Marshall Law is proud to represent Dr. Tamara Kuzma, a gynecologic oncologist, in her human rights case against the Ontario Government. There a list of patients needing life-saving treatment, but our client has been prevented from helping them due to a failure to accommodate her. Dr. Kuzma was forced to give up her gynecologic practice despite being qualified to perform the role with accommodations, and she was forced to close her medical practice and try to establish another practice in general gynecology in which she is only recognized as a part-time physician, leading to a loss of income and significant expenses.
Originally published by the London Free Press: https://lfpress.com/news/local-news/london-doctor-seeks-500k-alleges-disability-accommodations-denied
A London cancer doctor is seeking $2.5 million as part of a human-rights complaint
A London cancer doctor is seeking $2.5 million as part of a human-rights complaint alleging that she was denied accommodations to continue her job after being diagnosed with vertigo and other health ailments that led to a physical disability.
Tamara Kuzma, a former gynecologic oncologist at London Health Sciences Centre, launched a complaint to the Human Rights Tribunal of Ontario against two organizations and an Ontario government ministry in February 2025.
She alleges discrimination breaching Ontario’s Human Rights Code – the law protecting people from discrimination and harassment in areas such as employment, housing, and services, based on protected grounds such as race, age, disability and sex.
Kuzma details in her complaint that she was allegedly denied accommodations to continue working in her job at LHSC after developing medical symptoms that prevented her from performing part of her contracted role
The respondents named in the complaint are:
the now-defunct Ontario Oncology Association, a nonprofit association comprised of medical oncologists, radiation oncologists and gynecologic oncologists
- the Gynaecologic Oncology Group Ontario, an organization representing gynecologic oncologists in Ontario
- Ontario’s Ministry of Health
Marshall Law, the Toronto-based law firm representing Kuzma, provided The London Free Press with the applicant’s complaint, as well as the respondents’ responses to the provincial tribunal.
The lawyers listed as representatives of the respondents did not return Free Press requests for comment.
“The complainant’s physical disability and subsequent need for medical accommodation were factors in the discriminatory treatment in her employment and/or professional association,” the complaint alleges. “(Kuzma) claims that, by discriminating against her on this basis, the respondents have breached the (province’s human rights) code and caused damage to the complainant.”
In their filed submissions, the respondents deny Kuzma’s allegations and state that they have not engaged in any kind of discrimination.
Kuzma is seeking damages for pain and suffering as a result of her dismissal, compensation for wages and benefits lost, along with several other remedies, according to the complaint.
The allegations in complaints and responses have not yet been tested in front of the Human Rights Tribunal of Ontario.
Kuzma was hired by LHSC as a gynecologic oncologist as well as an assistant professor at the Schulich school of medicine and dentristy at Western University, a position she began on Dec. 1, 2022, according to the application to the tribunal.
As a gynecologic oncologist – one of five acting in the role at LHSC – Kuzma, who was 40 when the complaint was filed, was required by her contract to allocate 75 per cent of her time delivering clinical services, and the other 25 per cent for teaching and research, according to the complaint.
But, less than a year into her tenure at LHSC, Kuzma began developing multiple neurological symptoms.
By August 2023, Kuzma began experiencing “daily unrelenting vertigo, tinnitus and frequent episodes of unpredictable left arm and hand numbness,” her complaint said, noting she was later diagnosed with Meniere’s disease.
Meniere’s disease is an incurable and chronic disorder of the “inner ear that causes severe dizziness (vertigo), ringing in the ears (tinnitus), hearing loss and a feeling of fullness or congestion in the ear,” according to the Canadian Academy of Audiology.
Due to the onset of symptoms caused by the disease, Kuzma could no longer perform major surgeries, the complaint said, adding she approached her division head at LHSC after feeling it was unsafe and unethical to continue doing them.
The division head “initially expressed support” for finding her an alternate way to continue practising gynecologic oncology, such as taking on a larger role prescribing chemotherapy, the complaint states. The pair approached the department heads of obstetrics and gynecology, as well as the head of oncology, regarding the requests for accommodations, the complaint states.
