OLAT 2023

The applicant sought reconsideration of a Licence Appeal Tribunal decision denying a physiotherapy treatment plan, medication expenses, interest, and a special award under section 10 of Regulation 664.

The applicant argued the Tribunal erred in law and fact and violated procedural fairness by allegedly failing to consider submissions on the special award for non-earner benefits and by not adequately reviewing evidence for the treatment plan and expenses.

The Vice-Chair dismissed the request, finding the original decision properly addressed the issues, applied the correct legal tests, and provided adequate reasons.

The applicant sought statutory accident benefits following a 2015 motor vehicle accident, including an occupational therapy assessment, assistive devices, and chiropractic treatments.

The Tribunal found the occupational therapy assessment was duplicative of a prior in-home assessment by a registered nurse.

The request for assistive devices was denied as the applicant failed to establish they were reasonable and necessary, and some needs were already met.

The claim for chiropractic treatments was denied because the expenses were incurred before the treatment plan was submitted, contrary to s. 38(2) of the Schedule, and the invoiced services could not be reconciled with the approved plan.

Claims for interest and an award were consequently dismissed.

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

The respondent denied the benefits 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 for removal from the MIG due to pre-existing conditions, psychological impairments, and chronic pain.

The Tribunal found that the applicant failed to prove that his pre-existing conditions precluded recovery within the MIG, and assigned no weight to the applicant's expert reports regarding psychological issues and chronic pain because they failed to consider an intervening accident.

The application was dismissed.

The applicant sought statutory accident benefits following a motorcycle accident.

The respondent denied benefits, arguing the applicant's policy was cancelled prior to the accident and he was excluded under s. 31(1)(a)(i) of the Schedule for driving without insurance.

The Tribunal found the respondent validly terminated the policy by registered mail and the applicant ought reasonably to have known he was uninsured.

Furthermore, the Tribunal dismissed the applicant's claims for various medical benefits and treatment plans, finding the applicant failed to provide sufficient medical evidence to prove the plans were reasonable and necessary.

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

The Licence Appeal Tribunal found the applicant was entitled to funding for psychotherapy, a neuropsychological assessment, and a COGMED assessment/treatment, as these were reasonable and necessary given objective evidence of a traumatic brain injury and ongoing psychological symptoms.

Claims for chiropractic services and a driver evaluation were dismissed.

The Tribunal also held the applicant was barred from pursuing a neurological assessment due to his failure to attend scheduled insurer's examinations without a reasonable explanation.

A claim for a special award under s. 10 of O. Reg. 664 was dismissed, but interest was awarded on the approved treatment plans.

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

The respondent insurer denied benefits and argued as a preliminary issue that the applicant was barred from proceeding to a hearing under s. 55 of the Schedule for failing to attend an insurer's examination.

The Tribunal found that the respondent failed to provide copies of the notices of examination relevant to the issues in dispute, and therefore could not prove the notices complied with the strict requirements of s. 44(5).

The applicant was permitted to proceed to a substantive hearing.

The applicant sought a reconsideration of a Licence Appeal Tribunal decision that denied entitlement to a treatment plan for psychological services.

The applicant argued under Rule 18.2(b) that the Tribunal made an error of fact by referring to the treatment plan as proposing psychological treatment rather than a psychological assessment.

The Vice-Chair dismissed the request, finding that the applicant had failed to provide the OCF-18 or any supporting submissions at the original hearing.

The Tribunal held that the applicant's failure to meet his evidentiary burden at first instance did not constitute an error of fact by the Tribunal, and the reconsideration request was an improper attempt to re-litigate the case.

The applicant was struck by a vehicle while walking across a pedestrian crosswalk and sought statutory accident benefits.

The respondent 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 with a functional disability, removing him from the MIG.

The Tribunal ordered the respondent to pay for the disputed physiotherapy treatment plans and interest on the overdue payments.

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

The appellant argued she exercised due diligence and that the impoundment would cause exceptional hardship.

The Licence Appeal Tribunal dismissed the appeal, finding the appellant failed to take active steps to verify the driver's licence status near the time of the incident.

The Tribunal also found no exceptional hardship, as the appellant had alternative means of transportation, including assistance from friends, family, and taxis.

The respondent insurer requested a reconsideration of a decision awarding the applicant a non-earner benefit for a three-month period due to the insurer's failure to comply with its procedural obligations under s. 36(4) of the Schedule.

The insurer argued the adjudicator erred in law by not stopping the analysis after finding the applicant did not meet the substantive test for the benefit, and breached procedural fairness by allowing the applicant to profit despite alleged misrepresentations.

