. Both OTs found the applicant demonstrated independence with transfers, including bed mobility, as well as tub and toilet transfers with the use of various assistive devices. The evidence indicates the applicant travelled in the community with her wheel chair which indicates no issue gaining access to and from her home. Also, as the assistive devices were returned by April 2017, there was no need to assign assistance in Level 3 for maintenance of equipment

Other Limitations

34Ms. Chawla in her re-assessment of November 2, 2016 noted the applicant was completely limited with leisure and work and she was partially limited with personal care. As to leisure, this is not an accurate statement as the applicant was noted going into the community using her wheelchair and entering stores such as a Shoppers Drug Mart. As to work, the applicant had returned to work in January 2017 so the statement that she is completely limited with respect to work is not correct or supported by the evidence.

35The applicant was re-assessed by the respondent in April 2017, but no re-assessment however was completed by the applicant’s OT. Ms. Bertolo’s re-assessment in April 2017 provides an updated assessment of the applicant’s condition and symptoms which appear to be improving. Ms. Bertolo noted the pain for the lower extremities was 75% improved by November 2016 and an 85% improvement was noted with respect to shoulder pain. The same result was noted in the April 5, 2017 re-assessment. Dr. Ahn in his report of July 2017 noted improvement as the fractures had fully healed. The physiotherapy records of July 2017 also indicate an 80% improvement in the applicant’s symptoms.

36I agree with the respondent that the assessments by Ms. Bertolo of November 30, 2016 and re-assessment of April 5, 2017 provide the most up to date information on the applicant’s ACB needs. The applicant did not present any medical evidence to refute Ms. Bertolo’s assessment of ACB. I find the applicant is entitled to an ACB in the monthly amount of $984.52 effective January 1, 2017 and that this is reasonable and necessary. I find that with the improvement of the applicant’s condition, the reduced ongoing monthly ACB benefit to $509.86 a month effective May 1, 2017 is also reasonable and necessary.

WERE THE ACB EXPENSES “INCURRED”?

37Section 19(1) of the Schedule states that the respondent shall pay for all reasonable and necessary expenses that are incurred by the applicant as a result of the accident for services provided by an aide, attendant or a long-term care facility.

[38] Section 3(7)(e) of the Schedule states subject to subsection (8) that an expense has not been "incurred" unless: (i) the goods/services are received by the insured person; (ii) the insured person pays or promises to pay for the goods/services; and, (iii) the person who provided the goods or services: (A) did so in the course of their employment, occupation, or profession for which they would normally be engaged in but for the accident, or (B) sustained an economic loss as a result of providing the goods or services to the insured person.

All three criteria must be met.

[39] Section 3(8) provides that: “If in a dispute described in subsection 280 (1) of the Act, the Licence Appeal Tribunal finds that an expense was not incurred because the insurer unreasonably withheld or delayed payment of a benefit in respect of the expense, the Licence Appeal Tribunal may, for the purpose of determining an insured person’s entitlement to the benefit, deem the expense to have been incurred.”

40For the following reasons, I agree with the respondent and find the applicant has not incurred any compensable attendant care expenses.

41This Tribunal in the RO v Aviva decision has also held that sufficient particulars must be provided by the service provider in order to satisfy the first criterion of section 3(7)(e). This can include such details as: (i) what services were provided and when; (ii) why they were requested and provided; (iii) how long the services were on any given day; (iv) how the total number of hours was arrived at; and (v) what the hourly rate was.

42Regarding section 3(7)(e)(iii)(A), the parties did not present any argument that the provider Apex Health Care/Qualicare Family Homecare did not provide services which were not within the course of their employment, occupation, or profession. As such, the issue of incurred will focus on whether the applicant has proved what services were provided and if they are supported by the applicant’s Form 1.

43Details of the ACB services received were not specified in the applicant's submissions or evidence. The applicant did not submit any invoices to support her claim for the ACB and there were no invoices presented for the months of November, and December 2017 and January 2018. Moreover, the amounts claimed by the applicant for December 2016, April 2017, January, March and April 2018 were paid in full. The ACB for the months of January, February, March and April 2017 remain in dispute but no invoices were submitted for the services provided for these months. As such, there is no evidence presented to identify the services and support a claim for ACB in these 4 months in the early part of 2017.

44The invoices ³⁵ presented into evidence were submitted by the respondent but only for the months of February, March, April and May 2018. As such the information presented on the services provided by the PSW is limited. The invoices for these 4 months lack the required details and particulars of the services provided. For example, the March 29, 2018 and the April 19, 2018 invoices refer to walking and caring for a dog. The same invoices refer to light housekeeping such as sweep, mop and vacuum, empty trash can, do laundry, and clean the bathroom floor, sink, toilet and floor after client use. There is no detail of the time spent on these activities nor what the hourly rate was. Further, pet care such as walking the dog and light housekeeping was not an activity supported by the applicant’s Form 1. I find the applicant has not presented sufficient evidence to show the attendant care services were incurred or that they are as recommended in the applicant’s Form 1.

45The invoices also do not contain additional detail to show what exactly was done each day for the applicant. I am therefore unable to identify the actual “goods and services to which the expense relates” as required in the first criterion (i.e. section 3(7)(e)i) to establish that an expense is incurred under the Schedule by outlining what services were provided and when; (ii) why they were requested and provided; (iii) how long the services were on any given day; (iv) how the total number of hours was arrived at; and (v) what the hourly rate was. There was no additional documentation before me to assist in this regard. Therefore, the applicant does not, on the basis of the evidence before me, meet the first criterion of an incurred expense.

