Thomas v. The Commonwell Mutual Insurance Group, 2026 CanLII 45618

Licence Appeal Tribunal

Citation: Thomas v. The Commonwell Mutual Insurance Group, 2026 ONLAT 24-010174/AABS-R

RECONSIDERATION DECISION

Before: Craig Mazerolle, Vice-Chair

Licence Appeal Tribunal File Number: 24-010174/AABS

Case Name: Carla Thomas v. The Commonwell Mutual Insurance Group

Written Submissions by:

For the Applicant: Carlos Echeverria, Paralegal

For the Respondent: Cecil Jaipaul, Paralegal

OVERVIEW

1On October 14, 2025, the applicant requested reconsideration of the Tribunal’s decision released September 23, 2025 (“decision”).

2Stemming from an accident on May 17, 2022 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 videoconference hearing. In the decision, the Tribunal found the applicant was held to the Minor Injury Guideline (“MIG”), and that she was not entitled to a non-earner benefit, the six treatment plans in dispute, or interest.

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 relies on all three criteria to support her request. She is asking for an order to either vary the decision finding she is entitled to the disputed issues, or, in the alternative, to set up a new hearing.

5The respondent asks the Tribunal to deny the request.

RESULT

6The applicant’s request for reconsideration is granted, in part.

7Pursuant to Rule 18.4, the parties shall participate in a written rehearing before a different adjudicator. The only issues in dispute for the rehearing are the application of s. 18(2) to the MIG, the disputed treatment plans, and interest.

8The Tribunal’s findings regarding the denial of the NEB and the applicant’s arguments about s. 38(8) of the Schedule remain undisturbed.

ANALYSIS

9The 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.

10The applicant has raised a number of grounds for reconsideration. Though I have granted the request for reconsideration based on her arguments concerning Rule 18.2(c), it is necessary to first address the other, unsuccessful grounds for reconsideration. Briefly, not only is the rehearing being limited to certain issues, but the future adjudicator may find these reasons helpful in their determination of the case.

Rule 18.2(a) + Rule 18.2(b) – Section 18(2) and Pinpoint References

11To start, the applicant challenges the Tribunal’s interpretation of s. 18(2) of the Schedule. Citing the definition of “compelling evidence” from Scarlett v. Belair Insurance, 2015 ONSC 3635 (“Scarlett”), the applicant submits the Tribunal incorrectly elevated the standard of proof required to engage this provision. She also claims the Tribunal ignored a significant body of medical evidence due to her alleged failure to provide pinpoint references. The applicant argues that the cumulative effect of these errors would likely have impacted the outcome of the decision. I also note that, in a related vein, the applicant claims the Tribunal materially breached her right to procedural fairness by disregarding clinical notes and records that did not have pinpoint references.

12I first find the applicant has not shown that the Tribunal strayed from the guidance provided in Scarlett over what constitutes “compelling evidence” under s. 18(2). After confirming that the standard of proof remains “a balance of probabilities”, the Divisional Court stated at paragraph 27:

(1) that the word "compelling" is directed at the sufficiency of the evidence required to satisfy that standard; and (2) that whether the evidence in a particular case is sufficient to meet the test of "compelling" must be determined on the facts of each individual case having regard to what is reasonable in all of the circumstances.

13Aside from the fact that it explicitly noted at paragraph 26 that the standard of proof is “a balance of probabilities”, the Tribunal cited Scarlett at paragraph 34 as part of its summary of the respondent’s position. These legal standards helped to inform the Tribunal’s understanding of the case, as well as the test the applicant had to meet to engage s. 18(2). While the applicant may claim that the Tribunal’s approach “elevates form over substance”, I find these arguments are better understood as disagreements with the outcome. The reconsideration process is not a venue for a party to request a re-assessment of the evidence presented at first instance. Rather, a party requesting reconsideration must show a legal or factual error occurred, and the applicant has not done so.

