RECONSIDERATION DECISION
Before:
Harouna Saley Sidibé
Licence Appeal Tribunal File Number:
24-004415/AABS
Case Name:
Freeman Stringer v. Co-operators General Insurance Company
Written Submissions by:
For the Applicant:
Sundeep Singh, Counsel
For the Respondent:
Amanda Lennox, Counsel
OVERVIEW
1On February 13, 2026, the applicant requested reconsideration of the Tribunal’s decision dated January 26, 2026 (“decision”).
2Stemming from an automobile accident on July 12, 2023, and a request for accident benefits made pursuant to the Statutory Accident Benefits Schedule – Effective September 1, 2010 (including amendments effective June 1, 2016) (the “Schedule”), in the decision I found that the applicant was entitled to attendant care benefits, concussion and chronic pain assessments, an OCF-21 in part, and related interest. I denied the remaining benefits in dispute, including outstanding balances and treatment plans for physiotherapy and a treatment plan for chiropractic services. I also found that the respondent was not liable for an award.
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 seeks reconsideration pursuant to Rule 18.2(c). He asks the Tribunal to find that the outstanding amounts denied for physiotherapy, as well as the physiotherapy and chiropractic treatment plans, are reasonable and necessary.
5The respondent submits that the applicant has failed to meet the high threshold for reconsideration and that the request should be dismissed.
RESULT
6The applicant’s request for reconsideration is dismissed.
ANALYSIS
7I find that the applicant has not established grounds for reconsideration pursuant to Rule 18.2(c).
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.
9The applicant submits that he has established grounds for reconsideration. Although the parties and the Tribunal were aware that he was a candidate for right shoulder replacement surgery, his decision to proceed with surgery scheduled for February 17, 2025, was unknown at the time of the hearing. He relies on clinical records dated September 16, 2025, October 22, 2025, and December 18, 2025, which confirm that he elected to undergo surgery. The applicant submits that this information was not available at the time of the hearing and could not have been obtained earlier, as he had not yet decided to proceed. He further argues that had the Tribunal been aware of this development, it would likely have affected the outcome, as the disputed physiotherapy and chiropractic treatment plans are said to align with post‑surgical rehabilitation needs. Therefore, he submits that he has met the test for reconsideration under Rule 18.2(c).
10The respondent submits that even if the applicant’s decision to proceed with surgery is accepted as new evidence, it would not have affected the outcome of the decision. On the contrary, the respondent argues that this evidence reinforces the original findings. The respondent notes that the applicant had already completed a significant course of physiotherapy without sustained improvement and ultimately required surgery despite that treatment. Therefore, the respondent submits that this confirms the additional physiotherapy proposed in the disputed treatment plans was neither reasonable nor necessary, particularly since surgical intervention had been recommended prior to the requests for further physiotherapy. The respondent also submits that the applicant has failed to explain how this alleged new evidence would have affected the Tribunal’s findings regarding chiropractic treatment directed at concussion‑type symptoms.
11I find that the clinical notes and records submitted by the applicant with his reconsideration request constitute new evidence for the purposes of Rule 18.2(c). The evidence confirms that the applicant elected to proceed with right shoulder replacement surgery, a decision made after the hearing and therefore not before the Tribunal when it rendered its decision. I am also satisfied that this information could not reasonably have been obtained or presented earlier, as the applicant had not yet decided to proceed with surgery at the time of the hearing. Accordingly, the evidence is new in a chronological sense. However, the finding that the evidence is new does not end the analysis, as the applicant must still demonstrate that it would likely have changed the outcome of the decision.
