Oliver Gorman-Asal

The applicant sought statutory accident benefits following a motor vehicle accident, claiming her psychological impairments warranted removal from the Minor Injury Guideline (MIG).

The adjudicator found the applicant's psychological assessment unreliable due to inconsistencies in self-reporting and lack of clarity regarding the assessors' roles.

Preferring the respondent's psychological assessment, the adjudicator concluded the applicant did not suffer a psychological condition removing her from the MIG.

As the MIG limits were exhausted, the claim for a psychological assessment and interest was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident.

The Tribunal found the applicant sustained a catastrophic impairment under Criterion 7, reaching a 57% whole-person impairment rating.

The Tribunal also found the applicant met the test for post-104 income replacement benefits due to a complete inability to engage in suitable employment, but denied payment because the applicant failed to file income tax returns as required by section 4(5) of the Schedule.

Finally, the Tribunal determined the applicant was entitled to attendant care benefits of $889.21 per month, but denied payment because the expenses were not incurred.

The applicant sought a reconsideration of a previous decision denying her entitlement to an attendant care benefit, various medical benefits, and cost of examination expenses.

She argued the Tribunal committed a material breach of procedural fairness and made errors of law in assessing the evidence.

The Tribunal dismissed the request, finding no breach of procedural fairness as the applicant had the opportunity to respond to arguments and failed to submit key evidence.

The Tribunal also found no errors of law, concluding the applicant was attempting to relitigate issues already decided.

The applicant sought entitlement to several treatment plans for physiotherapy, chiropractic, and psychological services following a motor vehicle accident, as well as an award for unreasonable delay.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to prove the treatment plans were reasonable and necessary.

The Tribunal preferred the respondent's medical evidence, which indicated that further physical therapy would not provide lasting relief and that the applicant's psychological symptoms did not warrant the requested interventions.

Claims for interest and a special award were also dismissed.

The applicant sought statutory accident benefits following a 2019 motor vehicle accident, claiming entitlement to attendant care benefits, various treatment plans, and a special award.

The Licence Appeal Tribunal dismissed the majority of the claims, finding that the applicant failed to prove the expenses were reasonable and necessary or incurred.

The Tribunal preferred the respondent's insurer examination reports, which found the applicant independent in her activities of daily living and lacking neurological impairment.

However, the Tribunal granted the applicant's claim for a driving assessment due to undisputed vehicular anxiety, along with applicable interest.

The applicant was involved in a motor vehicle accident and sought statutory accident benefits.

The respondent denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant applied to the Licence Appeal Tribunal, claiming removal from the MIG due to chronic pain and psychological impairment.

The Tribunal found that the applicant failed to provide compelling medical evidence to support removal from the MIG.

As the MIG limits were exhausted, the applicant was not entitled to the disputed psychological assessment or medication expenses.

The application was dismissed, and claims for interest and an award were denied.

The applicant sought statutory accident benefits following a motor vehicle accident.

The respondent denied benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found the applicant failed to prove his psychological injuries or insomnia warranted removal from the MIG, noting inconsistencies with treating physician records.

The Tribunal also dismissed the claim for income replacement benefits, finding insufficient evidence of the applicant's essential work tasks or how his injuries impaired his ability to perform them.

All claims for treatment plans, medication, and an award were dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, disputing the respondent's denial of treatment plans for physiotherapy, psychological services, and chiropractic services.

The Tribunal found the applicant failed to prove the physiotherapy and psychological services were reasonable and necessary, preferring the evidence of the respondent's section 44 assessors over the applicant's medical records.

However, the Tribunal ordered the respondent to pay the incurred expenses for the chiropractic treatment plan because the respondent's denial letter failed to provide specific medical reasons, violating the notice requirements under section 38(8) of the Schedule.

The claim for a section 10 award was dismissed as the respondent's conduct was not unreasonable.

The applicant was assaulted and carjacked while sitting in his parked vehicle.

He applied for statutory accident benefits, which the respondent denied on the basis that the incident was not an 'accident' under s. 3(1) of the Statutory Accident Benefits Schedule.

The Tribunal applied the two-part purpose and causation test and found that while the applicant was using the vehicle for an ordinary purpose, the assault was an intervening act that broke the chain of causation.

The use or operation of the vehicle was not the direct cause of the applicant's injuries.

The application was dismissed.

The applicant sought payment for various treatment plans, including chiropractic services, a brain SPECT scan, medical services, and physiotherapy, following a motor vehicle accident.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to prove the treatment plans were reasonable and necessary.

The Tribunal preferred the evidence of the respondent's insurer's examination over the applicant's medical reports, noting the lack of physical examinations or detailed explanations of rehabilitative benefits in the applicant's evidence.

Furthermore, the treatment plans themselves were not entered into evidence.

The applicant sought payment for two psychological treatment plans following a 2017 motor vehicle accident.

