RECONSIDERATION DECISION
Before: Jeremy A. Roberts, Vice-Chair
Licence Appeal Tribunal File Number: 24-013189/AABS
Case Name: Sarah Friesen v. Intact Insurance Company
Written Submissions by:
For the Applicant: Dagmara Wozniak, Counsel
For the Respondent: Mahroze Khan, Counsel
OVERVIEW
1On February 3, 2026, the applicant requested reconsideration of the Tribunal’s decision dated January 13, 2026 (“decision”).
2In that decision, the Tribunal found that the applicant was not deemed catastrophically impaired under Criterion 8 and was not entitled to the treatment plan in dispute.
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.
4The applicant argues that the Tribunal made errors of law or fact such that it would have likely reached a different conclusion had those errors not been made. The respondent submits that the applicant has not satisfied the grounds for a reconsideration.
5The applicant requests that the decision be varied to find that the applicant sustained a marked impairment in social functioning and therefore satisfies the requirements to be deemed catastrophically impaired under Criterion 8.
RESULT
6The applicant’s request for reconsideration is denied.
ANALYSIS
7The 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.
Rule 18.2(b) – I find that the Tribunal has not made an error of law or fact such that it would have likely reached a different result had the error not been made
8I find that the Tribunal has not made an error of law or fact such that it would have likely reached a different result had the error not been made.
9The primary issue in dispute was catastrophic impairment under criterion 8. In order to be deemed catastrophically impaired under criterion 8, the applicant must demonstrate that she has suffered accident-related impairments that result in a marked (class 4) impairment in three or more areas of function according to the American Medical Association’s Guides to the Evaluation of Permanent Impairment (the “Guides”) 4th Edition due to a mental or behavioural disorder. Mental and behavioural impairments are rated according to how seriously they affect a person’s useful daily functioning. The Guides set out the four spheres of functioning that are relative levels of impairment (activities of daily living (“ADLs”), social functioning, concentration, persistence & pace, and adaptation).
10The applicant made a series of arguments regarding the Tribunal’s errors of law and fact, including that the Tribunal: (1) erroneously applied the Guides as they relate to Criterion 8 by treating the social functioning indicators as conjunctive rather than disjunctive, contrary to previous LAT findings (Simmons v. BelairDirect, 2023 CanLII 26935 (ON LAT); (2) made findings of fact and reached conclusions regarding the applicant’s social functioning which were not supported and/or contradicted by the evidentiary record before the Tribunal, in contradiction to guidance in Micanovic v. Intact Insurance, 2022 ONSC 1566; (3) improperly inserted the Adjudicator’s lay opinion on matters in issue requiring expert evidence, in contradiction to guidance from Ontario Association of Chicken Processors v. OBJECC, 2025 ONSC 4174 and Wilson v. Intact, 2025 ONSC 5305; and (4) inappropriately declared a consensus between assessors on the impairment rating for ADLs when Dr. Sivasubramanian actually changed his rating to be “marked” during his cross-examination.
11In making these arguments, the applicant pointed to reports from various clinicians (including notably Dr. Biederman and Occupational Therapist (“OT”) Herring) to submit that the Tribunal ignored significant evidence of social functioning impairment (relating to isolation, avoidance, dependance, and communication) and focused instead on more selective evidence of lack of social outburst, hostility, or conflict (which she argues do not constitute a truly holistic view of her social functioning impairment). The applicant concludes by arguing that had any of these errors not been made, the Tribunal would have found that applicant to have a marked impairment in the domain of social functioning, which would have satisfied the test to be deemed catastrophically impaired under criterion 8 and thereby would have altered the Tribunal’s conclusion.
12The respondent submitted that the applicant has failed to meet the high threshold of demonstrating that an error or law or fact has been made. It argued that the Tribunal assessed and weighed the evidence and provided sound reasoning in its decision. Furthermore, it argued that reconsideration is not an opportunity for a party to ask the Tribunal to reweigh or reconsider evidence, or relitigate its position where it disagrees with the decision. Lastly, it argued that even if an error was made, the applicant failed to demonstrate how any of these errors would have led to a different result.
13More specifically, the respondent argued that the applicant failed to properly consider the wording of moderate and marked impairments, urged the Tribunal in paragraphs 11-33 of its submissions to improperly reweigh evidence, and failed to demonstrate how the Tribunal made an error of law or fact in arriving at its decision.
14I find that the applicant has not met the high threshold of demonstrating that an error of law or fact was made that would have resulted in a different conclusion. The Tribunal identified the correct and relevant legal tests and analytical frameworks in paragraphs 7, 8, 19, 24, and 25 of the decision. It reviewed the evidence in paragraphs 26-29, and provided reasoning for its findings in paragraphs 30-31.
15Turning to the applicant’s specific arguments noted above. On point (1) regarding the Guides, I find that the Tribunal properly applied the AMA Guides when considering the issue of social functioning. The Tribunal weighed different pieces of evidence, placed higher weight on the report of Dr. Sivasubramanian and OTs Clark and Herring, and found that on the whole the applicant’s social functioning does not rise to the level contemplated as “marked” in the Guides. I find that the specific references to outbursts and altercations do not signify a conjunctive approach to the factors, but rather added evidence as part of a holistic review of the various factors contemplated by the Guides.
16On point (2) regarding unfounded conclusions, I find that there has been no error of fact here. I find that the Tribunal effectively reviewed the evidence and made findings commensurate with a proper process. I see no evidence that the Tribunal did not conduct a fair analysis of that evidence in paragraphs 26-29. Reconsideration is not an opportunity to re-litigate the issues considered at the initial hearing, and I find that in this case the applicant has not satisfied me than an error of law or fact occurred here that would meet the high threshold of Rule 18.2(b).
17On point (3) regarding expert opinion, I find that the Tribunal did not incorrectly substitute its own opinion. We know from Liu v. 1226071 Ontario Inc (Canadian Zhorong Trading Ltd.), 2009 ONCA 571 that the test for catastrophic determination is a legal one and not a medical one. The Tribunal is guided by expert reports in making its legal determinations. This does not conflict with the reasoning in Ontario Association of Chicken Producers or Wilson, but rather, collectively informs adjudicators how to consider expert opinion in making legal determinations. I see nothing in the decision that suggests that the Tribunal substituted its own opinion for that of a medical assessor. The Tribunal identified the legal tests, weighed the evidence, made a legal determination, and supported the finding with analysis based on the law, submissions and evidence before it.
18Lastly, on point (4) regarding the change in rating, I find that the applicant failed to demonstrate how an error or fact here would have likely led to a different result. Even accepting the applicant’s argument that Dr. Sivasubramanian changed his opinion on what impairment rating to assign this domain during his testimony, there is no evidence that this change from his own report would have been given sufficient weight to meaningfully alter the conclusion, especially without other corroborating evidence. In fact, the Tribunal specifically afforded Dr. Sivasubramanian’s report and testimony low weight in paragraphs 12-13 of the decision. As such, I find that even if there was an error of fact, I remain unconvinced that it would have resulted in a different conclusion.
19Given these findings, I find that the applicant has not met the high threshold required by Rule 18.2(b).
CONCLUSION & ORDER
20The applicant’s request for reconsideration is denied.
Jeremy A. Roberts
Vice-Chair
Tribunals Ontario – Licence Appeal Tribunal
Released: April 15, 2026