OLAT 2022

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

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

The applicant argued he should be removed from the MIG due to pre-existing conditions, chronic pain, and psychological impairments.

The Tribunal found the applicant's evidence, including expert reports, unreliable and inconsistent with his family doctor's clinical notes.

The Tribunal preferred the respondent's insurer examination reports, concluding the applicant failed to prove his injuries warranted treatment beyond the MIG.

As the MIG limits were nearly exhausted, the disputed treatment plans were denied and the application was dismissed.

The applicant sought various medical and rehabilitation benefits following a 2019 motor vehicle accident.

The Tribunal found the applicant was removed from the Minor Injury Guideline due to a psychological impairment, entitling her to an in-home assessment.

However, claims for a chronic pain assessment, physiatry assessment, and physiotherapy were dismissed as the applicant failed to prove they were reasonable and necessary, largely due to a lack of objective medical evidence and failure to produce pre-accident records.

A claim for the balance of a psychological treatment plan was also dismissed because the provider was a psychotherapist, not a psychologist, and the insurer's lower hourly rate was deemed reasonable.

Claims for an award and costs were dismissed.

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

The respondent denied several treatment plans on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and the $3,500 limit had been exhausted.

The applicant argued that pre-existing lateral epicondylitis and accident-related psychological injuries warranted removal from the MIG.

The Tribunal found that the applicant failed to provide compelling medical evidence that his pre-existing condition prevented maximal recovery within the MIG limits.

Furthermore, the Tribunal preferred the respondent's psychological assessment, which concluded the applicant did not suffer a psychological injury.

As the injuries were predominantly minor and the MIG limits were exhausted, the disputed treatment plans, interest, and an award were denied.

The applicant sought income replacement benefits (IRBs) and a special award under Regulation 664 following a motor vehicle accident.

The respondent insurer denied the benefits, arguing the applicant's impairments were based on subjective complaints and her evidence was unreliable.

The Tribunal found the applicant credible and determined she suffered a substantial inability to perform the essential tasks of her pre-accident employment as a gas bar attendant, entitling her to pre-104 week IRBs.

However, the Tribunal dismissed her claim for post-104 week IRBs, finding she failed to prove a complete inability to engage in suitable employment, as she had successfully worked part-time jobs post-accident and failed to prove her subsequent surgeries were accident-related.

The claim for a Regulation 664 award was also dismissed, as the insurer's delay in obtaining addendum reports was not unreasonable given the applicant's delay in providing requested documents.

The applicant sought medical benefits for chiropractic services and a psychological assessment following a motor vehicle accident.

The respondent denied the chiropractic treatment plans on the basis that they were not reasonable and necessary, and the applicant sought an award for delayed payment of the psychological assessment.

The Tribunal found that the applicant failed to prove the chiropractic treatments were reasonable and necessary, relying on the respondent's independent medical examination and the lack of support in the treating physician's records.

The Tribunal also dismissed the claim for an award, finding the respondent did not unreasonably delay approving the psychological assessment.

The applicant sought payment for six treatment plans (OCF-18s) for chiropractic, massage, and physiotherapy services following a motor vehicle accident.

The respondent insurer denied the plans on the basis that the applicant had reached maximum medical improvement and the proposed treatment was not reasonable and necessary.

The Licence Appeal Tribunal found that the applicant suffered soft tissue injuries and a thumb ligament strain, but failed to establish that the ongoing facility-based treatment was effective or necessary.

The Tribunal noted that the applicant did not follow specific treatment recommendations from a specialist for his thumb injury, and that clinical records did not support ongoing debilitating chronic pain.

The application was dismissed, and no interest was payable.

The applicant sought payment for a psychological treatment plan following a motor vehicle accident.

The insurer partially approved the plan, reducing the hourly rate to that of a social worker, reducing session lengths to one hour, and denying travel time and extra documentation fees.

The Tribunal found the appropriate hourly rate was $100 for a social worker in private practice, but restored the session length to 1.5 hours as the insurer provided no medical basis for the reduction.

The Tribunal denied travel time and extra documentation fees due to insufficient evidence.

The applicant was awarded the $600 balance with interest, but a claim for a special award was dismissed as the insurer's reliance on the Professional Fees Guideline was not unreasonable.

The appellant appealed the Registrar of Motor Vehicles' decision to suspend her driver's licence for medical reasons following a reported episode of syncope/loss of consciousness.

The appellant argued the event was a mere fainting spell and that further medical testing was unnecessary.

The Licence Appeal Tribunal found that the appellant suffered a single episode of syncope without warning signs, and that her abnormal EEG results raised the possibility of a structural lesion.

The Tribunal concluded that the Registrar met its burden of establishing that the appellant's medical condition was likely to significantly interfere with her ability to drive safely, and confirmed the licence suspension.

The appellant appealed the 45-day impoundment of her motor vehicle under the Highway Traffic Act, arguing exceptional hardship and that the vehicle was not driven on a highway.

The vehicle was impounded after police found the appellant's husband driving it while his licence was suspended.

The Licence Appeal Tribunal dismissed the appeal, finding that the appellant had alternative transportation options available, such as taxis, rides from co-workers, and public transit, and therefore failed to meet the test for exceptional hardship.

The Tribunal also held that challenging the location of the driving was not a permitted ground of appeal under the Act.

The applicant appealed a Notice of Proposal to Review an Application for a Liquor Licence for its convenience store in Brampton.