14Next, I do not accept the applicant’s position that the Tribunal ignored evidence that would have likely led it to find she met the standard under s. 18(2). The Tribunal explained its assessment of the applicant’s medical evidence at paragraphs 36 – 45 of the decision. In this analysis, the Tribunal notes at paragraph 37 that there were deficiencies in the way the applicant presented this evidence:

The applicant entered as evidence the CNRs of her family doctor, Dr. Bacher and other medical practitioners, comprising over 700 pages. However, I was not directed to any specific pages of the CNRs for corroborating medical evidence, despite my request for the applicant to provide pinpoint references. Instead, the applicant listed the names of various medical practitioners whose reports were included within the CNRs, and she explained that the CNRs were being submitted as evidence to show the Tribunal that they were provided to the respondent. Conversely, the respondent directed me to pages in the CNRs covering a period of at least one year pre-accident that did not address any complaints by the applicant of pre-existing conditions. It is not the Tribunal’s role to go through a party’s evidence to make their case for them: see Dooman v. TD Insurance Company, 2025 ONSC 184 at para. 50 (Div. Ct.).

15However, despite this concern, the Tribunal proceeded to assess the weight of the applicant’s evidence. For instance, it noted that an OCF-18 prepared by the applicant’s family doctor and a treating social worker found there were “no” barriers to recovery, and that it was “unknown” whether she had any prior or concurrent conditions. Additionally, a report from Cody Eriksen, psychologist (dated December 24, 2024), did not address any pre-existing psychological conditions related to her earlier accident in 2009.

16Further, though the applicant may claim this aspect of the decision evidenced a lack of engagement with the evidence (and, in turn, resulted in a material breach of procedural fairness), there is no obligation on the part of the Tribunal to mention every piece of evidence in the decision. Moreover, the quotation shows that the applicant’s arguments related to these records were procedural in nature, and not necessarily related to s. 18(2): “… she explained that the CNRs were being submitted as evidence to show the Tribunal that they were provided to the respondent.”

17Finally, after reviewing these records (and comparing them to the opinion of the respondent’s psychiatric assessor, Dr. Robert Paul Weinstein), the Tribunal made the following findings about the applicant’s choice not to present evidence that met the second stage of the s. 18(2) test (at paragraphs 43 – 45):

It is apparent that she suffered injuries from the 2009 accident. However, evidence of a pre-existing condition alone is not sufficient to justify removal. Rather, the evidence must demonstrate that the pre-existing condition prevents the achievement of maximal recovery in the MIG.

I find that the applicant has not satisfied the second part of the test under s. 18(2), which requires her health practitioner to determine and provide compelling evidence that the pre-existing medical condition will prevent her from achieving maximal recovery from the minor injury if kept within the MIG limit. It is this part of the test that the applicant has not satisfied and for which she has not persuaded me that she should be taken out of the MIG.

As noted, this matter was scheduled as a 2-day videoconference hearing in which the applicant was permitted to call witnesses to give evidence at the hearing. The applicant’s subsequent decision to not call any witnesses limited the hearing to oral submissions and references to documentary evidence. Oral submissions do not constitute evidence.

18Taken together, the Tribunal accepted that she had a pre-existing condition, but, ultimately, concluded that the applicant did not meet the second stage of the s. 18(2) test. The applicant has not shown how the Tribunal erred in this approach, nor has she demonstrated any material breach of procedural fairness.

Rule 18.2(a) + Rule 18.2(b) – Weight for the Eriksen Report

19Turning again to the report from Mr. Eriksen, the applicant submits that the Tribunal breached her right to procedural fairness and erred in law by assigning little weight to this opinion. The respondent had brought a motion to exclude this report based on Mr. Eriksen’s non-attendance at the hearing. The Tribunal dismissed this request, but, according to the applicant, it went on to use this non-attendance to discount the report’s evidentiary value. Further, the applicant takes issue with the Tribunal raising concerns about the report that were not only absent from the respondent’s motion, but ran counter to standards set out by the College of Psychologists and Behaviour Analysts of Ontario (“College”). For instance, the applicant challenges the Tribunal’s concerns about the participation of a supervised psychotherapist in the assessment, as she claims the College allows for this kind of arrangement.

