Todd A. Reybroek

The applicant sought statutory accident benefits after sustaining an exacerbation of a pre-existing back injury while riding as a passenger in a Wheel-Trans vehicle.

The respondent denied the claim, arguing the incident did not meet the definition of an 'accident' and that the applicant was barred from proceeding due to late notification.

The Tribunal found that the incident met the purpose and causation tests for an accident, as the injuries were directly caused by the unsafe operation of the vehicle.

Furthermore, the Tribunal held that the applicant provided a reasonable explanation for her delayed notification, noting her lack of sophistication and the TTC's delay in advising her of her rights.

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

The respondent insurer denied two physiotherapy treatment plans, arguing the applicant's injuries fell within the $3,500 Minor Injury Guideline (MIG) limit.

The Tribunal found that the applicant had a documented pre-existing workplace injury to his neck and upper back that had not fully resolved prior to the accident.

Relying on compelling medical evidence from the treating physiotherapist and family physician, the Tribunal concluded the pre-existing condition precluded recovery within the MIG.

The Tribunal ordered the respondent to pay for both disputed physiotherapy treatment plans, finding them reasonable and necessary, along with interest on overdue payments.

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

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

The Tribunal found that the applicant failed to establish that his injuries, including alleged post-concussion syndrome, psychological impairments, and chronic pain, warranted removal from the MIG.

The Tribunal preferred the evidence of the respondent's insurer examinations over the applicant's self-reported symptoms and chiropractor's report.

As the applicant remained within the MIG, the disputed treatment plans were not payable and the application was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident but was denied by the respondent insurer on the basis that the injuries fell within the Minor Injury Guideline (MIG).

The applicant argued for removal from the MIG due to chronic pain, relying on their family physician's clinical notes and records to meet the AMA Guides criteria.

The Tribunal found the medical evidence insufficient to establish excessive dependence on health care providers, use of prescription drugs beyond recommended duration, or failure to restore pre-injury function.

The Tribunal concluded the applicant's injuries were predominantly minor, dismissing the claims for chiropractic treatment plans and interest.

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

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

The Licence Appeal Tribunal found that the applicant demonstrated chronic pain with functional impairment, warranting removal from the MIG.

However, the Tribunal dismissed the claims for a physiotherapy treatment plan and a psychological assessment, finding the applicant failed to prove they were reasonable and necessary due to a lack of contemporaneous supporting medical evidence.

No interest was payable as no benefits were overdue.

The applicant sought statutory accident benefits for chiropractic services, a concussion assessment, and a neurological assessment following a 2019 motor vehicle accident.

The respondent denied the benefits.

The Tribunal found that the chiropractic treatment plan lacked support from treating medical professionals and objective findings.

The Tribunal also found that the concussion and neurological assessments were not reasonable and necessary, as independent medical examinations found no neurological impairment and the applicant failed to provide sufficient medical evidence to justify the assessments.

The application was dismissed.

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

The Licence Appeal Tribunal found that the applicant failed to prove on a balance of probabilities that she suffered from chronic pain with a functional impairment.

Applying the AMA Guides as an analytical tool, the adjudicator noted the applicant did not rely heavily on prescription medication and maintained independence in her daily activities.

The Tribunal accepted the respondent's s. 44 physiatry assessment, concluding the injuries were predominantly minor.

The application for a $2,941.38 chiropractic treatment plan and interest was dismissed.

The applicant was involved in a motor vehicle accident and sought statutory accident benefits for a treatment plan proposing physiotherapy and chiropractic services totaling $3,388.40.

The respondent denied the plan, arguing the accident-related injuries had resolved and the applicant's ongoing complaints were unrelated to the accident.

The Tribunal found that the medical evidence, including clinical notes and an independent medical examination, did not support the proposed treatment for the applicant's accident-related impairments.

The application was dismissed, and no interest was payable.

The applicant sought statutory accident benefits for various treatment and assessment plans following a motor vehicle accident, including chiropractic treatment, a chronic pain assessment, a neurological assessment, and a concussion assessment.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to meet her burden of proving the plans were reasonable and necessary.

The Tribunal preferred the evidence of the respondent's insurer's examinations and the applicant's own family doctors' clinical notes, which did not corroborate the need for the proposed assessments or treatments.

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

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

The applicant argued that chronic pain and psychological injuries removed him from the MIG.

