Citation: Yasmeen v. Belair Insurance Company Inc., 2026 ONLAT 25-002691/AABS

Licence Appeal Tribunal File Number: 25-002691/AABS

In the matter of an application pursuant to subsection 280(2) of the Insurance Act, RSO 1990, c I.8, in relation to statutory accident benefits.

Between:

Faiza Yasmeen

Applicant

and

Belair Insurance Company Inc.

Respondent

DECISION

ADJUDICATOR:

Gurleen Thethi

APPEARANCES:

For the Applicant:

Syed Raza, Counsel

For the Respondent:

Robbie Brar, Counsel

Court Reporter:

Sai Priya Sivalohan

HEARD by Videoconference:

January 6 – 7, 2026

OVERVIEW

1Faiza Yasmeen, the applicant, was involved in an automobile accident on April 27, 2023, and sought benefits pursuant to the Statutory Accident Benefits Schedule - Effective September 1, 2010 (including amendments effective June 1, 2016) (the “Schedule”). The applicant was denied benefits by the respondent, Insurer, and applied to the Licence Appeal Tribunal - Automobile Accident Benefits Service (the “Tribunal”) for resolution of the dispute.

ISSUES

2The issues in dispute are:

i. Are the applicant’s injuries predominantly minor as defined in s. 3 of the Schedule and therefore subject to treatment within the $3,500.00 Minor Injury Guideline (“MIG”) limit? Note: The parties agree the MIG limits have not been exhausted.

ii. Is the applicant entitled to an income replacement benefit in the amount of $400.00 per week from February 8, 2024, to date and ongoing?

iii. Is the applicant entitled to $769.74 for transportation costs to attend treatment sessions, proposed by Alliance Diagnostic & Treatment Inc. in a treatment plan/OCF-18 (“plan”) dated September 22, 2024?

iv. Is the applicant entitled to the assessments proposed by Alliance Diagnostic & Treatment Inc., as follows:

1. $2,550.00 for an Orthopaedic Assessment, in a plan dated July 22, 2024;

2. $2,175.91 for a Psychological Assessment, in a plan dated August 22, 2024;

3. $2,200.00 for an MRI Assessment, in a plan dated November 24, 2024; and

4. $2,550.00 for a Chronic Pain Assessment, in a plan dated November 24, 2024?

5. Is the applicant entitled to $2,400.00 for a Psychological Assessment, proposed by Pearson Medical Assessment Centre Inc. in a plan dated January 10, 2024?

v. Is the applicant entitled to interest on any overdue payment of benefits?

3During the hearing, the applicant withdrew her claim to an award as an issue in dispute and therefore the issue of an award will not be addressed as part of this decision.

RESULT

4I find that:

i. The applicant sustained minor injuries in the accident as defined under the Schedule. She remains within the MIG and is subject to the treatment limits of the MIG.

ii. The applicant is not entitled to an income replacement benefit.

iii. As the applicant is in the MIG, it is not necessary to consider if the treatment plans in dispute are reasonable and necessary.

iv. The applicant is not entitled to interest.

PROCEDURAL ISSUES

Respondent’s Motion

5The respondent filed a Notice of Motion on January 5, 2026, and submits that the applicant is in breach of the Case Conference Report and Order (“CCRO”) and the Licence Appeal Tribunal Rules (“LAT Rules”) pertaining to the service of productions. The respondent sought the following orders:

i. An order that Dr. Wilderman’s Chronic Pain Assessment Report, dated September 16, 2025, and any references thereto be excluded from the hearing and that the applicant not be permitted to rely on either the contents of the report or the opinions, conclusions, and diagnoses of Dr. Wilderman. The respondent submits that the report was submitted past the filing deadline, as per the CCRO.

ii. A declaration that the applicant is in default of Rule 9.3, Rule 9.4, and Rule 10.2 of the LAT Rules.

iii. An order that the applicant shall be barred from calling the witness who authored the reports, records, and/or documents, which he failed to produce pursuant to the CCRO, to give evidence at the hearing pursuant to Rule 9 of the LAT Rules.

iv. An order that any authorities introduced by the applicant be excluded from the hearing. The respondent submits that the applicant has not served their book of authorities; and,

v. An order that the respondent is permitted to include Dr. Bansal’s IE GP Report dated September 30, 2025. The respondent submits that the report was mistakenly omitted from their hearing brief and was served on the applicant on December 16, 2025.

