Sabina Arulampalam

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

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

The Tribunal found that the applicant failed to establish a documented pre-existing injury, chronic pain with functional impairment, or a psychological condition that would warrant removal from the MIG.

As the applicant was subject to the MIG, the disputed treatment plans were not analyzed for reasonableness and necessity, and the claim for interest was dismissed.

The appellant appealed and sought judicial review of a Licence Appeal Tribunal (LAT) decision finding she failed to establish catastrophic impairment under Criterion 8 of the Statutory Accident Benefits Schedule.

The appellant argued the LAT adjudicator breached procedural fairness by imposing strict time limits on witness examinations, making unequal evidentiary rulings regarding expert psychiatric testimony, and admitting a late surveillance report.

The Divisional Court dismissed the appeal, holding that the adjudicator's procedural choices were within her discretion to control the tribunal's process and did not result in unfairness.

The court also found no error of law in the LAT's application of the test for catastrophic impairment.

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

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

The applicant argued for removal from the MIG based on a pre-existing condition, chronic pain, and psychological impairment.

The Tribunal found the applicant did not meet her onus to prove her injuries fell outside the MIG, preferring the insurer's medical evidence and noting an intervening slip and fall accident.

However, the Tribunal found the respondent failed to provide a timely notice under s. 38(8) of the Schedule for a $768.25 physiotherapy treatment plan, making the respondent liable for incurred amounts starting on the 11th business day after submission.

The application was otherwise dismissed.

The applicant sought judicial review of a Licence Appeal Tribunal decision finding she was not catastrophically impaired under Criterion 7 of the Statutory Accident Benefits Schedule.

The Tribunal had concluded her whole person impairment rating was 49%, falling short of the 55% threshold.

The Divisional Court dismissed the application, finding the Tribunal's assessment of a 0% impairment for the spine and its correction of the upper extremity impairment calculation on reconsideration were reasonable and within its statutory authority to apply the AMA Guides.

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

The respondent denied a physiotherapy treatment plan on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant sustained a concussion, removing her from the MIG.

However, the Tribunal dismissed the claim for the physiotherapy treatment plan, finding that the applicant failed to meet her onus to prove the treatment was reasonable and necessary.

Claims for an award and interest were also dismissed.

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

The respondent denied benefits because the applicant failed to submit her Application for Accident Benefits (OCF-1) within 30 days of receiving the forms, as required by s. 32(5) of the Schedule.

The applicant argued she delayed submitting the form on the advice of her doctor to defer treatment.

The Tribunal found this was not a reasonable explanation for the delay and that the respondent suffered prejudice due to the nearly two-year delay.

Consequently, the application was dismissed as the applicant was precluded from applying to the Tribunal under s. 55(1)1 of the Schedule.

The applicant sought statutory accident benefits following a motor vehicle accident but failed to submit the OCF-1 application within the 30-day timeline prescribed by section 32(5) of the Schedule.

The applicant argued that past traumas triggered by the accident rendered her mentally incapable of applying on time.

The Tribunal applied the Horvath factors and found the applicant's explanation was not credible, noting she had actively advocated for her health, attended numerous medical appointments, and successfully navigated other government support programs during the 19-month delay.

The application was dismissed as barred under section 55(1)1 of the Schedule.

The applicant requested a reconsideration of a previous Tribunal decision which found she was not catastrophically impaired.

The applicant argued the Tribunal breached procedural fairness by limiting her testimony time and erred in law by misinterpreting Criterion 8 and allowing an expert to testify outside the scope of his report.

The Tribunal dismissed the request, finding no breach of procedural fairness as the hearing was managed efficiently under the Statutory Powers Procedure Act.

The Tribunal also found no errors of law or fact that would have changed the outcome, noting the applicant was attempting to re-litigate the weight assigned to the evidence.

The applicant sought a determination that she sustained a catastrophic impairment under Criterion 7 of the Statutory Accident Benefits Schedule following a motor vehicle accident.

The Tribunal assessed various Whole Person Impairment (WPI) ratings provided by multiple medical experts for physical and psychological impairments, including complex regional pain syndrome, sleep disturbances, and right upper extremity deficits.

The Tribunal rejected several of the applicant's expert ratings for failing to follow the AMA Guides' methodology and lacking objective medical evidence.

Ultimately, the Tribunal calculated a combined WPI rating of 50%, falling short of the 55% threshold required for a catastrophic impairment designation.

The application was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, arguing his injuries warranted removal from the Minor Injury Guideline (MIG) due to chronic pain and a pre-existing back condition.

The Tribunal found the applicant failed to establish chronic pain syndrome under the AMA Guides, noting insufficient evidence of medication abuse, excessive dependence on family, or failure to restore pre-injury function.

The Tribunal also found no compelling medical evidence that his pre-existing low back pain precluded recovery within the MIG.

As the injuries were predominantly minor and the MIG limit was exhausted, the claims for additional treatment plans, interest, and a special award were dismissed.

