Category: Reconsideration

The claimant filed a request for reconsideration arising from a decision in which the Tribunal found that his injuries fell within the MIG. Adjudicator Kaur first addressed the insurer’s motion to exclude certain documents and submissions that were included in the claimant’s request for reconsideration. Adjudicator Kaur granted the insurer’s motion. She found that the claimant was using a psychiatric report to supplement the evidence which was already before the Tribunal in an attempt to re-argue issues that had already been decided, and that the other documents and submissions did not add anything to the case substantively, were not relevant to the issues raised, or were misleading. Adjudicator Kaur dismissed the request for reconsideration on the grounds that the claimant failed to establish she acted outside of the Tribunal’s jurisdiction or violated the rules of natural justice or procedural fairness, or that the Tribunal made a significant error of law of fact such that it would have likely reached a different decision.

The insurer submitted a request for reconsideration following a decision in which the Tribunal found that the claimant was entitled to various medical benefits. In making its decision, the Tribunal addressed a procedural issue that arose as a result of the parties not filing the OCF-18s in dispute with their written submissions and evidence. As a result, the Tribunal issued an Order directing the parties to serve on each other and file with the Tribunal a copy of the missing OCF-18s along with written submissions on whether the claimant should be permitted to file the missing OCF-18s as evidence for the written hearing. Ultimately, the Tribunal allowed the missing OCF-18s into evidence and proceeded to determine that the claimant was entitled to the treatment set out in those OCF-18s. The insurer argued that the Tribunal made significant errors of fact and law such that the Tribunal would likely have reached a different decision by finding that the missing OCF-18s were submitted by the claimant (when they were in fact submitted by the insurer), by accepting the missing OCF-18s into evidence, and by making the claimant’s case for her on arguments that were never made by the claimant. Adjudicator Lake dismissed the insurer’s request for reconsideration, noting that the Tribunal did not err in admitting the missing OCF-18s into evidence, and that while it erred in stating that the treatment plans were submitted by the claimant when they were in fact submitted by the insurer, this error would not have led the Tribunal to a different decision. Adjudicator Lake further noted that the Tribunal correctly placed the onus on the claimant to prove entitlement, and did not act as an advocate for the claimant. Rather, the Tribunal reviewed all of the evidence in the matter, which included the missing OCF-18s.