The Tribunal found insufficient evidence of functionally disabling chronic pain or a psychological impairment, noting the lack of corroborating medical records.

As the applicant's injuries were predominantly minor and the MIG limits were exhausted, the application for disputed benefits and interest was dismissed.

The applicant sought $1,733.72 for chiropractic services following a motor vehicle accident.

The respondent denied the benefit, arguing the applicant had reached maximum medical recovery.

The Tribunal found that the applicant had a pre-existing back condition with similar physical limitations prior to the accident.

Relying on the insurer's examination, the Tribunal concluded the proposed treatment was not reasonable and necessary, as it would only provide temporary relief without substantial functional restoration.

The application was dismissed.

The plaintiffs were involved in two motor vehicle accidents, one in Georgia and one in Ontario.

They commenced a single action in Ontario against all defendants.

The defendants involved in the Georgia accident, who resided in the United States, brought a cross-motion to dismiss the action against them for lack of jurisdiction.

The court found that none of the presumptive connecting factors from Van Breda applied to the Georgia defendants.

The court declined to recognize a new connecting factor based solely on the presence of an Ontario co-defendant for a separate accident.

The action against the Georgia defendants was dismissed for lack of jurisdiction.

The applicant was catastrophically impaired in a motor vehicle accident and received a non-earner benefit (NEB) from the respondent insurer.

The insurer denied further payment of the NEB in October 2016.

The applicant appealed the denial to the Licence Appeal Tribunal in November 2018, beyond the two-year limitation period under section 56 of the Statutory Accident Benefits Schedule.

The insurer brought a motion to dismiss the appeal as time-barred.

The Tribunal found that the insurer had properly sent the denial notice by mail and fax.

Applying the four-part test under section 7 of the Licence Appeal Tribunal Act, the Tribunal declined to extend the limitation period, finding no bona fide intention to appeal within the period and no valid reason for the delay.

The application for the NEB was dismissed as time-barred.

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

The respondent denied the claims on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and the $3,500 limit had been exhausted.

The applicant argued her injuries fell outside the MIG due to a pre-existing condition, chronic pain syndrome, and psychological impairments.

The Tribunal found insufficient compelling medical evidence to establish a pre-existing condition or chronic pain syndrome.

Applying the "but for" test for causation, the Tribunal concluded the applicant's psychological impairments were related to social, work, and family stressors rather than the accident.

The application was dismissed.

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

The respondent denied claims for non-earner benefits, attendant care benefits, and a neurological assessment.

The applicant filed an application for dispute resolution with the Licence Appeal Tribunal after the limitation period had expired.

The Tribunal applied the Manuel factors under section 7 of the Licence Appeal Tribunal Act and granted an extension of time, finding that the applicant had a bona fide intention to appeal, the delay was not significant, the respondent was not prejudiced, and the appeal had merit given the applicant's recent catastrophic impairment designation.

The applicant in a statutory accident benefits dispute sought production of statistics regarding the number of reports completed by the respondent insurer's medical assessors over the past three years and the amounts paid for them.

The applicant argued this information was necessary to assess the experts' impartiality.

The adjudicator denied the request, finding that the information was not relevant to the substantive issues in dispute and was not necessary for a full and satisfactory understanding of the issues under the Tribunal's Rules of Practice.

The adjudicator noted that the appropriate forum to challenge an expert's objectivity is during cross-examination at the hearing.

The applicant, a pedestrian struck by a vehicle, sought statutory accident benefits including income replacement, dental, and housekeeping benefits.

The arbitrator found the applicant was not entitled to ongoing income replacement benefits, as she was not substantially unable to perform the essential tasks of her pre-accident employment as a companion.

The arbitrator awarded the cost of an alternative dental treatment plan, finding the accident materially contributed to the need for it, despite pre-existing dental neglect.

The claim for housekeeping benefits was dismissed, as the applicant failed to prove a substantial inability to perform her pre-accident housekeeping duties.

The applicants sought to withdraw their application for arbitration regarding death benefits following a motor vehicle accident, intending to pursue the claim in court instead.

The insurer opposed the withdrawal, arguing it was forum shopping and an abuse of process, and requested reimbursement of its $2,000 assessment fee.

The arbitrator permitted the withdrawal on the condition that the applicants pay the insurer the $2,000 assessment fee within 40 days, and ordered that the applicants may not reapply for arbitration on the same issues.