6The applicant objected to the motion in its entirety. I found as follows:

i. Dr. Wilderman’s Chronic Pain Assessment Report dated September 26, 2025 shall be admitted into the hearing record. The respondent submits that the report was submitted past the filing deadline, as per the CCRO. Despite the report being submitted after the applicable deadline, I am satisfied that the respondent has had ample opportunity to consider the assessment. The report was provided on November 17, 2025, and was served well in advance of the hearing. Any concerns regarding the timing of the report or its evidentiary value may be addressed through submissions regarding the weight to be given to the evidence.

ii. The respondent requested a declaration that the applicant is in default of Rules 9.3, 9.4, and 10.2 of the LAT Rules. The respondent has not pointed or directed me to any authority to make such a declaration and in my view, the Tribunal does not issue declarations of default, and accordingly, this request is denied.

iii. The respondent sought an order barring the applicant from calling witnesses who authored reports, records, and/or documents that were not produced in compliance with a previous order, pursuant to Rule 9 of the LAT Rules. The applicant confirmed that they do not intend to call any witnesses, aside from the applicant. As such, this request is moot.

iv. The respondent sought an order excluding any authorities relied upon by the applicant on the basis that the applicant’s book of authorities had not yet been received. The respondent also advised that it had not received the applicant’s hearing brief. The Tribunal was in receipt of the applicant’s hearing brief. I directed the applicant to serve and file all outstanding materials, including the book of authorities and hearing brief, and advised that any materials not served and filed before the end of the hearing would be excluded from the hearing record. The applicant was provided with time during the hearing to produce and serve this material, which was completed at the outset of the hearing. The respondent subsequently confirmed receipt of the documents before the conclusion of the hearing.

v. The respondent requested permission to include Dr. Bansal’s IE GP Report dated September 30, 2025, having been produced past the deadline, as per the CCRO. The applicant did not object to the inclusion of this report. Accordingly, the report is admitted into the hearing record.

Applicant’s Motion

7On the second day of the hearing, the applicant brought a motion to exclude the testimony of Dr. Bansal and Dr. McDowell, citing that the respondent had violated Rule 9.4.3 by filing the expert Duty Forms after the 21‑day deadline. I note that Rule 10.2 governs expert evidence, while Rule 10.3 requires the Expert Duty Form to be served no later than 45 days before the hearing. The applicant submitted that they were agreeable to having the expert reports admitted into evidence.

8I denied the motion for the following reasons: The motion was brought orally on the second day of the hearing, and no Notice of Motion was filed. The applicant was served the documents on December 19, 2025, and has had ample opportunity to bring the motion earlier than the second day of the hearing. It was unclear why the applicant sought to exclude the experts’ testimony, thereby losing the opportunity to cross‑examine, while at the same time consenting to the admission of their reports into evidence. Rather, I find that denying the respondent’s witnesses the opportunity to testify would be prejudicial to the applicant, given that their reports have been admitted into evidence.

ANALYSIS

The applicant’s injuries fall within the MIG

9I find that the applicant has not demonstrated that she should be removed from the MIG.

10Section 18(1) of the Schedule provides that medical and rehabilitation benefits are limited to $3,500.00 if the insured sustains impairments that are predominantly a minor injury. Section 3(1) defines a “minor injury” as “one or more of a sprain, strain, whiplash associated disorder, contusion, abrasion, laceration or subluxation and includes any clinically associated sequelae to such an injury.”

11An insured may be removed from the MIG if they can establish that their accident-related injuries fall outside of the MIG or, under s. 18(2), that they have a documented pre-existing injury or condition combined with compelling medical evidence stating that the condition precludes recovery if they are kept within the confines of the MIG. The Tribunal has also determined that chronic pain with functional impairment or a psychological condition may warrant removal from the MIG.

12The burden is on the applicant to demonstrate, on a balance of probabilities, that her injuries fall outside of the MIG.

13The applicant is seeking removal from the MIG on the basis that she suffers from a psychological impairment and chronic pain as a result of the subject accident.

The applicant does not have a psychological injury that would remove her from the MIG

14The applicant has not proven on a balance of probabilities that she suffers from a psychological impairment that would warrant removal from the MIG as a result of the subject accident.

15The applicant testified to experiencing anxiety and depression post-accident and relies on the clinical notes and records (“CNRs”) from her family physician, Dr. Reka, and a psychological assessment dated November 1, 2024, completed by Dr. Anand and supervised by Dr. Papazoglou, both psychologists. Dr. Anand diagnosed the applicant with Adjustment Disorder (with anxiety and depressed mood), Specific (Isolated) Phobia (driver/ passenger), and Somatic Symptom Disorder with predominant pain.

16The applicant also relies on a psychological assessment supervised by Ms. Aghamohseni, a psychologist, and conducted by Mr. Ross, a social worker and psychotherapist. Mr. Ross diagnosed the applicant with Major Depressive Disorder, Somatic Symptom Disorder, and Specific Phobia (vehicular). I place limited weight on this assessment, given that the conducting assessor, is not a psychologist.