The adjudicator dismissed the request, finding the insurer was improperly attempting to relitigate issues and raise new legal arguments not presented at the initial hearing.

The appellant appealed the 45-day impoundment of her vehicle under the Highway Traffic Act.

The vehicle was impounded after being driven by an individual whose licence required an ignition interlock device, which the vehicle lacked.

The appellant argued the impoundment would cause exceptional hardship due to her employment and her sister's health issues.

The Tribunal found that while the appellant had no alternative transportation, she failed to prove the impoundment would result in a threat to health or safety, or an immediate, significant, and long-lasting financial loss.

The appeal was dismissed and the impoundment confirmed.

The applicant sought entitlement to statutory accident benefits following a motor vehicle accident, specifically claiming costs for a chronic pain assessment and a chronic pain program.

The Tribunal found that the treatment plans were not reasonable and necessary, preferring the recent insurer's examination report over the applicant's older medical report.

The Tribunal noted the applicant was fully functional, working full-time, and had not utilized previously approved treatment.

The application was dismissed, and claims for interest and a special award were denied.

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

The respondent raised a preliminary issue that the applicant was barred from proceeding with his claims for non-earner benefits and a chronic pain assessment because he failed to attend multiple insurer's examinations (IEs).

The Tribunal found that the applicant failed to attend the scheduled IEs without a reasonable excuse and that the respondent was prejudiced by the non-attendance.

The Tribunal declined to exercise its discretion to allow the hearing to proceed.

The applicant's claims were barred, and he withdrew the remaining issues, resulting in the closure of the file.

The appellant appealed a Notice of Proposal by the Registrar to suspend his registration as a real estate broker for making false statements and having administrative staff complete his continuing education courses.

Shortly after the hearing commenced, the parties reached a resolution and filed Minutes of Settlement.

The Licence Appeal Tribunal issued a consent order suspending the appellant's registration for 60 days and requiring him to complete an ethics course.

The applicant sought medical and rehabilitation benefits following a motor vehicle accident, arguing her injuries warranted removal from the Minor Injury Guideline (MIG) due to chronic pain and psychological impairment.

The Licence Appeal Tribunal found that the medical evidence, including insurer's examinations, confirmed the applicant sustained only soft tissue injuries.

The Tribunal concluded the applicant failed to demonstrate chronic pain with functional impairment or a psychological condition that would justify removal from the MIG.

As the $3,500 MIG limit had been exhausted, the disputed treatment plans and claim for interest were dismissed.

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

The applicant argued the Tribunal erred in law and fact by finding her leg collapsing was an intervening cause and by misapplying the dominant feature test.

The Tribunal dismissed the request, finding the applicant was attempting to re-argue her case and had not established any error of law or fact under Rule 18.2.

The applicant requested a reconsideration of a decision denying her entitlement to post-104-week income replacement benefits (IRB) and interest.

The applicant argued that the adjudicator erred in law and fact by failing to properly analyze the post-104-week IRB test, misapprehending evidence, providing inadequate reasons, and demonstrating bias against subjective pain complaints.

The Tribunal dismissed the request, finding no violation of procedural fairness or significant error of law or fact that would have altered the original decision.

The adjudicator held that the original decision properly considered both objective and subjective evidence and correctly applied the post-104-week IRB test.

The applicant sought a physiotherapy treatment plan of $3,523.22 following a motor vehicle accident.

At the case conference, the applicant withdrew issues relating to the Minor Injury Guideline (MIG) and non-earner benefits.

However, the applicant's written submissions focused entirely on the withdrawn MIG and non-earner benefit issues, failing to address the disputed treatment plan or provide evidence that it was reasonable and necessary.

The Tribunal dismissed the application, finding the applicant failed to meet his burden of proof.

The applicant requested a reconsideration of a decision finding she was not catastrophically impaired under Criterion 8 of the Schedule.

The applicant argued the adjudicator erred in law and fact by misapplying the Schedule, rejecting expert psychiatric opinions, misapplying the causation test, and ignoring evidence of deterioration.

The Tribunal dismissed the request, finding no errors of law or fact that would have changed the outcome.

The adjudicator noted that assigning weight to evidence and preferring certain evidence over expert opinions falls within the adjudicator's role and does not constitute an error of law.

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

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

The applicant claimed his injuries were outside the MIG due to chronic pain and psychological impairments.

The Licence Appeal Tribunal found the applicant's medical evidence, including clinical notes and records, insufficient to prove his injuries were more than minor.

The Tribunal concluded the applicant was subject to the MIG and dismissed the claims for additional medical benefits, an award for unreasonable delay, and interest.