RECONSIDERATION DECISION
Before: Harry Adamidis, Adjudicator
Licence Appeal Tribunal File Number: 23-011240/AABS
Case Name: Irene Starr v. Intact Insurance Company
Written Submissions by:
For the Applicant: Alex Kluchuk, Counsel
For the Respondent: Shivani Mehta, Counsel
OVERVIEW
1On March 31, 2025, the applicant requested reconsideration of the Tribunal’s decision dated March 11, 2025 (“decision”).
2Following a videoconference hearing, I issued the decision. In the decision, I found that the applicant is not catastrophically impaired under Criterion 7. The applicant withdrew the remaining issues at the start of the hearing.
3The grounds for a request for reconsideration are found in Rule 18.2 of the Licence Appeal Tribunal Rules, 2023 (“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.
4Relying on Rule 18.2(b), the applicant submits that I made errors of law by not considering the Whole Person Impairment (“WPI”) ratings for medication and the right wrist by Dr. Atu Sekyi-Otu, orthopedic surgeon. If these errors had not been made, the applicant argues that she would have been found to be catastrophically impaired.
5The respondent argues that, even if the WPI ratings for medications and the right wrist are added to the applicant’s WPI rating, there would not have been a different result because her WPI rating would still be insufficient to find her catastrophically impaired.
6The applicant asks the Tribunal to vary its decision and find that she is catastrophically impaired.
RESULT
7The applicant request for reconsideration is dismissed.
ANALYSIS
8The 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.
9I have reviewed the decision and the Executive Summary of Dr. Sekyi-Otu, dated July 29, 2023. In the decision, at paragraphs 16 and 17, I considered Dr. Gladstone’s 3% rating for medications and provided reasons for why no impairment rating should be given for medications. However, I agree that I did not consider the WPI ratings for medications and the right wrist in the Executive Summary of Dr. Sekyi-Otu. I agree that not considering these WPI ratings constitutes an error of law and a ground for reconsideration under Rule 18.2(b). However, this error does result in a different outcome as the applicant still does not meet the WPI threshold to be found catastrophically impaired.
10I note that a 55% or more WPI rating is needed in order to be found catastrophically impaired under Criterion 7.
11The WPI rating for medications in the Executive Summary is 1%.
12The applicant submits that Dr. Sekyi-Otu’s WPI rating for the right wrist is unclear, because in various places in his Executive Summary he provides three different WPI ratings for the right wrist, i.e., 5%, 6%, or 9%. Because of the ambiguity, the applicant argues that she should be given a 9% WPI rating.
13The respondent argues that Dr. Seki-Otu gave a 5% WPI rating for the right wrist. It points to the Upper Extremity Impairment (“UEI”) ratings which he completed for the wrist. These include:
i. 2% UEI rating for extension
ii. 2% UEI rating for flexion
iii. 1% UEI rating for radial deviation
iv. 4% UEI rating for ulnar deviation
v. 1% UEI rating for right forearm and wrist pronation
14These add up to a 10% UEI rating. Dr. Sekyi-Otu subtracted the 1% UEI rating for the right forearm and wrist pronation from the right wrist rating, and then added it as a UEI rating for the forearm. As a result, the respondent submits that the right wrist has a 9% UEI rating, and the right forearm has a 1% UEI rating.
15On page 13 of his Executive Summary, Dr. Sekyi-Otu states that the 9% WPI rating for the right wrist is available for discussion. The respondent submits that this is a misstatement by Dr. Sekyi-Otu. I agree with the respondent. A careful reading of Dr. Sekyi-Otu’s report shows that the 9% refers to the UEI rating and not the WPI rating. There are no UEI ratings in the Executive Summary which can be converted to a 9% WPI rating for the right wrist.
16UEI values for regional impairments are combined as opposed to being added. This is noted on page 24 of the Guides:
Multiple regional impairments, as with those of the hand, wrist, elbow and shoulder, are expressed in terms of impairment of the upper extremity and are combined using the Combined Values Chart.
17I acknowledge that this method of combining values is the correct method and that this was not the method used in the decision. However, for the purpose of properly addressing the applicant’s reconsideration submissions, I must use this method of combining the UEI which is the correct method in the Guides. Thus, when the right wrist UEI rating is combined to the right upper extremity UEI rating, the following results:
| Impairment | UEI Rating |
|---|---|
| Shoulder | 20% |
| Right Wrist | 9% |
| Right Forearm | 1% |
| Right Hand | 28% |
| Right Grip Strength | 30% |
| Total: | 64%* |
*Using Combined Values Chart on p. 322 of the Guides
18Table 3 of Chapter 3 of the Guides converts the 64% UEI rating to a 38% WPI rating for the right upper extremity.
19All of the WPI ratings, including the 1% rating for medications, combine as follows:
| Impairment | WPI Rating |
|---|---|
| Medications | 1% |
| Sleep | 2% |
| Upper Extremity | 38% |
| Psychological Impairments | 15% |
| Total: | 49%* |
*Using Combines Values Chart on page 322 of the Guides.
20In light of the two errors of law identified by the applicant, I have re-assessed the applicant’s impairment ratings and determined that she does not meet the 55% WPI rating threshold to be found catastrophically impaired under Criterion 7.
CONCLUSION & ORDER
21The applicant’s request for reconsideration is dismissed.
Harry Adamidis Adjudicator Tribunals Ontario – Licence Appeal Tribunal
Released: July 2, 2025