46The applicant also raised the argument the ACB expenses are deemed incurred. If the Tribunal finds an expense was not incurred because the respondent unreasonably withheld or delayed payment of a benefit in respect of the expense, the Tribunal may deem the expense to have been incurred, pursuant to section 3(8) of the Schedule.

47I find no reason to deem ACBs were incurred. There is no evidence the payments were unreasonably withheld or delayed by the respondent. There is evidence of the differing opinions of the parties OTs. As outlined above, I prefer the Form 1 of Ms. Bertolo over Ms. Chawla’s. I find the recommendations of Ms. Bertolo to be reasonable. I also find that the applicant’s medical condition by mid 2017 continued to be improving and her fractures were fully healed. By January 2017 the applicant had also returned to work, additional evidence that Ms. Bertolo’s assessment and recommendations for ACB are reasonable. The applicant returned to engaging in her pre-accident activities, including shopping and work.

INTEREST

48Having found the applicant is not entitled to payment for the services provided over and above what has already been paid, I conclude she is not entitled to interest pursuant to section 51 of the Schedule.

CONCLUSION

49The applicant is entitled up to $984.52 as of January 1, 2017 and up to $509.86 as of May 1, 2017 for attendant care services. However, she is not entitled to payment for any expenses over and above the amounts already paid from December 20, 2016 to May 23, 2018 as the amounts do not meet the definition of an “incurred expense” within the meaning of section 3(7)(e) of the Schedule, nor can they be deemed incurred. Interest is not payable as there are no overdue payment of benefits.

Released: June 27, 2022

Thérèse Reilly Adjudicator

Footnotes

1. 1Respondent amended written submissions, paragraph 21, dated March 3, 2021. The amended written submissions appear identical to the respondents written submissions dated February 16, 2021 with the exception that paragraphs relating to the Income Replacement Benefit (IRB) issues, which have been withdrawn, are omitted from the amended written submissions.
2. 2Applicant written submissions, paragraph 18.
3. 3Ibid, paragraph 15.
4. 4Respondent amended written submissions, paragraph 24, and EOB dated July 19, 2016 dated March 3, 201016, tab m, respondent amended written submissions.
5. 5Ibid, paragraphs 25 and 27.
6. 6Ibid, paragraph 31.
7. 7Respondent amended written submissions, paragraphs 26.
8. 8The applicant withdrew her claim for an IRB, applicant written submissions dated February 1, 2021, paragraph 22. The respondent also withdrew the repayment claim for the IRB, respondent written submissions, dated March 3, 2021, paragraph 5. The applicant’s Reply was struck from the record by Motion Order of the Tribunal dated April 20, 2021.
9. 9Written submissions of the applicant, paragraph 10.
10. 10Written submissions of the applicant, paragraphs 17 and 18.
11. 11Discharge Planning Report dated June 23, 2016, tab 7, applicant written submissions. See also Discharge Summary from the Cambridge Memorial Hospital, tab e, dated June 20, 2016, respondent written submissions.
12. 12OT assessment report, dated November 30, 2016, by Angela Bertolo, tab h, page 14, respondent amended written submissions.
13. 13OT Assessment dated April 20, 2017 by Angela Bertolo, tab I, respondent amended written submissions.
14. 14OT assessment report, dated November 30, 2016, Angela Bertolo, tab h, page 20, respondent amended written submissions.
15. 15CNRs of Dr. Ahn, report of July 6, 2017, tab f of the respondent amended written submissions.
16. 16CNRs of Dr. Ahn, report of October 31, 2017, tab f of the respondent amended written submissions
17. 17Written amended submissions of the respondent, paragraph 10.
18. 18CNRs of Franklin Physiotherapy, dated July 7, 2017, tab G, respondent amended written submissions.
19. 19Written amended submissions of the respondent, paragraphs 15 and 35.
20. 20Form-1 dated June 23, 2016 by Ms. Sharat Chawla, tab 6, applicant written submissions. The applicant in her written submissions states this Form 1 is not an issue in dispute, paragraph 11.
21. 21Explanation of benefit dated July 19, 2016, tab m, respondent document brief, written amended submissions of the respondent, paragraph 17.
22. 22Attendant Care Form 1 Reassessment Report dated November 2, 2016, tab 10, applicant written submissions and tab n of the respondent written submissions and a Form1 dated October 23, 2016, tab n, respondent written submissions.
23. 23Ibid, tab 10, page 17.
24. 24Ibid, Form 1 dated October 23, 2016, tab n, respondent written submissions, page 4.
25. 25Attendant Care Reassessment Report, November 2, 2016, tab 10, page 5.
26. 26Ibid, page 14.
27. 27Ibid, page 13.
28. 28Ibid, page 10.
29. 29OT Assessment Report dated December 19, 2016, tab h and Form 1 dated October 30, 2016, tab h, respondent written submissions.
30. 30OT assessment report, dated November 30, 2016, by Angela Bertolo, tab h, page 14, respondent amended written submissions.
31. 31OT Assessment dated April 20, 2017, Angela Bertolo, tab I, respondent amended written submissions, page 13.
32. 32OT Assessment dated April 20, 2017 by Angela Bertolo, tab I, respondent amended written submissions, page 8.
33. 33Written Amended submissions of the respondent, paragraph 29.
34. 35Tab p, respondent amended written submissions.
35. 34RO v Aviva Insurance Company of Canada, 2019 CanLII 94029 (ON LAT) at para. 34.