12Turning to whether this evidence would likely have changed the outcome of the decision, I find that it would not. In sum, my reasons for denying the disputed physiotherapy and chiropractic treatment plans did not hinge on whether the applicant ultimately required shoulder surgery. Rather, the decision turned on the nature, volume, and clinical justification of the treatment sought at the time the plans were submitted, as well as the absence of persuasive evidence that extended or repeated courses of treatment were reasonable and necessary. The fact that the applicant later underwent surgery and may require rehabilitation thereafter is not relevant to the assessment of the disputed treatment plans, which were adjudicated based on the evidence available at the time. Accordingly, knowledge of the subsequent surgery would not have disturbed my original findings or changed the outcome of the decision.
Physiotherapy treatment plans and remaining balances
13In the decision, I found that the applicant had already undergone a substantial course of physiotherapy and that some physiotherapy treatment was reasonable and necessary. However, the dispute was not about entitlement to physiotherapy in principle, but rather about the volume and duration of treatment sought. I relied on the opinion of Dr. Alfonse Marchie, who assessed the proposed physiotherapy treatment plans and concluded that they were only partially reasonable and necessary. Dr. Marchie supported physiotherapy to a limited extent, imposed monetary limits, and opined that extending passive treatment beyond those limits was unlikely to yield meaningful or sustained functional improvement. While the applicant demonstrated an ongoing need for some physiotherapy, I found that the evidence did not justify repeated or prolonged courses beyond those supported by Dr. Marchie, as the treating records lacked objective measures of progress and a persuasive clinical rationale for extended treatment. I therefore concluded that physiotherapy was payable only to the extent supported by Dr. Marchie’s opinion, and that the remaining treatment plans and outstanding balances in dispute were not reasonable or necessary.
14Although the applicant argues that the treatment plans align with post-surgical needs, I find that the evidence of surgery would not likely have changed the outcome of the decision. This is because the evidence that the applicant subsequently had surgery does not affect my assessment of the treatment’s efficacy at the time the treatment plan was in place, nor does it affect my reliance on Dr. Marchie’s opinion that passive treatment beyond certain limits was not reasonable and necessary.
Chiropractic treatment plan
15Regarding chiropractic treatment for alleged concussion‑type symptoms, I found the medical evidence conflicting. Although Dr. James Fung diagnosed persistent post‑concussive symptoms, his opinion was largely based on subjective reporting and lacked corroboration from contemporaneous medical records. I preferred the evidence of Dr. Rehan Dost, whose opinion was detailed, grounded in recognized diagnostic criteria, and supported by objective findings. I accepted Dr. Dost’s conclusion that the applicant did not sustain a concussion. In light of that finding, I concluded that treatment directed at concussion‑related symptoms was unlikely to provide meaningful benefit. I also found that the proposed chiropractic plan lacked clear functional goals, measurable outcomes, and adequate clinical justification, and appeared duplicative of other treatment modalities.
16The evidence of surgery would likely not have changed the outcome of my decision on the chiropractic treatment plans, because the original findings turned on the lack of evidence supporting extended physiotherapy beyond approved limits and the factual finding that the applicant did not sustain a concussion.
17The applicant’s post‑hearing decision to proceed with shoulder surgery, while new in chronological terms, does not undermine or materially alter the evidentiary basis for assessing the chiropractic disputed treatment plans. Those plans were evaluated based on the applicant’s functional presentation and treatment history at the time of submission, and the later surgical intervention does not retroactively render the proposed volume or duration of physiotherapy reasonable or necessary.
18Moreover, even if the surgery is accepted as new evidence, it bears no logical connection to the chiropractic treatment plan, which was denied on the basis of a factual finding that the applicant did not sustain a concussion and that the plan lacked adequate clinical justification. Accordingly, the applicant has not shown that this evidence would likely have affected the outcome of the chiropractic treatment plan.
19Accordingly, I find that the applicant has not established grounds for reconsideration pursuant to Rule 18.2(c). As such, the applicant’s reconsideration request is dismissed.
CONCLUSION & ORDER
20The applicant’s request for reconsideration is dismissed.
Harouna Saley Sidibé
Adjudicator
Tribunals Ontario – Licence Appeal Tribunal
Released: May 6, 2026