RECONSIDERATION DECISION
Before: Craig Mazerolle, Vice-Chair
Licence Appeal Tribunal File Number: 24-015437/AABS
Case Name: Sharon Bekuschew v. CAA Insurance Company
Written Submissions by:
For the Applicant: Nick de Koning, Counsel
For the Respondent: Stanislav Bodrov, Counsel
OVERVIEW
1On November 28, 2025, the applicant requested reconsideration of the Tribunal’s decision released November 7, 2025 (“decision”).
2Stemming from an accident on September 22, 2020 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 not entitled to payment of an income replacement benefit (“IRB”) from October 1, 2024 to present. The Tribunal further found the applicant was not entitled to interest or 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 her request for reconsideration.
5The respondent asks the Tribunal to dismiss the request.
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.
8I find the applicant has not established grounds for reconsideration based on Rule 18.2(b).
9Section 5(1) of the Schedule states that insured persons are entitled to an IRB if they are employed at the time of the accident and sustain an accident-related impairment that causes “a substantial inability to perform the essential tasks of that employment”. The test becomes more stringent after 104 weeks post-accident, as s. 6(2)(b) then requires an insured person to show a “complete inability” to perform any role that they are “reasonably suited by education, training or experience”. The onus is on the applicant to demonstrate entitlement on a balance of probabilities.
10The 104-week post-accident mark for this claim is September 20, 2022.
11After conducting an extensive review of the parties’ medical evidence, as well as the applicant’s pre- and post-accident employment and education, the Tribunal determined that the applicant did not meet the test for a post-104 week IRB under s. 6(2)(b). Briefly, while she was unable to continue with her pre-accident role as a personal support worker, the applicant returned to work in October 2022 as a restorative aide with an organization called Maitland Manor—a role that the Tribunal found to be “reasonably suited by education, training or experience”. The Tribunal summarized its findings at paragraphs 37 and 38 of the decision:
The assessors and treatment providers have all acknowledged that the symptoms the applicant is experiencing from her accident-related injuries are ongoing, the parties do not dispute this. The dispute arises as to whether the applicant suffers a complete inability to engage in any employment or self-employment for which she is reasonably suited by education, training or experience. On the preponderance of evidence, I find the applicant does not suffer from a complete inability to engage in any employment or self-employment for which she is reasonably suited by education, training or experience.
Although the applicant is a credible witness, and I am persuaded that she continues to suffer from accident-related injuries, I find that there are inconsistencies between her testimony and her reporting to her treatment providers regarding her ability to complete the tasks of her employment. The most persuasive evidence is the applicant’s work performance over 12 months in roles for which she is qualified by education, training and experience, which is evidence that she does not suffer a complete inability, as a result of her accident-related injuries.
12The applicant raises two main errors with the decision. First, the applicant claims the Tribunal applied an “overly literal interpretation” of s. 6(2)(b). Specifically, the applicant submits the Tribunal erred in law by assuming that the role at Maitland Manor was a reasonable alternative to her pre-accident employment. Instead, the applicant claims the Tribunal should have compared the “nature, status and reward” of her pre- and post-accident positions, a framework that would follow the binding guidance from Traders General Insurance Company v. Rumball, 2025 ONCA 656 (“Rumball”). The applicant also claims that the Tribunal’s reasons do not make any reference to the parties’ case law, so there is no way for her to know what legal test was used to deny the IRB.
13Second, the applicant argues the Tribunal reached contradictory findings about her testimony, namely, it found she was credible when describing her impairments, but her comment about being “completely disabled from any employment… was not worthy of belief”. The applicant also notes that this latter comment is in line with the “preponderance of evidence.”
