Coban v. Allstate Insurance, 2025 CanLII 35907

Citation: Coban v. Allstate Insurance, 2025 ONLAT 21-012430/AABS-R

RECONSIDERATION DECISION

Before: Rachel Levitsky

Licence Appeal Tribunal File Number: 21-012430/AABS

Case Name: Josef Coban v. Allstate Insurance

Written Submissions by:

For the Applicant: Joseph Obagi, Counsel

For the Respondent: Jennifer Griffiths, Counsel

OVERVIEW

1This request for reconsideration was filed by Joseph Coban (the "applicant") on December 18, 2024. It arises out of a decision released on November 28, 2024, in which I found that the applicant was not "employed" prior to the accident pursuant to s. 5(1)(1) of the Statutory Accident Benefits Schedule – Effective September 1, 2010 (including amendments effective June 1, 2016) (the "Schedule"). As a result, I found that he was not entitled to an income replacement benefit ("IRB").

2The grounds for a request for reconsideration are found in Rule 18.2 of the Licence Appeal Tribunal Rules, 2023 (the "Rules"). To grant a request for reconsideration, the Tribunal must be satisfied that one or more of the following criteria are met:

a) The Tribunal acted outside its jurisdiction or committed a material breach of procedural fairness;

b) The Tribunal made an error of law or fact such that the Tribunal would likely have reached a different result had the error not been made; or

c) There is evidence that was not before the Tribunal when rendering its decision, could not have been obtained previously by the party now seeking to introduce it, and would likely have affected the result.

3The applicant seeks a reconsideration pursuant to Rule 18.2(b). He requests that my decision be replaced with a decision that the applicant was "employed" pursuant to s. 5(1)(1)(i) of the Schedule and is entitled to receive IRBs.

4The respondent submits that the applicant has failed to identify an error of law or fact such that the Tribunal would likely have reached a different decision had the error not been made.

RESULT

5The applicant's request for reconsideration is dismissed.

ANALYSIS

6The test for reconsideration under Rule 18.2 involves a high threshold. The reconsideration process is not an opportunity for a party to re-litigate its position where it disagrees with the Tribunal's decision, or with the weight assigned to the evidence. The requestor must show how or why the decision falls into one of the categories in Rule 18.2.

7During a written hearing, the dispute before me was whether the applicant was "employed" at the time of the accident, pursuant to s. 5(1)(1) of the Schedule. As a result of a workplace injury, the applicant was receiving payments from the WSIB. He entered into a Work Transition Plan ("WTP"), which was amended by the WSIB on a number of occasions depending on his schooling or work activities. At the time of the accident that gave rise to his claim for accident benefits, he was still receiving payments from WSIB. His WTP at the time of the accident included a provision that he would work at COLE & Associates Architects Inc. ("COLE").

8In my decision, I agreed with the applicant that he had an employment relationship with COLE, but I found that he did not receive remuneration in exchange for the services he provided to COLE.

9The applicant argues that I made three errors:

a. Considered the quantum of WSIB payments prior to the accident;

b. Considered the applicant's decision to pursue an extended placement with COLE; and

c. Narrowly interpreted and relied on the term "studies" in WSIB's letter from January 4, 2019.

10For the following reasons, I find that the applicant has not established grounds for reconsideration.

No error in considering the quantum of WSIB payments prior to the accident

11The applicant submits that in concluding that the applicant's remuneration was not dependent on whether he was actually providing services to COLE, I erred by relying on the fact that the quantum of the applicant's weekly payments under s. 43(3) of the Workplace Safety and Insurance Act, S.O. 1997, c. 16 ("WSIA") did not change prior to the accident. He submits that this evidence was irrelevant.

12The question before me was whether the applicant received remuneration in exchange for the services he provided to COLE. The fact that he received the same weekly amount from WSIB before and after he began working at COLE was information included in the agreed statement of facts prepared by the parties. The applicant has not demonstrated that it was an error to rely on this fact.

