Sonya Madeline Katrycz

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to psychological services, physiotherapy, and a psychological assessment.

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

The Tribunal preferred the respondent's s. 44 psychological assessment over the applicant's s. 25 assessment, noting the applicant's expert failed to review prior medical records showing pre-existing psychological conditions.

The Tribunal also found insufficient evidence of causation for the physiotherapy plan due to a significant gap in reporting accident-related pain.

The applicant sought statutory accident benefits, including income replacement benefits and medical benefits, following a motor vehicle accident.

The adjudicator found the applicant to be an unreliable witness who misrepresented her post-accident employment status.

The applicant's claim for a chiropractic treatment plan was barred by the two-year limitation period.

The claims for income replacement benefits and other medical benefits were dismissed as the applicant failed to prove she suffered a substantial inability to perform her employment tasks or that the treatments were reasonable and necessary.

Claims for interest and a special award were also dismissed.

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

The insurer denied funding for occupational therapy, physiatry, and neuropsychological assessments, as well as an accountant's report and transportation expenses.

The Licence Appeal Tribunal found that the applicant failed to attend properly scheduled insurer's examinations without a reasonable excuse, barring her from disputing entitlement to the medical assessments.

The claim for the accountant's report was dismissed because the applicant was previously barred from claiming income replacement benefits.

The transportation expenses were denied for failing to address the 50-kilometre deductible.

The application was dismissed in its entirety.

The applicant sought accident benefits following a motor vehicle accident.

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

The applicant claimed she suffered from chronic pain and a psychological condition warranting removal from the MIG, and sought a non-earner benefit (NEB) and various treatment plans.

The Tribunal found the applicant's testimony vague and unsupported by the clinical notes and records of her family doctor.

The Tribunal concluded the applicant failed to prove she suffered from chronic pain or a psychological impairment caused by the accident, and therefore remained subject to the MIG.

The Tribunal also found the applicant failed to establish a complete inability to carry on a normal life, denying the NEB claim.

The application was dismissed.

The applicant, injured in a pedestrian-vehicle collision, sought an award under section 10 of Regulation 664, alleging the respondent insurer unreasonably withheld or delayed payment of attendant care benefits and a treatment plan.

The Licence Appeal Tribunal found that the respondent's denial of the treatment plan was valid and compliant with section 38(8) of the Schedule, as the requested benefits exceeded the non-catastrophic limit.

The Tribunal also found insufficient evidence that attendant care benefits were unreasonably delayed.

The respondent's request for costs was denied, as the applicant's decision to proceed with the hearing was not unreasonable.

The application was dismissed.

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 chronic pain and psychological impairment.

The Tribunal found the applicant did not meet the AMA Guides criteria for chronic pain and that the evidence did not support a psychological impairment.

The Tribunal concluded the applicant's injuries were predominantly minor and he remained subject to the MIG limit.

As the MIG limits were exhausted, the disputed treatment plans were not considered, and claims for interest and an award were dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, including income replacement benefits (IRBs), a psychiatric assessment, and acupuncture treatment.

The respondent denied the benefits.

The Tribunal found that the applicant failed to establish a substantial inability to perform the essential tasks of his employment, noting a lack of medical evidence connecting his knee pain to the accident and consistent post-accident earnings.

The Tribunal also denied the psychiatric assessment, finding no evidence of psychological complaints prior to July 2023, and denied the acupuncture expenses because they were incurred before a treatment plan was submitted.

The application was dismissed.

The applicant sought various statutory accident benefits following a 2017 motor vehicle accident.

The Tribunal dismissed the claims for increased income replacement benefits, finding that 100% of the applicant's CPP-D benefits were properly deducted from the base amount.

Claims for treatment plans and housekeeping were also dismissed for lack of evidence.

However, the Tribunal found the applicant was entitled to attendant care benefits at the rates set out in the approved Form-1, despite the submitted invoices claiming higher rates.

The Tribunal also ordered a 10% award under s. 10 of Regulation 664, finding the insurer unreasonably withheld payment of the approved attendant care benefits after receiving sufficient documentation.

The applicant sought statutory accident benefits following a motor vehicle accident, including non-earner benefits and two treatment plans for chiropractic services.

The Licence Appeal Tribunal found that the applicant failed to prove a complete inability to carry on a normal life, relying on insurer evaluations that showed the applicant continued to perform daily activities.

The Tribunal approved the first treatment plan for chiropractic services, finding it reasonable and necessary based on the applicant's positive response to prior chiropractic care and support from his general practitioner.

The second treatment plan was denied because it was not submitted into evidence.

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 the applicant sustained a concussion, warranting removal from the MIG.

The Tribunal approved one treatment plan for physiotherapy services supported by contemporaneous medical evidence but denied two subsequent plans due to a lack of medical recommendations.