20The Tribunal reviewed Mr. Eriksen’s December 2024 report at paragraphs 39 and 40. This assessment allowed it to conclude the report would be afforded “little weight”:

I find that the psychological assessment report of Mr. Eriksen does not address the pre-existing psychological conditions that the applicant has presented relating to the 2009 accident. As well, I did not find this report to be persuasive as there was no record of reviewing the CNRs of the family doctor for the purposes of preparing the report. The document review was limited to six documents, which included an OCF-1, two Disability Certificates (“OCF-3”) and CNRs of Dr. Girish Birdi. The only pre-accident document listed as reviewed was a psychological progress report dated November 1, 2018 of Mr. Frank Kennedy, social worker, and a September 16, 2024 psychiatry assessment report of Dr. Ariel Zielinsky, psychiatrist. The report makes brief reference to the 2009 accident in connection with a prior diagnosis of fibromyalgia, but does not reference pre-existing psychological conditions or otherwise discuss the pre-accident reports listed in the report.

As well, the assessment was undertaken virtually by a registered social worker, Viktoria Tolmatshov, and indicates it was done under the supervision of Mr. Eriksen. The report is dated December 24, 2024, but the supervisory notes of Mr. Eriksen are dated December 27, 2024 and January 5, 2025, which is subsequent to the report date. I agree with the respondent that this calls into question how Mr. Eriksen, a psychologist, could provide input and supervision on the report after it had already been completed, as a registered social worker is not qualified to make psychological diagnoses. For these reasons, I give little weight to Mr. Eriksen’s report.

21Once again, the reconsideration process is not a venue for asking the Tribunal to re-weigh evidence considered at first instance. Though the applicant has framed this argument as a legal error, these complaints are an attempt to have the Tribunal assign more weight to this evidence. For example, while the applicant may claim there was an incorrect understanding of the College’s standards for supervision, the applicant has not provided any legal authority to show the Tribunal is unable to review this aspect of the assessment process when assigning weight. The applicant is entitled to disagree with this finding, but, unless she shows there was a legal or factual error in the Tribunal’s analysis, I do not find this ground merits reconsideration.

22I further find the applicant has not established a material breach of procedural fairness. Even if the respondent’s motion did not raise the specific concerns that the Tribunal turned to in its analysis, the applicant has not provided a persuasive explanation for why these considerations fall outside the allowable scope of this review. Adjudicators are tasked with assessing different aspects of a report when determining its weight, e.g., the assessor’s qualifications; the scope of the document review, etc. The applicant may claim the Tribunal’s process for weighing this report “shifted… without notice”, but I see no issue with this approach.

23I also note that the concerns about the participation of a psychotherapist in the assessment, as well as the dates of Mr. Eriksen’s notes, both appear to have played a secondary role to the more significant concern that the Tribunal had about the assessor’s understanding of the applicant’s pre-accident condition. Similarly, though the Tribunal commented at paragraph 45 on the applicant’s choice “to not call any witnesses”, I do not find this brief reference can then be used to support the applicant’s position that Mr. Eriksen’s non-attendance at the hearing played a pivotal role in its evidentiary assessment.

24Taken together, the applicant has not established any grounds for reconsideration in relation to the Tribunal’s assessment of Mr. Eriksen’s report.

Rule 18.2(b) – Section 38(8) Analysis

25The applicant argues that the Tribunal erred in its assessment of the respondent’s denial letters. Specifically, by concluding that “conclusory MIG references” are sufficient to meet the standard for compliant denial reasons under s. 38(8) of the Schedule, the applicant submits the Tribunal did not following binding case law, namely, Scarlett.

