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 Volume. 8 Issue. 17 – May 8, 2024


This week the Tribunal demonstrates what set of circumstances would warrant a rehearing based upon a reasonable apprehension of bias. In the case considered, it seems as if the actions/inactions of a former adjudicator constituted a textbook example for at minimum a perception of bias.



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Reasonable Perception of Bias Involving Former Adjudicator Requires Rehearing

Former Adjudicator’s Clear Conflict of Interest – In a September 2022 decision by the Tribunal, then adjudicator Therese Reilly found against the Applicant Nagesu who was seeking income replacement benefits and medical benefits. In June 2023, the Tribunal sent a letter to both parties, indicating that it was initiating a reconsideration of the decision on the Tribunal’s initiative. This was predicated upon a letter from Applicant’s counsel in May 2023, that confirmed the former adjudicator was now working for Aviva, with a start date of December 2022, with the insurer in the initial hearing being Traders General, wholly owned by Aviva. Ultimately, in 19-008171 v Traders, the Tribunal cancelled the decision of the former adjudicator and ordered a rehearing.

Following receipt of the correspondence from counsel, the Tribunal immediately commenced an investigation,

The findings of fact were as follows:

a. The former adjudicator applied to a job posting for Aviva in May 2022;

b. The former adjudicator had an interview with Aviva in June 2022;

c. The former adjudicator accepted an offer of employment from Aviva in June 2022;

d. The former adjudicator heard four matters involving Aviva/Aviva owned insurers between May 2022 and November 2022;

e. The former adjudicator released a decision in this case on September 12, 2022;

f. The former adjudicator’s appointment to the Tribunal ended on November 4, 2022; and,

g. The former adjudicator started working at Aviva in approximately December, 2022.



Given the findings above, a reconsideration was initiated by the Tribunal, for this matter in addition to three other decisions rendered by the former adjudicator in cases involving Aviva. The Tribunal noted that there were many safeguards in place to ensure that adjudicators do not place themselves in potential conflicts of interest. As part of her initial appointment in 2016, the former adjudicator was required to swear an oath to uphold the duties as a public servant including ethical duties. Of particular note, “the former adjudicator executed the Code of Conduct during her appointment, as recently as February 2022. Adjudicators bear the onus to adhere to these duties and obligations. In this case, the former adjudicator ought to have known that she had the ethical obligation to recuse herself from the hearing in this matter.”

The Tribunal further found that the Code of Conduct included the edict that “Members will not adjudicate any proceeding involving a party or representative with whom he or she has a close personal relationship” and “to act impartially in the conduct of proceedings”. The Tribunal did not agree with the Respondent’s assertion that the Tribunal was at fault for the adjudicator’s actions. It was noted that Tribunals Ontario has a rigorous conflict of interest process, and that “it remains the responsibility of the individual adjudicator to identify and disclose any and all potential conflicts of interest both with the Tribunal and Ethics Executive. This was not done in this matter. If it had been done, I am confident the Tribunal safeguards would have ensured the former adjudicator did not conduct the hearing in this matter.”

The Tribunal noted as well that the former adjudicator, post resignation, continued to inform the Tribunal that she was retiring. At no point did she suggest that she was in fact leaving for alternative employment. In fact, as late as June 2023, she still referred to her “retirement in November 2022”. Once “new and contradictory information came to the attention of the Tribunal, the Tribunal immediately took steps to determine the former adjudicator’s employment details and then remedy the circumstances.”

Based upon the evidence, the Tribunal found that “there are grounds for reconsideration pursuant to Rule 18.2(a). I find that the former adjudicator’s failure to recuse herself resulted in a violation of the rules of procedural fairness on the grounds of a reasonable apprehension of bias.” The Tribunal agreed with Nagesu that “the former adjudicator violated procedural fairness in this matter. The former adjudicator undertook to adjudicate a matter involving her future employer. She had accepted an offer of employment in June 2022, and a month later, conducted a hearing with that employer as the Respondent.” These facts were never disclosed to the Associate Chair of the Tribunal or Tribunals Ontario’s Ethics Executive. The “relationship between the former adjudicator and Respondent/employer is sufficient to find a perception of bias”. There was no requirement to determine whether there was actual bias, rather “there was, at minimum, a perception of bias, which is sufficient to find a violation of procedural fairness.”

This decision was confirmed as covering only decisions involving Aviva or Aviva owned entities. There was found to be no reason to disturb other decisions of the former adjudicator during the relevant time period. The Tribunal found that a rehearing would proceed orally, confirming that a rehearing by transcript alone was not appropriate, as the former adjudicator had made rulings on procedural matters that impacted the course of the hearing.

Both parties sought a variety of expenses to be covered by the Tribunal. However, the Tribunal found that neither party demonstrated the legal authority for such a claim, nor could the Tribunal see any “comparable situation in which a tribunal would absorb legal expenses for parties…The remedy of the hearing”..



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Archive of LAT Updates

May 8, 2024: Reasonable Perception of Bias Involving Former Adjudicator Requires Rehearing

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April 29, 2024: Credibility of Assessment Favored Over Psych Validity Testing

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April 24, 2024: Wilful Misrepresentation Abounds on IRB Repayments

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April 10, 2024: Court Upholds Tribunal Decision That a MIG Removal is a Complete MIG Removal

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April 3, 2024: Court Sends Matter Back to Tribunal Concerning “Accident”

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March 27, 2024: Supreme Court Takes Issue with Tribunal, Divisional Court & Court of Appeal

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March 25, 2024: Expert’s Conclusory Statement Insufficient on Pre-existing Condition

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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 4, 2024: Concussion and Chronic Pain Diagnoses Require Expertise

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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 20, 2023: Radiculopathy Complaint Requires a Diagnosis

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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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