Citation: Okafor-Ogbujiagba v. Security National Insurance Company, 2026 ONLAT 25-000848/AABS

Licence Appeal Tribunal File Number: 25-000848/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:

Anthony Okafor-Ogbujiagba

Applicant

and

Security National Insurance Company

Respondent

DECISION

ADJUDICATOR:

Jeff Chatterton

APPEARANCES:

For the Applicant:

Mobina Khan, Counsel

For the Respondent:

Matthew Nieuwland, Counsel

HEARD: In Writing

May 27, 2026

OVERVIEW

1Anthony Okafor-Ogbujiagba, the applicant, was involved in an automobile accident on April 3, 2018, 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, Security National Insurance Company, and applied to the Licence Appeal Tribunal - Automobile Accident Benefits Service (the “Tribunal”) for resolution of the dispute.

ISSUES

2The issues in dispute are:

1. Is the applicant entitled to the treatments proposed by Tanya Polonenko, as follows:

i. $1,970.00 for optometric services, in a treatment plan/OCF-18 (“plan”) dated December 14, 2023; and

ii. $970.00 for optometric services, in a plan dated November 15, 2024?

2. Is the applicant entitled to the treatment and assessment proposed by Tobias Chung, as follows:

i. $2,486.00 for a functional abilities assessment, in a plan dated August 12, 2023; and

ii. $4,794.72 for physiotherapy services, in a plan dated August 21, 2023?

3. Is the respondent liable to pay an award under s. 10 of Reg. 664 because it unreasonably withheld or delayed payments to the applicant?

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

RESULT

3The applicant has not met their onus to demonstrate that the treatment plans in dispute are reasonable and necessary.

4Neither interest nor an award are payable.

5The application is dismissed.

PROCEDURAL ISSUES

6The respondent has asked the Tribunal to draw an adverse inference because the applicant has failed to produce requested medical evidence. Specifically, the applicant has not provided Clinical Notes and Records (“CNRs”) for the applicant’s opthamologist, Dr. Wilkinson, or employment records.

7I have reviewed the Case Conference Report and Order (“CCRO”), dated May 22, 2025, where the applicant agreed to provide to the respondent “CNRs from all treating physicians and health practitioners” as well as “All employment files.”

8The applicant has chosen not to file reply submissions to explain why these records were not produced in compliance with the CCRO.

9I find that the requested records are highly relevant to the issues in dispute because the issues concern both optometric and employment issues.

10I draw an adverse inference from the failure to produce agreed upon medical documentation, and infer that the records were not produced because they are detrimental to the applicant’s claim.

ANALYSIS

Is the applicant entitled to optometric services?

11The applicant has not met their onus to establish that the optometric services proposed as issues 1a and 1b are reasonable and necessary.

12To receive payment for a treatment and assessment plan under s. 15 and 16 of the Schedule, the applicant bears the burden of demonstrating on a balance of probabilities that the benefit is reasonable and necessary as a result of the accident. To do so, the applicant should identify the goals of treatment, how the goals would be met to a reasonable degree and that the overall costs of achieving them are reasonable.

13The applicant submitted two OCF-18s for vision, optical and vision-therapy services proposed by Optometrist Dr. Tanya Polonenko. The proposed services included 14 sessions of vision therapy. The applicant argues that the applicant’s bifocal lenses broke during the accident and caused vision trauma, and as a result, the applicant requires ongoing vision therapy. In support of this treatment, the applicant relies on a Functional Oculo-Vision Assessment conducted by Dr. Polonenko, dated November 14, 2022 and updated December 13, 2023.

14The respondent disagrees, and argues that the applicant has previously completed 34 sessions of vision therapy, but his reported symptoms remain. It argues that it is not reasonable or necessary to continue with vision therapy when there is no therapeutic benefit. The respondent further argues that the applicant is attempting to secure treatment for a medical condition – “Optometric Post Trauma vision syndrome” which is not a recognized medical condition.

15The respondent relies on its s. 44 ophthalmology assessment report of Ophthalmologist Dr. Calvin Breslin dated January 23, 2024 in support of its position that the proposed vision therapy is not reasonable and necessary.

16I find that the applicant has not met his onus to prove that the proposed optometric services are reasonable and necessary.

17The applicant has not provided objective evidence as to why further vision therapy is reasonable or necessary. A treatment plan on its own is not compelling evidence of treatment. The onus rests with the applicant not only to establish that he suffers from an accident-related injury, but that the goals of treatment would be met with these proposed services.

18To meet his onus, the applicant must direct me to evidence indicating that he is receiving benefit from treatment, or that the treatments would be reasonable and necessary. I have read the Oculo-Vision Assessment conducted by the treatment provider, Dr. Polonenko. I give this minimal weight because I do not find it to come from an objective neutral source, and the report itself has no evidence indicating that the applicant has received benefit from prior therapy sessions.