The applicant was injured in a motor vehicle accident and initially received income replacement benefits (IRBs), which were terminated by the insurer in January 2019.

The applicant continued to work at a reduced level until April 2020, when he fully withdrew from self-employment and subsequently claimed post-104 week IRBs.

The insurer argued the claim was barred by the two-year limitation period under s. 56 of the Schedule.

The Tribunal applied the doctrine of discoverability, finding that the post-104 week IRB has a distinct eligibility test that could not have been met or denied until two years post-accident.

Therefore, the limitation period did not bar the applicant from proceeding to a hearing for post-104 week IRBs.

The applicant sought statutory accident benefits after slipping and falling on ice while opening the trunk of a vehicle.

The respondent denied benefits, arguing the incident was a slip and fall on ice and not an 'accident' under the Schedule.

The Tribunal applied the purpose and causation tests, finding that the mechanics of opening the trunk created a significant fall risk that was the dominant feature of the incident.

The Tribunal concluded the incident met the definition of an 'accident' under s. 3(1) of the Schedule.

The applicant sought statutory accident benefits after her vehicle caught fire in her garage due to an electrical malfunction while she was asleep inside her home.

The respondent denied benefits on the basis that the incident was not an 'accident' under s. 3(1) of the Statutory Accident Benefits Schedule.

The Licence Appeal Tribunal applied the purpose and causation tests, finding that the vehicle was not being used or operated at the time of the fire, and that the fire was an intervening act that broke the chain of causation.

The application was dismissed.

The applicant sought statutory accident benefits after her vehicle caught fire in her garage due to an electrical malfunction while she was asleep inside her home.

The insurer denied the claim on the basis that the incident was not an 'accident' under s. 3(1) of the Statutory Accident Benefits Schedule.

The Licence Appeal Tribunal held a preliminary issue hearing and found that the incident did not meet the purpose or causation tests.

The vehicle was not being used or operated at the time, and the fire was an intervening act that broke the chain of causation.

The application was dismissed.

The applicant sought various medical benefits, transportation expenses, and assessment costs under the Statutory Accident Benefits Schedule following a motor vehicle accident.

The respondent denied the claims.

The Tribunal found the applicant's evidence lacked credibility due to inconsistent self-reports regarding the accident details and his functional limitations.

Relying on the respondent's independent medical examinations, which found the applicant had recovered and returned to his normal activities, the Tribunal concluded the applicant failed to prove the disputed treatment plans and assessments were reasonable and necessary.

The application was dismissed.

The applicant sought an extension of the two-year limitation period under section 7 of the Licence Appeal Tribunal Act to dispute the termination of his income replacement benefits.

The Tribunal applied the four-part test from Manuel v. Registrar, considering the applicant's intention to appeal, the length of the delay, prejudice to the insurer, and the merits of the appeal.

Finding that the applicant failed to demonstrate a clear intention to appeal within the limitation period and provided little evidence on the merits, the Tribunal declined to extend the time.

The claim for income replacement benefits was dismissed as out of time.

The applicant sought statutory accident benefits after sustaining injuries in a parking lot while waiting for an Uber.

The applicant had no memory of the incident, but emergency reports indicated a slip and fall.

The adjudicator held a preliminary issue hearing to determine if the incident met the definition of an 'accident' under section 3(1) of the Schedule.

Applying the purpose and causation tests, the adjudicator found no evidence that a vehicle was present or involved in the incident.

The application was dismissed as the incident was a slip and fall, not an accident arising from the use or operation of an automobile.

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

The respondent insurer denied treatment plans for psychiatric, social work, and chronic pain assessments on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant applied to the Licence Appeal Tribunal, arguing for removal from the MIG due to chronic pain and psychological injuries.

The Tribunal found that the applicant failed to prove on a balance of probabilities that he suffered from chronic pain or psychological injuries caused by the accident, preferring the insurer's expert evidence over the applicant's.

As the applicant's injuries did not fall outside the MIG and the $3,500 funding limit was exhausted, the application was dismissed.

The applicant was injured in a motor vehicle accident and sought a medical benefit of $2,004.96 for chiropractic services.

The respondent insurer denied the claim on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Licence Appeal Tribunal found that the applicant failed to provide persuasive medical evidence that his injuries were anything but minor or that he suffered from chronic pain.

Relying on insurer examinations and the lack of active treatment recommendations from the applicant's family physician, the Tribunal concluded the injuries were predominantly minor and subject to the MIG.

The application was dismissed.

The insurer sought its expenses following an arbitration where it was entirely successful in defending against the applicant's claim for non-earner benefits.

The arbitrator found that the self-represented applicant's conduct had substantially prolonged the hearing, requiring five days of testimony without relevant supporting evidence, and causing the insurer to cancel its expert witnesses twice.

The arbitrator awarded the insurer its expenses, fixing the amount at $16,700.58, inclusive of fees, disbursements, and HST.