Thomas Gold Pettingill LLP is pleased to provide this online resource to our clients. Below is a searchable database of the publicly released decisions from the Licence Appeal Tribunal. Assembled by the accident benefits group, the decisions are reviewed, briefly summarized, and categorized for easy access.
As of March 2020, we will not include any further decisions focused solely on the Minor Injury Guideline or treatment plans, unless the case may have broader applicability.
This is a reconsideration in which the insurer sought to have the LAT overturn the award of various treatment plans. The insurer also argued that the claimant had submitted documents too late, and should not have been considered by the adjudicator. Executive Chair Lamoureux held that there was sufficient evidence for the adjudicator to conclude...
The claimant sustained injuries when he was assaulted in a parking lot. During the assault, the claimant managed to get into his car and turn the engine on. The claimant applied for accident benefits. The insurer took the position that the incident was not an "accident" as defined in the SABS. Adjudicator Neilson dismissed the...
The claimant suffered catastrophic injuries while running down a street, and tripping headfirst into a parked vehicle. The insurer argued that the evidence did not support the facts of loss as reported by the claimant, and that even if the facts as reported were true, the claimant was not involved in an "accident" for the...
The claimant applied for a CAT determination based on GCS. The insurer denied the determination based on a paper review of a neurologist. Adjudicator Bickley reviewed the medical evidence, which included two ambulance call reports both showing GCS scores of 15. However, during the course of hospitalization, the claimant scored GCS scores of 7, 8,...
The claimant sought entitlement to a medical treatment plan. In addition to the issues outlined in the Case Conference Order, the claimant also sought a lump sum payment of $35,000.00 for 5 years of future medical treatment. Adjudicator Truong noted that issues not codified by the Case Conference Order were not properly before the Tribunal...
The claimant sought a determination that his impairments were outside of the MIG and entitlement to one treatment plan for a psychological assessment. Adjudicator Sewrattan found that the claimant's injuries were predominantly minor and that his entitlement was subject to the MIG. In terms of psychological impairments, the adjudicator found that the diagnosis of mixed...
The claimant sought entitlement to a medical treatment plan. The insurer relied on IE reports and denied the benefit. On review, Adjudicator Norris preferred the evidence of the claimant and determined the treatment plan was reasonable and necessary.
The claimant sought payment for various clinic balances for medical treatment. Adjudicator Sewrattan ruled that the claimant failed to submit the treatment plans as evidence and therefore the issue as to whether the treatment was reasonable and necessary was not at issue. The claims were dismissed.
The claimant sought entitlement to a number of medical benefits. The insurer asserted a MIG defence. On review of the evidence, Adjudicator Sewrattan determined the claimant's psychological injury was as a result of the accident and not predominantly minor. The psychologically-based treatment plans were found payable, and the physically-based treatment plans were denied as not...
The claimant sought and was successful in obtaining a Tribunal Order for a number of treatment plans. In making the determination, the Tribunal also ordered interest payable at 2 percent per month. On reconsideration, however, Executive Chair Lamoureux noted the Tribunal erred by using the interest provisions of the previous SABS; the correct provision is...
The claimant had been involved in two accidents. He had been removed from the MIG due to pre-existing back injuries and sought entitlement to a treatment plan proposing psychological therapy in relation to the first accident. The treatment plan was submitted after the second accident occurred. Adjudicator White took issue with the treatment provider's failure...
The claimant sought entitlement to medical benefits. At the case conference the parties were able to resolve the issues with the exception of costs, which the claimant continued to seek. Adjudicator Truong reviewed Rule 19.1 and affirmed that costs may only arise out of the Tribunal process. While the claimant argued the insurer failed to...
The claimant sought and was successful in obtaining a Tribunal Order for a number of treatment plans. In making the determination, the Tribunal also ordered interest payable at 2 percent per month. On reconsideration, however, Executive Chair Lamoureux noted the Tribunal erred by using the interest provisions of the previous SABS; the correct provision is...
The claimant sought entitlement to a number of benefits. At the case conference, a number of timelines were set. The claimant missed a number of document exchange deadlines and subsequently sought an adjournment and the insurer did not consent. The Tribunal did not grant the adjournment. On reconsideration Executive Chair Lamoureux noted the reason for...
The claimant was originally placed within the MIG. During that period, the insurer denied medical benefits as well as an assessment of attendant care needs. The insurer later removed the claimant from the MIG, but did not approve the previously denied treatment plans. The claimant sought entitlement to the previous plans. Adjudicator Leslie found the...
The claimant applied for FSCO mediation on January 21, 2016 and disputed a denial of IRBs dated February 26, 2014. The FSCO Mediation was scheduled for May 6, 2016 and was not successful. The claimant subsequently applied to the LAT on August 11, 2016 (97 days after the report of mediator). The insurer raised a...
The claimant was injured in an accident. The insurer had previously sought and received a declaration from WSIAT that under section 31 of the WSIA the claimant was barred from seeking accident benefits. WSIAT indicated that the claimant only had a claim against its employer, but could not make a declaration against accident benefits due...
The claimant had sought production of all of clinical notes and records of the insurer's IE assessors prior to the LAT hearing. Those records had not been produced in accordance with the Case Conference order. The claimant sought an order extending the deadline for his opening statements. Adjudicator Lester granted the claimant's motion and issued...
In advance of the scheduled LAT hearing, the insurer sought the production of the complete clinical notes and records from a variety of medical practitioners. Adjudicator Markovits rejected the insurer's motion, reasoning that the Case Conference adjudicator clearly set out the documents that the parties had agreed to exchange prior to the hearing. The newly...
The claimant sought entitlement to NEBs and removal from the MIG. Adjudicator Belanger-Hardy denied all claims. First, she held that the claimant failed to adduce sufficient evidence of the details of his pre-accident lifestyle and activities to establish his eligibility to NEBs. Second, the claimant did not adduce sufficient evidence that he sustained a non-minor...