The City of Brampton opposed the licence, arguing it was not in the public interest having regard to the needs and wishes of the residents.

The Tribunal found that the City failed to provide direct evidence regarding the needs and wishes of the residents or the impact on the immediate community.

The Tribunal ordered the Registrar to issue the licence without conditions, noting that the applicant had sufficient policies and procedures in place to responsibly handle the sale of alcohol.

The appellant appealed the Minister of Transportation's decision to downgrade his class DZ commercial driver's licence to a class G licence due to a diagnosis of epilepsy.

The appellant argued his condition was stable with medication and lifestyle changes, and his neurologist supported reinstatement.

The Tribunal confirmed the Minister's decision, finding that the appellant's condition, particularly given the stress and night shifts associated with his snow-plowing work, posed a significant risk and warranted adherence to the CCMTA Medical Standards recommending a 5-year seizure-free period.

Tarion Warranty Corporation brought a motion to add the builder, Greystone Village Inc., as a party to the homeowners' appeal regarding denied warranty claims under the Ontario New Home Warranties Plan Act.

Tarion argued that Greystone had a significant interest because it might be liable to indemnify Tarion if the appeal succeeded.

The Tribunal dismissed the motion, finding that the builder's potential future liability for indemnification did not constitute a significant interest in the warranty appeal itself, as the builder would maintain its right to defend any subsequent indemnification claim.

The appellant appealed a Notice of Proposal to Review an Application for a Liquor Licence.

An added party objected to the issuance of the licence, citing concerns about the proximity to schools, poverty, and crime in the neighbourhood.

The Tribunal found that the added party failed to prove that issuing the licence was not in the public interest, noting the appellant's compliance plans and training.

The Tribunal directed the Registrar to issue the licence subject to a single condition agreed upon by the parties requiring signage asking patrons to keep outdoor noise to a minimum.

The applicant sought statutory accident benefits for psychological treatment following a motor vehicle accident.

The core dispute was whether the applicant's psychotherapist should be paid at an enhanced hourly rate of $149.61, akin to a psychologist, rather than the $100.00 rate approved by the respondent.

The adjudicator found that the psychotherapist was not listed in the Professional Services Guideline and the applicant failed to demonstrate entitlement to the enhanced rate, noting the absence of evidence that specialized cognitive behavioural therapy was provided.

Claims for ancillary documentation fees and workbooks were also denied for lack of evidence.

The application was dismissed.

The applicant suffered a catastrophic brain injury in a 1999 motor vehicle accident.

The respondent insurer initially paid attendant care benefits (ACB) but reduced and then suspended them in November 2000 without proper notice.

The applicant sought retroactive and ongoing ACB at 24-hour care levels.

The Tribunal found that 24-hour care was not medically necessary, as the applicant had achieved a level of independent living with family support.

The Tribunal upheld the $120.40 monthly rate but ordered a top-up for two six-month periods following changes in living arrangements.

The Tribunal also awarded a 10% penalty under section 10 of Regulation 664 due to the insurer's 20-year delay in reinstating the suspended benefits, along with 2% monthly interest under the 1996 Schedule.

The applicant requested a reconsideration of a decision that found her application for statutory accident benefits was statute-barred.

The respondent brought a motion to strike the applicant's reply submissions on the reconsideration, arguing they improperly raised new issues.

The Tribunal granted the motion to strike the reply submissions but declined to award costs.

On the reconsideration, the Tribunal found no error of law or fact in its previous application of the Manuel test for extending limitation periods or its interpretation of s. 56 of the Schedule.

The request for reconsideration was dismissed.

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

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

The applicant contended that she suffered from accident-related psychological impairments and chronic pain, warranting removal from the MIG.

The Tribunal found that the applicant failed to prove on a balance of probabilities that she suffered from a psychological impairment or chronic pain with functional impairment that would remove her from the MIG.

As the disputed treatment plans were submitted on the basis that the injuries were outside the MIG, they were not payable.

The application was dismissed.

The applicant sought statutory accident benefits following a rear-end motor vehicle collision.

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

The Tribunal found that the applicant suffered predominantly minor soft tissue injuries, relying on the respondent's Insurer's Examination report and the clinical notes of the applicant's family physician, which indicated the injuries had largely resolved.

Because the $3,500 MIG limit had already been exhausted, the disputed treatment plans were not payable.

Claims for an award and interest were also dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, arguing his physical injuries, chronic pain, and psychological impairments warranted removal from the Minor Injury Guideline (MIG).

The Licence Appeal Tribunal found that the applicant's partial supraspinatus tear and C6 radiculopathy met the definition of minor injuries.

Applying the four-part test for chronic pain, the adjudicator concluded the applicant failed to demonstrate severe and constant pain or functional impairment sufficient to remove him from the MIG.

The Tribunal also accepted the respondent's psychological assessment finding no psychological injury.

As the injuries fell within the MIG and the respondent provided valid denials for the disputed treatment plans, the application was dismissed, and no interest or awards were granted.

The applicant requested a reconsideration of a Tribunal decision which found she was not involved in an accident.

The applicant argued the Tribunal violated procedural fairness by allowing a preliminary issue hearing and erred in law by improperly applying the causation test.

The adjudicator dismissed the request, finding no exceptional circumstances to permit new arguments regarding procedural fairness and concluding that the original decision correctly applied binding jurisprudence on causation.