13The applicant also submits that the evidence in the agreed statement of facts establishes that his entitlement to s. 43(3) payments at the time of the accident was dependent on his ability to continue providing services to COLE in accordance with a WTP. He argues that my conclusion, which was that his remuneration was not dependent on whether he was actually providing those services, runs contrary to the agreed statement of facts.

14It was an agreed fact that the applicant was no longer able to continue working at COLE and was therefore unable to comply with the WTP in place at the time, thus resulting in a reduction in his payments from WSIB. I acknowledged this at paragraphs 11 and 12 of my decision. However, whether the WTP in place was contingent on the work the applicant did for COLE is a separate issue from whether he received remuneration from WSIB in exchange for services provided to COLE. Making the determination that he did not receive remuneration in exchange for his services to COLE involved looking at all of the facts before me, including that he received the same amount from WSIB during the time that he did not work for COLE. I accordingly find that the applicant has not demonstrated that my conclusion ran contrary to the agreed statement of facts.

No error in considering the applicant's decision to pursue the extended placement with COLE

15The applicant submits that, when I concluded that working for COLE was not mandated by the WSIB in order for him to continue receiving weekly payments, I erred in relying on the fact that it was the applicant who sought to extend his placement with COLE. He argues that this evidence was irrelevant and that the ultimate inference drawn from this fact was inconsistent with the agreed statement of facts and the documentary evidence.

16The applicant has not established that there was anything contained within the agreed statement of facts or the documentary evidence that ran contrary to my finding. The only reason I knew that the applicant sought to continue working with COLE after his summer placement ended was because this information was included in the agreed statement of facts. The ultimate inference drawn was not that the applicant's continued work at COLE was not mandated by the WTP; it was that the WSIB did not mandate that the WTP include continued work at COLE, and this requirement was only included in the WTP because the applicant was the one who requested it. This information provided context as to the nature of the applicant's agreement with the WSIB, which was relevant in determining whether the payments made by the WSIB were provided in exchange for services to COLE. The applicant has not established that it was an error to consider this evidence.

No error in interpreting and relying on the term "studies" in WSIB's January 4, 2019 letter

17The applicant submits that I erred by narrowly interpreting the WSIB's letter of January 4, 2019, specifically placing undue emphasis on the term "studies". He submits that I inferred that the WSIB's reference to "studies" meant that had the applicant been able to return to his "studies" in the future, his WTP would not necessarily include a requirement that he also engage in employment activities. He argues that this was an unreasonable finding of fact which ran contrary to the express terms of the agreed statement of facts and had no basis in the evidence before me. He also submits that this finding was irrelevant to the Tribunal's determination of whether he was "employed" at the time of the accident, and that it was an error of law for me to conclude that the payments received by the applicant and their subsequent reduction were not contingent on him providing services to COLE based on a speculative and hypothetical future scenario.

18At paragraph 20, I explained that the WSIB's letter noted that the applicant was forced to discontinue his studies due to the accident and advised him that it was closing the WTP and that he should contact the WSIB when he believed he could start to plan for a return to his studies. I noted that his ability to work was not mentioned. Considering the contents of this letter, there was no error in my finding that a future WTP would not necessarily include a requirement that the applicant also engage in employment activities. I find that the applicant has not shown how this determination was based on a speculative or hypothetical future scenario, when the letter provided information as to what was expected of the applicant by the WSIB, and it did not mention a return to work. Again, this provided context as to the nature of the payments from WSIB, which was directly relevant to whether they were made in exchange for services rendered to an employer.

19The applicant has not established that my finding ran contrary to the agreed statement of facts or the evidence as a whole. The letter was appended to the agreed statement of facts and was admitted for the truth of its contents. The applicant has not pointed me to any evidence adduced at the hearing showing that, after his participation in the WTP ended, he would have to work in order to receive full benefits from the WSIB. The applicant has accordingly not demonstrated that it was an error to make the finding that I did.

CONCLUSION & ORDER

20For the reasons above, I find no error of fact or law such that I would likely have reached a different result had the error not been made.

21The applicant's request for reconsideration is dismissed.

Rachel Levitsky

Adjudicator

Tribunals Ontario – Licence Appeal Tribunal