19As I have not been provided with the CNR’s from the applicant’s treating opthomalogist, Dr. Wilkinson, I was not able to clarify whether such treatment was recommended by him. As noted above, the applicant has not submitted Dr. Wilkinson’s CNR’s, despite agreeing to do so in the Case Conference Report and Order. While the onus remains with the applicant to establish such treatments are reasonable and necessary, I have not been provided with corroborating medical evidence – such as Dr. Wilkinson’s CNR’s - to indicate this.

20I further find the respondent’s s. 44 ophthalmology assessment to be persuasive. Dr. Breslin opined that “Optometric post trauma vision syndrome is not a medical diagnosis and will not be found in the ICD10. The use of vision therapy to treat muscle imbalance secondary to mild traumatic brain injury is not a recognized form of therapy and its use is not supported by the evidence-based medical literature.” I have not been led to medical evidence from the applicant to refute Dr. Breslin’s findings or to explain how the proposed optometric services are of therapeutic benefit.

21For these reasons, I find the applicant has not, on the balance of probabilities, met his onus to establish that the optometric therapy proposed in issues 1a and 1b to be reasonable and necessary.

Is the applicant entitled to a Functional Abilities Evaluation?

22The applicant is not entitled to a Functional Abilities Evaluation (“FAE”).

23The purpose of an assessment is to determine whether a condition exists. For an insured, they bear the onus to demonstrate that there are grounds on which to believe that a condition exists that would warrant further investigation by way of an assessment.

24The applicant argues that the respondent has erred because they failed to recognize that ‘functional and employability assessments are not limited to full-time employees.’ The applicant states that the FAE was initially denied because the respondent believed the applicant to be retired, and therefore, an FAE was unnecessary. The applicant states that the respondent is mistaken, in that he is only ‘semi-retired’ and still engaged in his occupation as a project manager and property manager.

25In response, the respondent argues the applicant has not provided any evidence that he is even partially employed, and that his own s. 25 evaluations indicate he has been fully retired since 2013.

26I agree with the respondent. The applicant’s tax returns from 2013 onward show no employment income at all. This does not support the applicant’s claim that he is currently only semi-retired.

27I further note that no employment records, agreed upon in the CCRO, have been submitted by the applicant. The absence of these records undermines the applicant’s argument. I cannot rule that the applicant is currently fully or partially employed if the applicant, who has the onus, does not provide me with evidence in support of his employment. I must draw an adverse inference on the applicant’s argument if he fails to produce promised evidence which would support his argument.

28For these reasons, I find the applicant has not, on the balance of probabilities, met his onus to establish he is entitled to a Functional Abilities Evaluation.

Is the applicant entitled to physiotherapy?

29The applicant is not entitled to physiotherapy services.

30In dispute are $4,794.72 worth of physiotherapy services, proposed by Chiropractor Tobias Chung in an OCF-18 dated August 21, 2023.

31The applicant argues that physiotherapy services are reasonable, necessary and directly related to the injuries sustained in the motor vehicle accident. The applicant did not specify what his accident-related injuries are, and argued only that he suffers from “musculoskeletal pain, stiffness and functional restrictions that have persisted despite prior treatment.”

32The respondent denies that physiotherapy treatment is reasonable and necessary, and relies on a s. 44 Orthopedic Assessment report by Orthopedic Surgeon Dr. Oleg Safir dated January 16, 2023. Dr. Safir opined that seven years have passed since the accident and that, as the applicant has not demonstrated any improvement in his condition, he has achieved maximum medical recovery.

33I find that the applicant has not met his onus of proof to establish that ongoing physiotherapy services are reasonable and necessary. I say this because the applicant dedicated a considerable portion of their submission in an attempt to discredit the rationale behind Dr. Safir’s position, or in other words, point out why the respondent is wrong.

34However, the onus remains on the applicant to establish that such treatments are reasonable and necessary, not to establish that the respondent’s assessor is incorrect. I find that the applicant has not done so.

35The applicant submitted 3,499 pages of medical evidence and documentation, but in his submissions, merely says that the medical evidence as a whole is sufficient to prove that such treatments are reasonable and necessary. I have not been led to any specific reference, a specific expert report, or a CNR entry date from a treating medical practitioner which indicate that ongoing physical treatments, seven years post accident, would be reasonable or necessary. I note that it is not this Tribunal's role to search through the evidence and make the argument on behalf of the applicant see Dooman v TD Insurance, 2025 ONSC 184 at para 50 (Div Ct).

36For this reason, I find the applicant has not, on the balance of probabilities, met his onus to demonstrate entitlement to the physiotherapy plan in dispute.

Interest

37Interest applies on the payment of any overdue benefits pursuant to s. 51 of the Schedule. As no benefits are overdue, no interest is payable.

Award

38The applicant sought an award under s. 10 of Reg. 664. Under s. 10, the Tribunal may grant an award of up to 50 per cent of the total benefits payable if it finds that an insurer unreasonably withheld or delayed the payment of benefits. As the insurer has not unreasonably withheld or delayed the payment of benefits, no award is payable.

ORDER

39The application is dismissed.

i. The applicant has not met their onus to demonstrate that the treatment plans in dispute are reasonable and necessary.

ii. Neither interest nor an award are payable.