26I do not accept this argument. As noted above, the reconsideration process is not an opportunity for a party to re-litigate an argument when it disagrees with the outcome. Disagreement alone will not trigger Rule 18.2(b). I also note that the applicant has not provided a persuasive explanation of how the decision runs counter to the guidance in Scarlett. Aside from the fact that the main issue in this earlier case was whether the MIG applied to Mr. Scarlett’s claim, the only reference to s. 38(8) involved an example of how decision-makers should interpret references to the MIG in the Schedule (at paragraph 36):

Let me provide one final example. Section 38(9) of the [Schedule] provides that if the insurer believes that the MIG applies to the insured person's impairment, the notice under s. 38(8) must so advise the insured person. The MIG is expressly referred to in this subsection; however, the contents of the MIG are not required to understand or interpret the subsection. It is simply a procedural section that requires notice if the insurer believes the MIG applies. Accordingly, the MIG is not, in this subsection, incorporated by reference. Not in whole. Not in part.

27In sum, the applicant has not provided a persuasive account of how the Tribunal erred in its assessment of the respondent’s denials. Rather, it appears the applicant again disagrees with the outcome of the Tribunal’s analysis.

Rule 18.2(b) – NEB Eligibility

28The applicant claims the Tribunal erred by “strictly enforcing” the requirement under s. 36(2) for a completed OCF-3 to access a specified benefit, namely, she argues the Tribunal ignored her “substantial compliance” with this provision and the impacts that the respondent’s denials had on her ability to comply.

29The relevant section of the decision is at paragraphs 61, 62, 64, and 65 (emphasis added):

The applicant submits that on August 10, 2022 an OCF-3 was included along with an OCF-18 submission to the respondent. The applicant argues that the respondent failed to respond to the OCF-3 within 10 business days of receiving the OCF-3 as required by s. 36(4) and is thus required by s. 36(6) to pay an NEB retroactively from the date of disability. The applicant did not produce a completed OCF-3 dated August 10, 2022 or enter it into evidence.

The respondent counters that the applicant failed to submit a completed OCF-3 relating to her NEB claim within 104 weeks of the accident, as required under s. 36(2). This then triggers s. 36(3), which establishes that an applicant claiming a benefit such as NEB is not entitled to it for any period before an OCF-3 has been submitted. As a result, the applicant is not entitled to an NEB.

The applicant made reference to the OCF-3 being included within CNRs provided to the respondent on August 9, 2024. Such CNRs, which were included as evidence at the hearing and consisting of over 700 pages of documents, include 3 pages which appear to be an extract from an OCF-3. The applicant did not specifically direct me to those pages, nor did she explain whether a completed OCF-3 exists and how it was provided to the respondent. As such, I do not find this to be persuasive evidence to support the applicant’s position that she submitted a completed OCF-3 within 104 weeks of the accident. As well, I note that this OCF-3 extract found within CNRs was provided nearly 3 months after the 104-week eligibility period ended on May 14, 2024.

As a result, I find that the applicant has not provided persuasive evidence to demonstrate that she complied with s. 36(2), which mandates that an applicant claiming a specified benefit, such as NEB, file a completed OCF-3. This then means that she is not entitled to an NEB pursuant to s. 36(3), as there is no evidence that a completed OCF-3 was submitted during the 104-week NEB entitlement period.

30The applicant challenges the finding that she never provided a copy of this August 10, 2022 OCF-3. She claims the Tribunal was “overlooking the Applicant’s evidence of inclusion (entered into record as Exhibit 1; Tab 13, p. 500).”

31Respectfully, this citation is confusing for several reasons. First, while Exhibit 1 is marked in the Exhibit List as the “CNRs provided to the respondent Aug 9/24… [Applicant’s Document Brief] tab 13”, Tab 13 leads to a copy of a report from Dr. Tajedin Getahun. Additionally, page 500 of the document brief is not a copy of the OCF-3, but rather it is a page from a progress report prepared by Tingling’s Counselling Services.

32The applicant does not address this aspect of her request in reply.

