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 Volume. 6 Issue. 40 – October 12, 2022


The first case this week, ‘A Losing Proposition’ considers the implications of self-employed business losses on the Applicant’s IRB quantum.

In ‘No Draconian Measures Called For’ the Tribunal’s conclusions were at odds with its own precedents in concluding there was no remedy called for under the Schedule when an Applicant attends an IE found have been secured by way of a deficient notice.


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Business Losses Not Factored Into IRB Calculation

A Losing Proposition – At issue, in 20-012014 v TD Insurance, was the appropriate quantum of IRB to which the Applicant Mears was entitled for the period April 30, 2016, through to June 22, 2022, with entitlement not being disputed.

Prior to the accident, Mears was both employed as a health information professional as well as being the self-employed owner/operator of a hair styling salon. Following the accident, Mears returned to her employment until January 21, 2017, at which time she was unable to work further. She also ceased operations of her salon on or before May 31, 2017. For the period in question, TD’s expert calculated IRB payable of $152, 478, whereas Mears’ expert calculated $166,812, The main point of contention being the amount of post accident losses of the salon, and the extent to which same was attributable to the subject accident.

Mears contended that TD’s calculation fails to fully consider post accident losses from self-employment, as evidenced by the CRA returns, specifically noting the forced shut down of the business in May 2017. TD’s expert countered that the business operated at a loss even prior to the accident, with the CRA records confirming a much larger loss during the year end of May 31, 2016, the majority of which was prior to the accident. They indicated that “given the average weekly business loss after the accident…is similar to the pre-accident weekly loss from June 1, 2015 to April 22, 2016, and the average weekly business loss after the accident…is similar to the pre-accident weekly loss…we have not considered the loss to be an additional loss due to the accident.”

The Tribunal found TD’s position persuasive, and as the losses were occurring prior to the subject accident, they could not be claimed as any part of an IRB award from the date of loss until the cessation of the business. Further, any IRB calculation had to be based upon a standard of proof demonstrating that any such losses were attributable to the accident, with evidence required to confirm “the negative impact of the subject accident on the ability of the applicant to operate the business in question.” However, the evidence supplied by Mears, CRA records 2014 – 2017, rather served to “show a relatively consistent pattern of losses sustained by New Way Beauty Depot Limited both before and after the subject accident”.

Ultimately, the evidence failed to demonstrate “enough of a decline or change in financial status to be clear that such losses are entirely a result of the accident. Even if one wanted to assign some value to the accident here, it would be impossible to determine a number with any sense of accuracy, as no evidence was presented by the applicant to demonstrate how and why the business suffered losses as a result of her injuries. We just have the financial records, which as noted above, do not demonstrate that the accident caused the losses”.



No Remedy For Improperly Scheduled IE

No Draconian Measures Called For – In 20-002008 v Unica, the Tribunal was asked to consider an appropriate remedy with respect to inclusion of an IE report in the record, given a subsequent finding that the notice used by Unica to secure same was found to have been deficient. The Applicant Carleton contended that the OT IE ought to be excluded from the record, citing a precedent Tribunal case. We have previously featured an identical case where this very issue was canvassed, with a finding that Tribunal case law had established that a “significant remedy” was required.

For the within matter however, the Tribunal found that by excluding the IE from the record, this would be “creating a remedy for a breach of s. 44(5) when none exists in the Schedule, would be reading into the Schedule a remedy that was not provided for.” Noting that other sections of the Schedule provided for remedies for failing to comply, and “the Legislature could have included a remedy for a section 44(5) non-compliance as it did for other sections of the Schedule, but it chose not to.” Excluding the evidence, when same was provided in accordance with the production deadlines in the Order “would be a draconian remedy.” Rather, the parties were asked to provide submissions as to the weight that ought to be afforded the report in question due to its deficient notice.



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Archive of LAT Updates

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March 20, 2024: Non-Compliance by Both Parties Impacts IRB and Medical Claims

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March 18, 2024: No Weight Afforded to Handwritten Illegible CNR’s

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March 13, 2024: Denials Deficient and Pain Relief Validates Treatment Plans

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March 11, 2024: “Radicular Irritation” & MRI Findings Not MVA Related

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March 6, 2024: Tribunal Upholds Decision Excluding Improperly Secured IEs From the Evidence

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March 4, 2024: Concussion and Chronic Pain Diagnoses Require Expertise

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February 28, 2024: Prior Health Concerns Complicate Claim for CAT

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February 26, 2024: Unchallenged Virtual Chronic Pain Assessment Accepted

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February 21, 2024: Consent by Parties for Adjournment Not Determinative

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February 14, 2024: Tribunal Does Not Accept the CAT Findings of Either Party

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February 12, 2024: MIG Escape on Concussion Diagnosis Despite Resolution of Symptoms

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February 7, 2024: Financial Hardship Not A Defense for Repayment Responsibility

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February 5, 2024: CT Scan of Wrist Fracture Contradicts Medical Opinion

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January 29, 2024: Concussion Despite No Head Injury?

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January 24, 2024: One Assessment Process Produces Two Discrete Reports

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January 22, 2024: Defective Notices Do Not Trigger Limitation

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January 17, 2024: Election Not Required, LAT Act Invoked & Limits Exhausted?

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January 15, 2024: Chronic Pain Diagnosis Contradicted by Self-Reports

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January 10, 2024: NEB Reinstated After Six Years Generates Award

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January 8, 2024: Undisputed Psychological Diagnosis Prevails

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January 3, 2024: Significant & Competing Price of Non-Compliance for Both Parties

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December 20, 2023 (Throwback Edition): Statutory Relief Within Tribunal’s Jurisdiction

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December 18, 2023: ‘Incident’ of Viewing Video Not Use and Operation

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December 13, 2023 (Throwback Edition): Employed Applicant Remains Entitled to Post 104 IRB

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December 11, 2023: Chronic Pain Diagnosis In Absence of Physical Exam?

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December 6, 2023: Four Marked Impairments for 2010 MVA

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December 4, 2023: No Adverse Inference Drawn Despite Lack of pre MVA CNRs

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November 29, 2023 (THROWBACK EDITION): 18 Month Delayed Notice Reasonable, However 7 Month Delay is Not

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November 27, 2023: Confirmed High Bar to Escape MIG on Pre-Existing

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November 22, 2023: Multiple IEs Excluded From Evidence

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November 15, 2023: Court Applies Tomec & CAT Decision Varied

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November 13, 2023: Insurer Expert Conclusion Inconsistent with Findings

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November 8, 2023: Maximum Award in Excess of $60K on CAT Case

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November 6, 2023: Medical Evidence Overrides Legal Referrals

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November 1, 2023: Eighteen Month Delayed Notice Reasonable However Seven Month Delay is Not

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October 30, 2023: Which MVA Exacerbated Injuries?

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October 25, 2023: Application Seeking CAT Determination an Abuse of Process

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October 23, 2023: Functional Disability Despite 50 Hour Work Week

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October 18, 2023: Statutory Relief Renders Equitable Remedy Moot

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October 16, 2023: Injuries Not Static - MIG Determined Again

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October 11, 2023: CERB is Income However Not “Gross Employment Income”

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October 4, 2023: Employed Applicant Remains Entitled to Post 104 IRB

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October 2, 2023: ‘IE’ Does Not Establish Causation

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