14Starting with the application of s. 6(2)(b), the applicant submits the Court of Appeal “went to some lengths” in Rumball to differentiate its post-104 week IRB analysis from the framework used by the lower court. In particular, the applicant highlights the following passage from Rumball (at paragraph 42):
In sum, in determining entitlement to IRBs in the post-104-week period, the decision maker must decide, based on the evidence, if the insured person is completely unable to work in any job or capacity for which they are suited by education, training or experience. This is necessarily a contextual analysis. In order to make this determination, the decision maker must consider all the relevant evidence and factors, including whether any alternative employment is employment in a competitive, real-world setting that is comparable to the insured’s former employment in nature, status and reward. These factors are not stand-alone components of the test but inform the evidence-based determination of whether the insured person has suffered a complete inability to engage in employment for which they are reasonably suited by education, training or experience.
15The applicant also adds that a narrow interpretation of s. 6(2)(b) runs counter to the ruling in Tomec v. Economical Mutual Insurance Company, 2019 ONCA 882, namely, that the Schedule must be interpreted to promote the remedial nature of the accident benefits regime.
16I agree with the applicant that the Tribunal is obligated to use the more holistic analysis from Rumball when assessing a post-104 week IRB, a framework that aligns with the consumer protection mandate of the Schedule. I further accept that the Tribunal’s choice not to reference any case law in the decision may have caused some confusion over what legal test was used. However, despite these observations, I am not satisfied that the applicant has shown the Tribunal erred in its IRB analysis.
17Aside from those explicitly listed in s. 6(2)(b), there is no definitive list of factors that a decision-maker must weigh when applying the post-104 week IRB test. The Court of Appeal did not add any new, necessary elements to the test in Rumball, but rather accepted that evidence about job status, remuneration, etc. may assist a decision-maker when assessing what constitutes “reasonably suited” employment. Therefore, even though the Tribunal did not explicitly lay out the standard enumerated in Rumball, I still find it conducted the kind of contextual analysis that the Court of Appeal has asked decision-makers to perform.
18In the decision, the Tribunal conducted a detailed assessment of the available vocational evidence to conclude that there is a reasonably suited form of employment that the applicant can perform: i.e., a restorative aide at Maitland Manor. Though aspects of this post-accident work were not expressly weighed against her pre-accident role (e.g., the lower salary at Maitland Manor), the Tribunal’s reasons still show there was an extensive comparison of these two positions. Again, there is no definitive list of factors that a decision-maker must consider (aside from “education, training or experience”), and it is a well-accepted principle that adjudicators are not expected to list every piece of evidence or argument raised during a hearing.
19Most importantly though, the Tribunal’s analysis touched on the key elements of s. 6(2)(b), i.e., whether the applicant’s accident-related impairments impacted her ability to perform reasonably suited employment. This analysis was exhaustive, as the Tribunal reviewed the expert evidence of numerous specialists, as well as the applicant’s own understanding of her impairments. The Tribunal also laid out the parties’ positions in a significant amount of detail. Overall, this comprehensive review shows the Tribunal applied the correct test to the evidence, and I do not find the applicant has shown how it erred in reaching its conclusions about the post-104 week IRB.
20Turning to the applicant’s concern about the allegedly contradictory handling of her testimony, I find this ground is largely an attempt to have the Tribunal re-weigh evidence considered at first instance. Once again, the reconsideration process is not a venue for parties to seek a different weighing of evidence from the hearing. Rather, they must show there was a factual or legal error in this evidentiary assessment.
21I see no reason why the applicant’s testimony could be seen as a credible account of her impairments, all the while her self-reported inability to work was not accepted by the Tribunal. As the decision makes clear, the Tribunal compared and contrasted the applicant’s testimony against the available medical and vocational evidence. This analysis allowed the Tribunal to conclude that she did not meet her evidentiary onus, despite finding that she was a credible witness. The applicant has not shown how this evidentiary assessment was incorrect in fact or law.
22Taken together, I do not find the applicant has established a ground for reconsideration under Rule 18.2(b).
CONCLUSION & ORDER
23The applicant’s request for reconsideration is dismissed.
Craig Mazerolle
Vice-Chair
Released: January 29, 2026