33Once again, the applicant has the onus to show that a ground for reconsideration has been met. By not pointing to a missed copy of the OCF-3 in the records presented during the hearing, I do not find the applicant has established how the Tribunal erred in its consideration of the NEB under s. 36(2).

34The applicant also briefly mentions that there was evidence presented during the hearing that met the test for NEB entitlement under Heath v. Economical Mutual Insurance Company, 2009 ONCA 391. However, according to the decision at paragraph 66, there was no need to conduct the Heath analysis without a completed OCF-3. I see no error in this approach.

Rule 18.2(a) + Rule 18.2(b) – Exclusion of the Eriksen Addendum

35Next, the applicant contests the Tribunal’s order to exclude Mr. Eriksen’s addendum to his December 2024 report, as well as his Acknowledgement of Expert’s Duty form. According to the applicant, the Tribunal breached her right to procedural fairness, as this order did not account for “the Applicant’s explanation for delay from Respondent non-payment (clinic withholding) or its minimal content (MIG referral question/response).”

36I do not accept this argument. The Tribunal provided a detailed explanation for its decision not to admit these documents, and it was cognizant of the applicant’s arguments. For instance, the Tribunal addressed the argument about the limited scope of the addendum at paragraph 22 (emphasis added):

…I find that the production of these documents did not comply with the deadlines set out in the CCRO for document exchange. Further, the applicant did not advise that it took any steps to alert the respondent that an addendum was forthcoming. I find, under these circumstances, that the production of these documents less than one day prior to the hearing is prejudicial to the respondent as it does not provide it with sufficient time to review and respond to the documents, particularly as the hearing was being conducted in a single day. I also find the addendum would be of limited relevance since, as the applicant submitted, it was the same as the original report other than an additional referral question on the applicability of MIG and a two sentence response.

37Despite the applicant’s desire to rely on this evidence, I see no unfairness in the Tribunal’s determination that admitting evidence first served on the eve of the hearing would imperil the respondent’s right to a fair hearing. I am also satisfied that the Tribunal took stock of the applicant’s arguments.

Rule 18.2(c) – Newly Received s. 44 Report and Explanation of Benefits

38Following the filing of her reconsideration request (and the release of the Tribunal’s order setting out the timetable for responding and reply submissions), the applicant sent the Tribunal and the respondent the following e-mail (dated October 24, 2025):

Please be advised that on October 22, 2025, the respondent served upon the applicant new evidence that was not before the Tribunal when it rendered its decision, could not reasonably have been obtained earlier by the applicant, and would likely have affected the outcome.

Specifically, the respondent produced a Section 44 Physiatry Insurer's Examination Report dated June 17, 2025, after the filing of our reconsideration request, despite multiple prior follow-ups from the applicant. Please see attached copy of Section 44 Physiatry Insurer's Examination Report dated June 17, 2025 along with Explanation of Benefits letter dated October 22, 2025, in which the Respondent acknowledges the sec 44 Physiatry Insurer.s [sic] Examination Report was available July 2, 2025 (pg.4).

This report is directly relevant to the issues under reconsideration (issue of Minor Injury Guideline) and raises serious procedural concerns. The evidence indicates that the report was available to the respondent prior to the oral hearing of July 8, 2025, but was not disclosed to the applicant until October 22, 2025. This late disclosure has caused prejudice to the applicant and is inconsistent with the Tribunal’s Rules of Practice and Procedure, as well as the principles of procedural fairness under the Statutory Accident Benefits Schedule (SABS).

In light of the foregoing and pursuant to Rule 18.2 (c) of the LAT Rules, we respectfully request leave to file supplementary submissions addressing this newly disclosed evidence, or, in the alternative, that the Tribunal consider this material as part of the reconsideration record.

Kindly confirm whether the Tribunal will accept the supplementary filing and advise on the applicable timeline for doing so.

39A copy of this s. 44 physiatry report and the Explanation of Benefits were attached to this e-mail.

40On March 9, 2026, the Tribunal released an order granting the parties leave to file supplementary submissions about this new evidence. Both parties filed supplementary submissions.