17I find that the applicant’s testimony does not support a finding that the applicant suffers from a psychological impairment, as the applicant did not testify to experiencing any psychological impairments, aside from indicating she has anxiety and depression. The applicant testified to experiencing a worsening of anxiety and depression when driving or being a passenger in a vehicle. Further, the applicant testified that since the accident, she has not seen a psychologist, she has not received any psychological treatment, and nor has she been referred to a psychologist by her family physician.

18I have reviewed the CNRs of the family physician and find that they do not speak to any psychological impairments that would warrant the applicant’s removal from the MIG. The CNRs from Dr. Reka do not show any ongoing psychological accident-related complaints. The clinical notes are limited, and the applicant did not provide detailed symptom reports. The only mention of a potential psychological impairment in the CNRs is on October 2, 2024, where the applicant discussed her mental health concerns/headaches, and was advised to continue with Escitalopram and prescribed Zyprexa Zydis for anxiety attacks. I note that there is no reference to the accident, but rather financial stress is noted in detail.

19The respondent relies on the IE report completed by Dr. McDowall, a psychologist, and dated May 29, 2024. It is Dr. McDowall’s clinical opinion that the applicant does not currently meet the clinical criteria for an accident-related DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) diagnosis. The respondent submits that limited weight should be given to the psychological assessment conducted by Dr. Anand and Dr. Papazoglou, given that they were completed virtually, they did not conduct the same assessments as Dr. McDowall, and that they are insufficient.

20Where the opinions of the experts diverge, I prefer the evidence of Dr. McDowall to that of Dr. Anand and Dr. Papazoglou. I place limited weight on the report of Dr. Anand and Dr. Papazoglou for several reasons. Their assessment was conducted virtually, and I find that the assessors did not review any medical documentation to corroborate their conclusions. The report relies primarily on the applicant’s self‑report, behavioural observations, and the results of psychometric testing, without reference to supporting medical records.

21In contrast, Dr. McDowall conducted an in‑person assessment over a two‑hour period. I find that Dr. McDowall undertook a more comprehensive review of the available evidence, including a variety of medical records. For these reasons, I prefer and place greater weight on Dr. McDowall’s opinion.

22I find that the applicant has not met her onus in proving on a balance of probabilities that she suffers from a psychological impairment as a result of the subject accident. The clinical notes and records do not demonstrate ongoing, accident-related psychological complaints, the applicant’s testimony was limited and did not establish psychological impairment, and the psychological assessments relied upon lack sufficient corroboration in the medical records. As such, the applicant has not established that her accident-related impairments warrant removal from the MIG.

The applicant does not have chronic pain that would remove her from the MIG

23The applicant has not proven on a balance of probabilities that she suffers from chronic pain that would warrant removal from the MIG as a result of the subject accident.

24The applicant testified to having headaches, shoulder pain, and backpain as a result of the accident. The applicant testified she is currently taking Naproxen on a daily basis. The applicant relies on the CNRs from her family physician, a prescription summary dated June 19, 2025, and a report dated September 26, 2025, and completed by Dr. Igor Wilderman, a family physician with a chronic pain management practice, who diagnosed the applicant with chronic pain syndrome.

25I have reviewed the CNRs of the family physician and find that they do not speak to a chronic pain condition that would warrant the applicant’s removal from the MIG. The CNRs from Dr. Reka do not show any ongoing chronic pain complaints as a result of the subject accident. The only instances of pain post-accident are noted below:

i. On May 1, 2023, the applicant met her doctor regarding the motor vehicle accident. Dr. Reka diagnosed the applicant with soft tissue and musculoskeletal injuries, prescribed physiotherapy and Baclofen.

ii. On May 16, 2023, the applicant met with her doctor regarding hypothyroidism and the musculoskeletal injuries from the accident. The applicant was prescribed Synthroid, Tylenol, Baclofen, and Ibuprofen, which were all faxed to her pharmacy, with repeats.

iii. On June 13, 2023, Dr. Reka renewed the applicant’s prescription of Baclofen for her back pain.

iv. On July 27, 2023, Dr. Reka notes that the applicant is recovering well from her low mechanical back pain, from the accident, and now wants to return to work on July 30. The applicant was given a note to return to work.

v. On August 9, 2023, the applicant saw Dr. Reka regarding low back pain. Dr. Reka advised the applicant to do core strengthening, ordered an MRI, and renewed the Blexten prescription.

vi. February 27, 2024, the applicant obtained a renewal of Blexten, and was prescribed Ketorolac a medication for headaches.

vii. December 23, 2024, the applicant saw Dr. Reka regarding stress-related headaches. There is no mention of the accident. A prescription for Naproxen was renewed.

