RECONSIDERATION DECISION
Before:
Craig Mazerolle, Vice-Chair
Licence Appeal Tribunal File Number:
24-009368/AABS
Case Name:
Harry Grant v. TD General Insurance Company
Written Submissions by:
For the Applicant:
Steven Glowinsky, Counsel
For the Respondent:
Philip Byun, Counsel
OVERVIEW
1On April 23, 2026, the applicant requested reconsideration of the Tribunal’s decision released April 2, 2026 (“decision”).
2Stemming from an accident on July 28, 2021 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 entitled to the WPI component of the plan for a CAT assessment, plus interest. It denied the applicant’s other requests, i.e., an attendant care benefit (“ACB”); a treatment plan for physical modalities services; the interview and file review components of the CAT assessment plan; and 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 relies on Rule 18.2(b) to support his request. His request is limited to the physical modalities treatment plan and award. He is asking the Tribunal to find he is entitled to these issues, plus interest.
5The respondent asks the Tribunal to dismiss the request for reconsideration.
RESULT
6The applicant’s request for reconsideration is dismissed.
ANALYSIS
7The 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.
8The applicant raises several alleged errors with the Tribunal’s denial of the physical modalities treatment plan. I will address these grounds in turn.
9First, the applicant challenges the Tribunal’s assessment of the clinical notes and records from Dr. Simon Brown, family physician. According to the applicant, though he did not explicitly use the term “chronic pain”, Dr. Brown’s findings of ongoing pain are a clear indication that there is a diagnosis of chronic pain. In support of this position, the applicant further highlights the notes from St. Joseph’s Health Centre, as there is evidence that the applicant complained about left shoulder pain for nearly three years post-accident.
10The Tribunal mainly addressed the symptoms noted in Dr. Brown’s records at paragraph 29 of the decision:
The applicant also submits that his family physician, Dr. Simon Brown, diagnosed him with chronic pain. I have reviewed Dr. Brown’s clinical notes and records (“CNRs”), and I note that on May 7, 2024, Dr. Brown indicated “Complaint: chr pain lt shoulder.” I find that this documents the applicant’s reporting and is not a diagnosis.
11There is also a brief reference to “a hospital visit on April 18, 2024” at paragraph 30. This appears to be a reference to the St. Joseph’s Health Centre record that was included with the applicant’s initial written hearing submissions.
12Though the applicant may disagree with the Tribunal’s interpretation of these medical records, this submission is, in effect, a disagreement with the Tribunal’s weighing of the evidence. Adjudicators are empowered to consider various aspects of the hearing record when assessing the relative weight to assign to different pieces of evidence. Unless a requesting party can show that a factor is legally impermissible (or a finding is factually incorrect), these assessments will not be disrupted on reconsideration.
13I also note that the Tribunal’s main takeaway from these notes was not the absence of a formal chronic pain diagnosis. Rather, it focused on the information they provided about the applicant’s functional capacities: see paragraph 35.
14Second, the applicant takes issue with the Tribunal’s handling of the adjuster’s log notes. Not only did the Tribunal downplay the adjuster’s determination that he sustained “major” injuries, but the applicant claims the lack of weight assigned to this notation is at odds with its finding that the log notes could be used as evidence about his employment.
15Specifically, the applicant takes issue with the following comment made at paragraph 31 of the decision (emphasis added):
The applicant submits that, given his diagnosis of chronic pain syndrome, it is appropriate that he participate in a multidisciplinary program specifically tailored to address his ongoing ailments and that it is reasonable and necessary that he engage in a rehabilitative program to jump start his recovery. The applicant further submits that the respondent, in its log notes, has deemed the severity of the applicant’s injuries to be “major.” I do not place any weight on the indication in the log notes that the injury is “major” because this is a comment made by an adjuster rather than a medical opinion by a treatment provider.
16He argues this finding is not consistent with comments made at paragraph 33:
The respondent refers to a letter dated August 14, 2024, from the respondent to the applicant, confirming a conversation with the applicant’s counsel who advised that the applicant had worked full time at various construction companies between May 30, 2022, and May 5, 2023. I also note that the applicant reported to Dr. Karmy during the October 7, 2024 assessment that he was still working in construction. The respondent submits that the applicant has failed to produce any evidence of formal work accommodations from any of these employers.