The applicant was awarded interest on overdue payments, but the claim for a special award under s. 10 of Regulation 664 was dismissed as the insurer's conduct was not unreasonable.

The applicant sought non-earner benefits and funding for two chiropractic treatment plans following a motor vehicle accident.

The Tribunal found the applicant did not meet the test for non-earner benefits, as medical assessments demonstrated her daily routine remained largely unchanged and her impairments were largely attributable to pre-existing musculoskeletal conditions.

The Tribunal lacked jurisdiction over the first treatment plan because it was not properly submitted or denied.

The second treatment plan was denied because the applicant failed to provide objective medical evidence that the treatment was reasonable and necessary for accident-related injuries.

The application was dismissed.

The applicant requested a reconsideration of a preliminary issue decision which found that an incident involving a malfunctioning hoist was not an 'accident' under the Statutory Accident Benefits Schedule.

The applicant argued the Tribunal erred in finding the hoist was an intervening act rather than a foreseeable risk.

The Tribunal dismissed the reconsideration request, finding no error of law or fact and noting the applicant was attempting to relitigate the case.

The respondent's request for costs was also dismissed as the applicant's conduct was not unreasonable, frivolous, vexatious, or in bad faith.

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

The respondent insurer denied benefits and scheduled an insurer's examination (IE) to assess entitlement.

The applicant failed to attend the IE.

The Tribunal held a preliminary issue hearing to determine if the applicant was barred from proceeding under s. 55(1) of the Schedule.

The Tribunal found the IE was reasonably necessary and properly noticed, and the applicant's explanations for non-attendance were not compelling.

Consequently, the applicant was barred from proceeding to a hearing, and the application was dismissed.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that denied her claims for a neurological assessment and a multidisciplinary chronic pain assessment.

The applicant argued that the Tribunal made errors of fact and breached procedural fairness.

The Vice-Chair dismissed the request, finding that the applicant was attempting to re-litigate the case and disagreeing with the weight assigned to the evidence, rather than establishing any material errors of fact or law that would have changed the outcome.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits from the respondent insurer.

The adjudicator found the applicant was entitled to income replacement benefits for a limited period, as well as two treatment plans for physical therapy and partial payment for prescription medication.

Claims for further income replacement benefits, a psychiatric assessment, and costs for preparing disability certificates were denied.

The applicant's motion to strike the respondent's late-filed submissions was also denied, as excluding them would be severely prejudicial.

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 applicant argued for removal from the MIG based on pre-existing back pain and accident-related chronic pain.

The Tribunal found the applicant failed to provide sufficient medical evidence of a pre-existing condition that precluded recovery within the MIG, or of functionally disabling chronic pain.

The applicant's motion to strike the respondent's late-filed submissions was denied, as was his request for costs.

The application was dismissed, with the applicant entitled only to any remaining amounts within the $3,500 MIG limit.

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

The respondent denied the benefits on the basis that the applicant had exhausted her non-catastrophic policy limits and had not been determined to be catastrophically impaired.

The Tribunal held that the application for benefits was premature, as the applicant could not be entitled to further benefits without a catastrophic impairment designation.

The claims for benefits were dismissed without prejudice.

However, the Tribunal allowed the applicant to proceed to a hearing on her standalone claim for an award under Regulation 664.

The respondent's request for costs was dismissed.

The applicant, a self-employed auto mechanic, was injured when a vehicle he was inspecting fell from a hoist due to a mechanical failure.

He sought statutory accident benefits, but the respondent denied the claim on the basis that the incident was not an 'accident' under s. 3(1) of the Schedule.

The Tribunal found that while the purpose test was met, the causation test failed because the malfunctioning hoist was an intervening act that broke the chain of causation.

The application was dismissed.

The applicant insurer sought repayment of $48,628.57 in Income Replacement Benefits (IRB) paid to the respondent, alleging the benefits were paid due to wilful misrepresentation and fraud.

The respondent failed to participate in the written hearing or comply with Tribunal orders to produce employment and income records.

The Tribunal drew an adverse inference from the respondent's non-compliance and relied on surveillance evidence showing the respondent working as a manual labourer while claiming IRB.

The Tribunal ordered the respondent to repay the full amount of the IRB plus interest pursuant to section 52 of the Statutory Accident Benefits Schedule.

The applicant was injured in a 2017 motor vehicle accident and sought various statutory accident benefits, including attendant care, psychological treatments, and medical assessments.

The respondent denied the benefits and brought a preliminary motion arguing the applicant was statute-barred for failing to attend insurer's examinations (IEs).

The Tribunal granted the respondent's motion, finding the applicant failed to attend the scheduled IEs.

In the alternative, the Tribunal found the applicant failed to establish entitlement to any of the substantive benefits, as she did not prove the attendant care expenses were incurred and failed to show the proposed treatments and assessments were reasonable and necessary given her pre-existing conditions and post-accident level of functioning.

The application was dismissed.