RECONSIDERATION DECISION
Before: Craig Mazerolle, Vice-Chair
Licence Appeal Tribunal File Number: 24-007836/AABS
Case Name: Tian You Si Tu v. TD General Insurance Company
Written Submissions by:
For the Applicant: Anh Vo, Paralegal
For the Respondent: Karina Dziuba, Counsel
OVERVIEW
1On January 30, 2026, the applicant requested reconsideration of the Tribunal’s decision released January 12, 2026 (“decision”).
2Stemming from an accident on July 10, 2019 and a request for benefits made pursuant to the Statutory Accident Benefits Schedule – Effective September 1, 2010 (including amendments effective June 1, 2016) (the “Schedule”), the parties participated in a written hearing. In the decision, the Tribunal found the applicant was not entitled to the three treatment plans in dispute, interest, or an award.
3According to paragraph 17 of the decision, all three plans proposed “similar treatment modalities of massage, chiropractic and physiotherapy treatments”.
4The 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.
5The applicant relies on Rule 18.2(a) and Rule 18.2(b) to support his request. The applicant asks the Tribunal to either order a rehearing, or, in the alternative, to determine that he is entitled to the three treatment plans, plus interest. The applicant did not present any grounds in support of overturning the Tribunal’s denial of the award claim.
6The respondent asks the Tribunal to dismiss the request for reconsideration.
RESULT
7The applicant’s request for reconsideration is granted.
8Pursuant to Rule 18.4, the decision is cancelled, save for the award determination. The remaining issues in dispute will be sent to a rehearing.
9The rehearing will be conducted by a new adjudicator. This adjudicator shall review the existing record, i.e., the submissions and evidence from the written hearing.
ANALYSIS
10The test for reconsideration under Rule 18.2 involves a high threshold, and the requesting party must show how or why the decision falls into one of the categories in Rule 18.2. 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.
Rule 18.2(a) – Sufficiency of Reasons
11The applicant claims the Tribunal did not provide sufficient reasons to explain why it found he did not meet his evidentiary burden. He raises several issues with the decision, but I will focus on the applicant’s claim that the Tribunal did not adequately grapple with one of his key arguments. Specifically, the applicant argues the Tribunal did not address his position that the physical treatment proposed in the plans will assist with both his pain and his psychological symptoms.
12I find the applicant has shown that the Tribunal did not adequately grapple with this argument. As such, the applicant has shown the Tribunal materially breached his right to procedural fairness, pursuant to Rule 18.2(a).
13The Supreme Court of Canada has repeatedly recognized the important role that reasons play in supporting the fairness and legitimacy of administrative decision-making. Most notably, in Canada (Minister of Citizenship and Immigration) v. Vavilov, 2019 SCC 65 (“Vavilov”), the Supreme Court stated at paragraph 79 (citations removed):
Reasons explain how and why a decision was made. They help to show affected parties that their arguments have been considered and demonstrate that the decision was made in a fair and lawful manner. Reasons shield against arbitrariness as well as the perception of arbitrariness in the exercise of public power…
14Similarly, in Baker v. Canada (Minister of Citizenship and Immigration), 1999 CanLII 699 (SCC) (“Baker”) at paragraph 39, the Court ruled that reasons allow decisions to be questioned: “Reasons… are invaluable if a decision is to be appealed, questioned, or considered on judicial review”.
15Despite their importance to the fair administration of tribunal decision-making though, reasons are not to be judged on the standard of perfection: see, for example, Newfoundland and Labrador Nurses' Union v. Newfoundland and Labrador (Treasury Board), 2011 SCC 62, at paragraph 18. For instance, it is well-accepted that a tribunal is not expected to address every argument and piece of evidence presented by the parties: see Clifford v. Ontario Municipal Employees Retirement System, 2009 ONCA 670. Rather, reasons will meet the standard set out in Vavilov and Baker if a decision-maker shows they grappled with the key arguments and evidence presented by the parties.
16The Tribunal summarized the applicant’s position about the disputed treatment plans at paragraph 15 (emphasis added):
The applicant submits that the treatment plans in dispute are reasonable and necessary to treat his neck and back pain. He contends that his pain complaints are corroborated by his healthcare providers as well as through the independent assessors. He relies on his family doctor’s clinical notes and records (“CNRs”), and CNRs of York Medical Centre, the s. 25 psychological assessment report, the Insurer Examination (“IE”) psychological assessment, as well as the chronic pain assessment report.
17Aside from this brief reference to the parties’ psychological assessment reports, the decision contains no explicit assessment of what, if any, impact the proposed physical treatment will have on the applicant’s psychological condition. There is also no explicit assessment of what, if any, relevant information was contained in these reports.
18After reviewing the applicant’s initial written hearing submissions, I am satisfied that the impact of pain on his psychological condition formed a key part of his argument in support of these plans for physical treatment. In particular, at paragraph 22 of his submissions, the applicant explicitly linked his psychological condition to the disputed plans: “Since the proposed physical treatments provided him with temporary pain relief, it is submitted that they also help him cope with his somatic pain disorder”. I am satisfied that this argument was not a minor, tertiary submission. Rather, it was a core element of the applicant’s theory of the case.
19The respondent claims the applicant is asking the Tribunal to re-litigate the dispute, as it effectively summarized and addressed the applicant’s position about the plans. The respondent further contends that the treatment plans were only focused on addressing his physical condition, i.e., they did not “propose an integrated approach to somatic symptom management or identify any psychological benefit”. As such, there was no need to assess the applicant’s psychological condition when determining the reasonable and necessary nature of these plans.
20I do not find these arguments alter my conclusions about the sufficiency of the Tribunal’s reasons. Not only am I satisfied that one of the applicant’s key arguments was not adequately addressed, but the respondent’s submission about the lack of any connection between the plans and the applicant’s psychological condition is exactly the kind of analysis that the Tribunal was asked to engage in. It may very well be that an adjudicator will find there is no credible line that can be drawn between these plans and the recovery of one’s psychological symptoms, but the applicant has the right to see how the Tribunal will address this central part of his case.
21In sum, the applicant has established grounds for reconsideration based on Rule 18.2(a). Due to this conclusion, I further find I do not need to address the applicant’s other grounds for reconsideration.
Rule 18.4 – Rehearing the Disputed Treatment Plans and Interest
22Considering the nature of the Rule 18.2(a) breach, I find the most appropriate remedy under Rule 18.4 is to send the treatment plans and interest back to be reheard by a new adjudicator. By not explicitly addressing a central aspect of the applicant’s argument, the Tribunal must provide a fresh assessment of these issues. However, to ensure the efficient resolution of this dispute, the new adjudicator will conduct this rehearing based on the parties’ evidence and submissions from the written hearing.
23Since the applicant has not challenged the Tribunal’s denial of his award request, I will not send this issue back to be reheard.
CONCLUSION & ORDER
24The applicant’s request for reconsideration is granted.
25Pursuant to Rule 18.4, the decision is cancelled, save for the award determination. The remaining issues in dispute will be sent to a rehearing.
26The rehearing will be conducted by a new adjudicator. This adjudicator shall review the existing record, i.e., the submissions and evidence from the written hearing.
27I am not seized.
Craig Mazerolle
Vice-Chair
Released: May 12, 2026```