41The applicant highlights how this s. 44 physiatry report includes a finding that directly impacts the s. 18(2) analysis:

It is the opinion of this assessor that there is sufficient documentation on file to confirm that she had ongoing chronic pain and fibromyalgia and these would prevent her from achieving maximal recovery from the accident-related impairment if limited to the medical and rehabilitation limits of $3,500.00.

42The applicant further submits that, while the respondent concluded in its Explanation of Benefits that “we are not bound by this report as it provides conflicting findings”, this stance is at odds with the non-adversarial nature of the accident benefits regime.

43The respondent claims the applicant is attempting to circumvent the document exchange requirements set out during the case conference, and she “chose to proceed to the merits hearing without the benefit of this assessment”. Further, the respondent echoes its comments from the Explanation of Benefits, namely, that it is not bound by the findings of its assessors, and that this particular assessment is “fundamentally flawed” as it relates to the s. 18(2) analysis. Finally, citing caselaw involving the principle of res judicata, the respondent claims the applicant has not met her onus to show that this evidence is “new” within the meaning of Rule 18.2(c), nor has she laid out her case about this new evidence in a manner that would allow the respondent to fairly respond.

44Considering the timeline laid out in the October 24, 2025 e-mail, I am satisfied that the s. 44 report and Explanation of Benefits were not before the Tribunal when rendering the decision. I am also satisfied that the applicant could not have previously obtained these documents. The decision was released on September 23, 2025, and the applicant did not receive these records until October 22, 2025.

45The respondent takes issue with this timeline, claiming the applicant knew she was going to the hearing in July 2025 without this report. I do not find this consideration is relevant. The timeline for when the s. 44 report would be sent to her was out of her control. It was not incumbent upon the applicant to delay the adjudication of her accident benefits claim based on the possibility that a further expert report would be forthcoming, especially as she had no concrete date for when it would arrive.

46I am also satisfied that this new evidence would likely have impacted the outcome of the decision. An insurer is not bound by the findings of its assessors, but, when assessing the applicability of the MIG, the question before the Tribunal is not whether a respondent was correct in maintaining its MIG position. Rather, the Tribunal is tasked with assessing whether an applicant has met the test for removal from the MIG. In this case, the applicant claimed she should be removed from the MIG based on s. 18(2). I am satisfied that an expert report indicating that she meets this test is highly relevant. Similarly, though the Explanation of Benefits denied the applicant’s request for removal, additional context about the report (and the respondent’s interpretation of the report) may provide relevant information for the Tribunal’s MIG analysis.

47Turning to the respondent’s caselaw involving res judicata, while there may be some overlap between this principle and this criterion, meeting the test under Rule 18.2(c) is sufficient to trigger a remedy under Rule 18.4. There is no need to then overcome the application of res judicata as well.

48I also do not accept the respondent’s position that the applicant did not adequately articulate the nature of her Rule 18.2(c) position in her supplementary submissions. I have been able to assess the merits of this part of her request, and it appears the respondent was able to provide a response in its submissions.

49In sum, I am satisfied that both the s. 44 physiatry report and related Explanation of Benefits are new pieces of evidence that the applicant could not have previously obtained. I am further satisfied that these documents would likely have affected the result of the decision had they been before the Tribunal.

50I note that the respondent took issue in its supplementary submissions with how this new evidence was presented to the Tribunal, namely, the applicant did not file a Notice of Motion. Though I accept that the applicant did not follow the requirements for bringing a motion under Rule 15, this breach was addressed in the Tribunal’s March 9, 2026 order (at paragraph 5):

Even though this request was not made using a Notice of Motion form (a breach of Rule 15), I will grant the applicant’s request. The timeline presented in the applicant’s e-mail shows that she was unable to provide these documents as part of her initial reconsideration submissions. I further find that this reconsideration process should address all possible avenues of reconsideration under Rule 18.2, a holistic approach that promotes both efficiency and fairness.