17I see no issue with the different uses that the Tribunal made of these log notes. On the one hand, the applicant has not shown how it was inappropriate for the Tribunal to place no weight on the respondent’s understanding of his injuries, especially as he had the onus to show that he was entitled to this plan. Put another way, even if the respondent believed the applicant’s injuries were “major”, he still had to present evidence to the Tribunal to show that this treatment plan was reasonable and necessary. Further, there is a significant difference between relying on an adjuster’s opinion about the applicant’s injuries vs. relying on a statement about the applicant’s employment that was relayed to the adjuster (and then detailed in the log notes).
18Relatedly, the applicant claims the Tribunal improperly relied on his employment to discount the complaints of pain and fatigue that he made to Dr. Grigory Karmy, chronic pain physician. Moreover, he claims the Tribunal overlooked medical evidence where he discussed his “informal work accommodations and modifications”.
19I do not agree. Not only was Dr. Karmy’s evidence addressed at length in the decision, but the applicant’s claim about work accommodations was addressed at paragraph 35 of the decision: “The applicant has not directed me to evidence of any formal work accommodations”. He may claim that more focus should have been placed on whether there were “informal” arrangements, but I find both of these grounds are better understood as another request to reweigh the evidence.
20Next, the applicant submits the Tribunal erred by focusing too heavily on how Dr. Karmy did not opine on the benefits of the specific physical treatment at issue. The applicant claims this standard “seems unreasonable and unfair to claimants”.
21The applicant has not provided any legal authorities to support this position. Further, the Tribunal conducted a comprehensive assessment of Dr. Karmy’s treatment recommendations. Most notably, the Tribunal explained its reasoning about this treatment proposal at paragraphs 36 and 37:
To consider whether the disputed plan is reasonable and necessary, I must turn to whether the applicant has demonstrated on a balance of probabilities that the goals would be met to a reasonable degree. I note that Dr. Karmy indicates in the report that a comprehensive multidisciplinary rehabilitation therapy would be beneficial in alleviating the applicant’s pain and optimizing his day-to-day functioning. Dr. Karmy also indicates that he feels that some gradual improvement in the applicant’s functioning may be achieved if his post-accident problems were appropriately addressed using the modern approach to chronic pain management. Dr. Karmy does not discuss to what extent the proposed modalities would be “beneficial.” Further, I find that Dr. Karmy’s indication that “some gradual improvement” in the applicant’s functioning “may” be achieved is unspecific and vague.
I also note that Dr. Karmy indicates in the report that the applicant has already received “active and passive rehabilitation treatments, including exercise program, physiotherapy, chiropractic adjustments, and massage therapy.” Dr. Karmy points out that the applicant has suffered impairments that have continued without significant improvement for a long time. The plan proposes physiotherapy sessions, acupuncture, massage therapy, chiropractic adjustments and spinal decompression. The applicant does not direct me to the specific types of therapies the applicant has already received “without significant improvement for a long time” and why the new proposed treatments are different and might achieve a different result.
22I see no issues with this analysis, nor has the applicant shown why it was inappropriate for the Tribunal to require evidence that would support the necessity of the specific services being proposed in this treatment plan.
23Finally, by focusing on the physiotherapy and massage therapy he has received to date, the applicant claims the Tribunal erred in its assessment of the treatment plan. New forms of physical treatment are being proposed (e.g., acupuncture), and the applicant claims he has reported relief and improvement with pain and range of motion following his earlier physical therapy. At the very least, the applicant submits that “a claimant’s lack of benefit from a single Treatment Plan is not determinative of his/her entitlement to, or potential to benefit from, a subsequent Treatment Plan”.
24Once again, the applicant has not shown any legal or factual errors with the Tribunal’s assessment of the reasonable and necessary nature of the specific services being proposed in the plan. He is again asking the Tribunal to conduct a reweighing of the evidence. A party is entitled to dispute the Tribunal’s findings, but disagreement alone is not sufficient to trigger Rule 18.2(b).
25Taken together, I find the applicant has not established an error that meets the standard of Rule 18.2(b).
CONCLUSION & ORDER
26The applicant’s request for reconsideration is dismissed.
Craig Mazerolle
Vice-Chair
Released: June 5, 2026