The Tribunal found that the applicant failed to prove the treatment plans were reasonable and necessary.

The Tribunal preferred the diagnosis of the insurer's examining psychologist over the applicant's doctor, noting the latter provided no analysis to support a PTSD diagnosis.

As the applicant had already received some psychological treatment and provided no further medical evidence beyond a new treatment plan, the claims were dismissed.

Claims for interest and an award for unreasonable delay were also dismissed.

The applicant was injured in a motor vehicle accident and sought income replacement benefits (IRBs).

The respondent denied the benefits, arguing the applicant's post-accident business results from his flooring company offset his entitlement.

The Tribunal found that the applicant was paid as an employee, not a shareholder, and preferred the applicant's accounting report.

The Tribunal ordered the respondent to pay IRBs of $400.00 per week from March 17, 2020, ongoing, plus interest.

The applicant sought non-earner benefits, medical benefits for physiotherapy, and the cost of examinations for mental health and chronic pain assessments following a motor vehicle accident.

The Tribunal dismissed the application, finding the applicant failed to establish a complete inability to carry on a normal life.

The Tribunal gave little weight to the applicant's expert reports due to their reliance on self-reporting without a Somali interpreter and failure to include signed expert duty acknowledgments.

The respondent's section 44 assessments, which utilized an interpreter and found symptom magnification and minor injuries, were preferred.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming her physical and psychological injuries removed her from the Minor Injury Guideline (MIG).

The respondent denied the claims, relying on insurer's examinations that concluded the injuries were soft tissue in nature and fell within the MIG.

The Tribunal found that the applicant failed to provide compelling medical evidence to prove her injuries warranted treatment outside the MIG, noting that her chiropractic expert's methodology lacked proven reliability and her psychological expert relied heavily on self-reporting.

The application for benefits and interest was dismissed.

The self-represented applicant sought entitlement to a post-104 income replacement benefit, medical benefits, an award, and interest following a motor vehicle accident.

The applicant's previous counsel removed himself from the record prior to the hearing, and the applicant proceeded without submitting any documentary evidence.

The Licence Appeal Tribunal dismissed the application, finding that while the applicant's oral testimony regarding the accident's impact was sympathetic, she failed to provide any objective medical evidence to discharge her onus of proving entitlement to the disputed benefits.

The applicant brought a motion seeking further particulars regarding a statement made by the respondent's claims representative and seeking to exclude the claims representative from the motion on the basis that she was providing legal services without a license.

The Tribunal dismissed the request for particulars, finding it was a factual issue to be determined at the hearing.

The Tribunal found the request to exclude the representative was moot as counsel had been retained, but noted that unlicensed representatives risk exclusion under the Statutory Powers Procedure Act and the Law Society Act.

The applicant sought statutory accident benefits, claiming that a motor vehicle accident caused her to subsequently develop meningitis and an empyema.

The applicant's expert theorized that the accident caused a rupture in the dura mater, allowing a middle ear infection to migrate to the brain.

The Tribunal found the expert's theory to be overly speculative and concluded that the applicant failed to prove on a balance of probabilities that the accident was a necessary cause of her meningitis.

The preliminary issue was answered in the negative.

The applicant, an Uber driver, was injured in a motor vehicle accident and claimed entitlement to post-104 week income replacement benefits (IRBs).

The insurer terminated IRBs on the basis that the applicant could return to suitable employment.

The Tribunal found that the applicant suffered a complete inability to engage in any employment for which he was reasonably suited by education, training, or experience, due to the synergistic impact of his physical injuries and psychological impairments, including chronic pain and depression.

The Tribunal ordered ongoing IRBs at $200 per week plus interest, but dismissed the applicant's claims for a special award and costs, finding the insurer's conduct was not unreasonable or in bad faith.

The applicant sought statutory accident benefits following a motor vehicle accident.

The respondent denied income replacement benefits (IRB) and various medical and rehabilitation benefits, arguing the applicant failed to comply with requests for information under s. 33 of the Schedule.

The Tribunal found the applicant adequately complied with the s. 33 requests and was procedurally entitled to the IRB.

The Tribunal also found that a proposed mattress and chiropractic treatment were reasonable and necessary, preferring the evidence of the applicant's treating practitioners over the respondent's assessors.

The applicant was awarded the disputed benefits with interest.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision which found her injuries fell within the Minor Injury Guideline.

The applicant argued the Tribunal erred in its weighing of the medical evidence, specifically regarding the reports of Dr. Nathanson, Dr. Oshidari, and Dr. Wilderman.

The adjudicator dismissed the request, finding that the Tribunal properly exercised its discretion in weighing the evidence, including giving limited weight to diagnoses of chronic pain and severe PTSD that lacked sufficient foundation or were outside the assessors' scope of expertise.

The reconsideration was dismissed.