26I note that the applicant testified that there was no MRI that was conducted, as of the date of this hearing. Further, I find it notable that on July 27, 2023, as noted above, the applicant was cited to have been recovering well and a note to return to work was provided. The applicant testified that she conveyed this to her doctor as a result of pressure from her husband to return to work and contribute financially, despite not being ready to do so.

27In his report, Dr. Wilderman reported that the applicant met six of the six criteria for chronic pain syndrome found in the 6th edition of the American Medical Association (“AMA”) Guides for the Evaluation of Permanent Impairment. Dr. Wilderman reported that the applicant’s injuries fall outside of the MIG and diagnosed the applicant with the following injuries he considered to be caused by the subject accident:

i. Chronic pain syndrome

ii. Chronic Whiplash Associated Disorder (WAD) type II

iii. Mechanical Lower Back Pain Pattern 1 PEN

iv. Lumbago

v. Sacroiliac joint dysfunction on the right

vi. Post-traumatic chronic headaches

vii. TMJ syndrome

viii. Impingement syndrome of shoulder on the right

ix. Rotator cuff syndrome on the right

x. Subacromial bursitis on the right

xi. Myofascial pain syndrome of rhomboid region on the right

xii. Lightheadedness

xiii. Depression

xiv. Anxiety & PTSD

28I am not persuaded that the CNRs of the applicant’s treating physician, read together with the applicant’s testimony, corroborate the diagnoses set out in Dr. Wilderman’s report or support the presence of a functional impairment at the level described. While the applicant’s testimony is generally consistent with ongoing pain complaints, the treating physician’s CNRs do not reference a diagnosis of chronic pain or chronic pain syndrome, nor do they demonstrate the criteria associated with such a condition under the AMA Guides. Therefore, I find that they do not support the extent of impairment identified by Dr. Wilderman.

29As a result, I find that there is a disconnect between the contemporaneous clinical evidence and the conclusions reached in Dr. Wilderman’s report, and I place limited weight on his assessment.

30Further, I find that Dr. Bansal’s opinion should be given greater weight. Dr. Bansal reviewed the complete accident benefits file, including clinical records, treatment and assessment plans, diagnostic imaging, psychological reports, and documentation describing the claimant’s functioning over time, both before and after the accident. Dr. Bansal considered the full history of symptoms, treatment progression, and ongoing impact of the accident‑related injuries. By contrast, Dr. Wilderman’s review was more limited and focused on select clinical notes, an orthopaedic assessment, and X‑ray imaging only. I therefore find that Dr. Bansal’s conclusions are more persuasive, as they are grounded in a broader and more complete evidentiary foundation.

31I find that the CNRs do not support a finding that the applicant suffers from chronic pain as they do not show any ongoing accident-related complaints, and nor has the applicant directed me to any evidence to establish the same. While the applicant reported pain in the months immediately following the accident, the records indicate improvement over time, including a noted recovery and return-to-work clearance by July 2023. There is no evidence of persistent functional impairment or documentation addressing the criteria associated with chronic pain as contemplated by the AMA Guides. In these circumstances, I find that the contemporaneous medical evidence does not corroborate the applicant’s claim, and is insufficient to establish, on a balance of probabilities, that she suffers from chronic pain as a result of the subject accident.

32For these reasons, I find that the applicant has not, on a balance of probabilities, met her onus to prove that she should be removed from the MIG on the basis of chronic pain.

The applicant is not entitled to IRBs in the amount of $400.00 per week from February 8, 2024, to date and ongoing.

33To receive payment for an IRB under s. 5(1) of the Schedule, the applicant must be employed at the time of the accident and, as a result of and within 104 weeks after the accident, suffer a substantial inability to perform the essential tasks of that employment. The applicant must identify the essential tasks of their employment, which tasks they are unable to perform and to what extent they are unable to perform them. The applicant bears the burden of proving, on a balance of probabilities, that they meet the test.

34At the time of the accident, the applicant was employed as a machine operator with Superior Laundry. The applicant submitted a Disability Certificate/OCF-3 on May 23, 2023 and was paid an IRB of $400.00 per week from May 4, 2023 to February 8, 2024. Following the IE of Dr. Bansal and Dr. Rudzinski on January 23, 2024, the applicant’s IRB was stopped on February 8, 2024. The applicant seeks a continuation of her IRB from February 8, 2024, to ongoing.

