6 total
Application for income replacement benefits dismissed as applicant was laid off and did not meet the 26-week employment threshold.
The applicant sought income replacement benefits (IRBs) following a motor vehicle accident.
The applicant had been laid off due to the COVID-19 pandemic prior to the accident and had only worked 22 weeks in the 52 weeks preceding the accident, falling short of the 26-week statutory requirement.
The Tribunal found that the applicant was not 'employed' at the time of the accident within the meaning of section 5(1) of the Schedule, as intent to return to work does not satisfy the requirement of receiving wages for services.
Furthermore, the applicant failed to prove a substantial inability to perform the essential tasks of his employment.
The application for IRBs and interest was dismissed.
Catastrophic impairment claim dismissed; applicant failed to meet WPI threshold or show marked mental impairments.
The applicant sought a determination that he sustained a catastrophic impairment following a motor vehicle accident, relying on Criteria 7 and 8 of the Statutory Accident Benefits Schedule.
The Licence Appeal Tribunal dismissed the application, finding the applicant did not meet the 55% whole-person impairment threshold under Criterion 7 or demonstrate three marked impairments under Criterion 8.
The Tribunal gave no weight to the reports of the applicant's medical experts who failed to attend the hearing for cross-examination, and preferred the evidence of the respondent's assessors, which showed only mild physical and psychological impairments.
Catastrophic impairment claim dismissed; applicant's experts given no weight for failing to attend hearing.
The applicant sought a determination that he sustained a catastrophic impairment as a result of a motor vehicle accident under Criteria 7 and 8 of the Statutory Accident Benefits Schedule.
The Tribunal weighed competing multidisciplinary expert reports.
The Tribunal gave no weight to the applicant's orthopaedic and psychiatric experts because they failed to attend the hearing for cross-examination, and found the applicant's occupational therapist's evidence unreliable due to inconsistencies with observed function.
Preferring the respondent's experts, the Tribunal found the applicant sustained a 5% physical WPI and 5% psychological WPI, failing to meet the 55% threshold under Criterion 7, and sustained only mild impairments in the spheres of functioning under Criterion 8.
The application was dismissed.
Application for accident benefits dismissed; applicant's injuries fall within the Minor Injury Guideline and IRB repayment ordered.
The applicant sought statutory accident benefits following a motor vehicle accident.
The respondent denied the benefits, arguing the injuries fell within the Minor Injury Guideline (MIG).
The Tribunal found the applicant's injuries were predominantly minor and she did not establish a pre-existing condition, chronic pain, or psychological impairment to warrant removal from the MIG.
The claims for a chronic pain assessment, psychological assessment, and Income Replacement Benefits (IRBs) were dismissed.
The Tribunal also ordered the applicant to repay $1,227.49 in overpaid IRBs to the respondent, as she had returned to work without notifying the insurer.
Reconsideration request dismissed as original decision did not apply the permanent serious impairment test.
The applicant requested a reconsideration of a Licence Appeal Tribunal decision which found his injuries fell within the Minor Injury Guideline.
The applicant argued the Tribunal erred in law by requiring him to meet the definition of permanent serious impairment.
The Vice-Chair dismissed the request, finding that the original decision did not reference or apply the permanent serious impairment test, and the applicant failed to establish any error of law that would have changed the result.
Arbitration not barred where mediation deemed failed after 60 days without active participation.
The applicant was injured in a motor vehicle accident and sought statutory accident benefits from the insurer.
The applicant filed an Application for Mediation, but neither party took steps to schedule it within the prescribed 60-day period, leading FSCO to close the file and deem the mediation failed.
The insurer brought a preliminary issue motion to dismiss the subsequent Application for Arbitration, arguing the applicant failed to participate in mediation in good faith.
The Arbitrator dismissed the motion, applying the Court of Appeal's decision in Hurst et al., which held that mediation fails simply upon the expiry of the 60-day prescribed time limit, regardless of the parties' subjective intentions or active participation.