51I see no reason to disrupt this reasoning.

52Taken together, the applicant has established a ground for reconsideration based on Rule 18.2(c).

Rule 18.4 – Written Rehearing

53Having found the applicant established a ground for reconsideration, I will use my authority under Rule 18.4 to order a rehearing for the issue of s. 18(2) of the MIG (and, if she is removed from the MIG, the disputed treatment plans and interest). Briefly, the applicant has demonstrated that there is new evidence that would likely impact the outcome of the s. 18(2) claim, so I am satisfied that the only appropriate remedy is to have the Tribunal render a decision based on this new evidence.

54The denials of the NEB, as well as the applicant’s arguments about s. 38(8), remain undisturbed.

55I note that the initial hearing was done via videoconference. However, due to the limited scope of this rehearing, I am satisfied that this matter can be heard by way of written submissions. The need for an efficient conclusion to this proceeding leans in favour of allowing these remaining issues to be decided in a focused and expeditious manner. I am also satisfied that the MIG and a series of treatment plans can be adequately addressed through written submissions and documentary evidence. Taken together, I see no prejudice facing the parties from ordering a written hearing.

CONCLUSION & ORDER

56The applicant’s request for reconsideration is granted, in part.

57Pursuant to Rule 18.4, the parties shall participate in a written rehearing before a different adjudicator. The only issues in dispute for the rehearing are:

1. Is the applicant entitled to removal from the MIG based on s. 18(2) of the Schedule?
2. Is the applicant entitled to $3,832.28 for physiotherapy services, proposed by Rouge Valley Physiotherapy in a treatment plan/OCF-18 (“plan”) submitted August 8, 2022?
3. Is the applicant entitled to $5,498.00 for psychological services, proposed by Malvern Medical Clinic and Kennedy's Intervention Services Inc. in a plan submitted December 8, 2022?
4. Is the applicant entitled to $3,092.28 for physiotherapy services, proposed by Rouge Valley Physiotherapy in a plan submitted December 9, 2022?
5. Is the applicant entitled to $3,092.28 for physiotherapy services, proposed by Rouge Valley Physiotherapy in a plan submitted July 26, 2024?
6. Is the applicant entitled to the assessments proposed by East Rehabilitation Center, as follows: A. $2,200.00 for a psychological assessment, in a plan submitted November 14, 2024; and B. $2,200.00 for an attendant care assessment, in a plan submitted December 23, 2024?
7. Is the applicant entitled to interest on any overdue payment of benefits?

58The parties shall file with the Tribunal and serve their written submissions, evidence, and authorities according to the following timetable:

Submissions:	Due Date:	Page Limit:
Applicant’s submissions, evidence and authorities:	30 calendar days following the release of the reconsideration decision	10 pages
Respondent’s submissions, evidence and authorities:	45 calendar days following the release of the reconsideration decision	10 pages
Applicant’s reply submissions or written notice that no reply submissions will be filed:	50 calendar days following the release of the reconsideration decision	5 pages

59Aside from the s. 44 physiatry report (dated June 17, 2025) and the Explanation of Benefits (dated October 22, 2025), no new evidence (including affidavits) may be relied upon by the parties. In addition to the new s. 44 report and Explanation of Benefits, only evidence that was exchanged between the parties in accordance with the deadlines set out in the case conference report and order (released January 10, 2025) may be relied upon by the parties in their written submissions for the rehearing.

60All submissions filed with the Tribunal must be double-spaced, 12-point, Arial or Times New Roman font with 1.5-inch margins and be indexed, bookmarked/tabbed and consecutively paragraph and page numbered. Submissions must make specific reference to the evidence and authorities by tab and page number.

61The page limits are exclusive of evidence and authorities. The rehearing adjudicator has the discretion to determine whether to consider submissions that do not comply with the filing requirements.

62Unless specifically modified in this reconsideration decision, all prior orders of the Tribunal remain in effect.

63I am not seized.

Craig Mazerolle Vice-Chair