35In the OCF-3 dated May 23, 2023, Dr. Zdriluck indicated that the applicant sustained sprain and strain injuries to multiple areas including her spine, back, and shoulder, and that she had not returned to work. She noted that the applicant had difficulty performing the essential tasks of her work as a machine operator including bending, lifting, carrying, and conducting repetitive movements, i.e. cleaning washrooms, mopping, and doing laundry.

36Dr. Reka’s clinical notes and records provide limited assistance in determining the impact of the applicant’s injuries on her ability to return to work. The records reflect relatively few documented complaints of pain and do not address any work restrictions or functional limitations consistent with the injuries identified in the OCF‑3. To the contrary, the July 27, 2023, entry indicates that the applicant requested a return‑to‑work note, which suggests an ability to resume employment at that time. While I acknowledge the applicant’s testimony that she requested the note due to pressure from her husband and that she did not feel ready to return to work, she has not directed me to any objective medical evidence or contemporaneous documentation demonstrating that she was unable to substantially perform the essential tasks of her employment. In the absence of such evidence, her explanation does not alter my finding.

37Overall, the treating physician’s records do not corroborate an ongoing inability to work or a level of impairment consistent with the applicant’s evidence.

38The applicant testified that she was unable to work as a machine operator at the time her IRB was stopped. The applicant reported that her duties involved removing items from a machine and placing them onto a line, bending to pick up towels from the ground, feeding towels, pillows, and sheets into the machine, and lifting up to 40–50 pounds at her heaviest. She indicated that the job required continuous standing and that she worked full-time hours pre-accident.

39The applicant testified that after the IRB stoppage, she attempted to go back to work on a gradual basis in June 2024, and continued working until September 2024, at which point she was laid off.

40The applicant testified that from October 2024 to September 2025, she worked at Tim Hortons for approximately 30–35 hours per week. She reported to Dr. Bansal that her role involved performing cashier and customer service duties, preparing food and sandwiches on occasion, operating the drive‑through, removing garbage, and cleaning. The applicant testified that she stopped working due to ongoing pain.

41Although the applicant’s pre‑accident employment as a machine operator and her post‑accident employment at Tim Hortons involved different tasks, I find that the physical demands of the two positions are broadly similar. Both roles require prolonged standing, repetitive physical activity, and sustained endurance throughout the workday. In each position, the applicant was required to bend, reach, handle items, and remain on her feet for extended periods. While the machine operator role involved heavier lifting and the Tim Hortons position involved customer service and food preparation, both jobs were physically demanding rather than sedentary.

42The applicant submits that her post‑accident attempt to return to work should be viewed as a failed return‑to‑work effort and does not necessarily establish that she was able to sustain employment on a consistent or ongoing basis. I accept that an attempt to return to work, on its own, does not automatically demonstrate functional capacity, however, the nature and duration of the applicant’s post‑accident employment remain relevant when assessing her overall work tolerance and functional abilities.

43The respondent relies on the IE reports of Dr. Bansal and Dr. McDowall, and concludes that the applicant did not suffer, at that time, an impairment that resulted in job tasks that she was unable to perform, and therefore the applicant does not meet the substantial inability test required by s. 5(1) of the Schedule to be eligible for further IRBs.

44I am not persuaded that the applicant has established that she suffered a substantial inability to perform the essential tasks of her pre‑accident employment at the time her IRB was stopped. Although she reports ongoing symptoms, the medical evidence does not demonstrate functional restrictions preventing her from performing work involving prolonged standing and repetitive physical activity. Further, the applicant has been able to maintain employment at Tim Hortons for an extended period post‑accident. While that position may not involve heavy lifting to the same degree as her pre‑accident work, it nonetheless requires sustained standing, physical activity, and endurance throughout the workday.

45For these reasons, I find that the applicant has not met her onus of proving, on a balance of probabilities, that as a result of her accident‑related injuries she suffered a substantial inability to perform the essential tasks of her employment after February 8, 2024. Accordingly, the applicant is not entitled to income replacement benefits from that date onward.

46As I have found that the applicant remains subject to the MIG and its $3,500.00 funding limit, it is not necessary for me to consider whether the treatment plans are reasonable and necessary.

The applicant is not entitled to interest

47Interest applies on the payment of any overdue benefits pursuant to s. 51 of the Schedule. As no payments are owing, no interest is due.

ORDER

48The applicant sustained minor injuries in the accident as defined under the Schedule. She remains within the MIG and is subject to the treatment limits of the MIG.

49The applicant is not entitled to an income replacement benefit.

50As the applicant is in the MIG, it is not necessary to consider if the treatment plans in dispute are reasonable and necessary.

51The applicant is not entitled to interest.