To accommodate Kuzma’s request, the complaint says she would require a change to her billing codes to a fee-for-service billing model – a practice in which a doctor is paid a set fee for each individual medical service provided to patients during a visit.
The complaint describes this billing method as: “Essentially billing for each separate procedure or action taken during the appointment, with the payment coming from the Ontario Health Insurance Plan through a claim submission process.”
However, as a full-time gynecologic oncologist, Kuzma was subject to the provincial oncology alternative funding plan agreement (POAFP). It’s a contract negotiated between the Ministry of Health, Cancer Care Ontario, various hospitals, including LHSC, as well as the Gynaecologic Oncology Group Ontario (GOGO) – which took over representing gynecologic oncologists under the POAFP from the Ontario Oncology Association (OOA) in 2023.
The provincial oncology funding plan agreement:
Determines how gynecologic oncologists can bill for their services
- Requires gynecologic oncologists to collectively allocate 75 per cent of their time to clinical services and 25 per cent to teaching and research
- Funds the payments for the oncologists
- Decides how many oncologists can work at various hospitals, such as at LHSC, where the maximum is five full-time gynecologic oncologists
- Requires gynecologic oncologists to be part of the Ontario gynecologic oncology group
Kuzma’s restrictions required such a model because LHSC was allotted a limited number of positions under the provincial oncology alternative funding plan agreement within each specialty, the complaint said.
“(LHSC’s) gynecological oncology department only had five . . . positions and redistributing surgeries to only four physicians was felt a risk to increasing burnout for the four physicians as well as not being sustainable long-term,” the complaint states.
Though Kuzma’s division head and obstetrics and gynecology department head were “supportive” of trying to find a way for her to remain employed as a gynecologic oncologist in the fee-for-service billing model, the complaint alleges the Ontario gynecologic oncology group indicated it wouldn’t allow the alternative billing structure as “all oncologists have to be a part of the (provincial oncology funding plan agreement).”
Around February 2024, Kuzma and her division head contacted the Ministry of Health requesting a waiver to allow her to bill gynecology oncology codes in a fee-for-service billing model amid her practice restrictions. This would enable LHSC to hire five positions included in the provincial oncology funding plan agreement, while opening a sixth position at 60 per cent full time for Kuzma to account for her performing all of her responsibilities except surgeries, the complaint alleges.
On March 4, 2024, the Ministry of Health denied her request, citing as the reason for the denial that if accommodations were given to Kuzma, it would ”open a flood gate of accommodation requests,” the complaint alleges.
But in its response to the complaint, the ministry dismissed the assertion, saying “it made no such statement,” noting the waiver wasn’t declined based on concerns of further accommodation requests, but because it would contravene the terms of the provincial oncology funding plan agreement.
The ministry said it wouldn’t overrule the Ontario gynecologic oncology group – also noting it was bound by the provincial oncology funding plan agreement, which precludes fee-for-service billing for gynecologic oncologists – the complaint alleges, resulting in Kuzma’s removal as a party of the funding plan agreement on June 30, 2024, two years before her contract with LHSC was to expire.
The refusal of the Gynaecologic Oncology Group Ontario and the Ministry of Health to grant Kuzma’s accommodations “has had profound and far-reaching consequences for her,” the complaint alleges, adding that like most people, she “never anticipated developing a disability, especially so early in her career.
“The complainant has been treated differently than her colleagues, creating an environment where she has been isolated and treated inequitably,” Kuzma’s complaint alleges.
Due to a “failure to accommodate” Kuzma’s disability, she was forced to give up her gynecologic practice despite being qualified to perform the role with accommodations, she alleges, adding she had to close her medical practice and try to establish another practice in general gynecology in which she is “only recognized as a part-time physician, leading to a loss of income and significant expenses.”
The “discriminatory treatment” caused Kuzma a deep loss of dignity and confidence resulting in “significant stress,” Kuzma alleges, further exacerbating her health issues and compounding the toll of her disability on her life.
“Beyond the complainant’s personal experience, the closure of her oncologic practice has caused significant distress to her patients, who were suddenly left without the continuity of care they needed and deserved during a vulnerable time in their lives,” the complaint alleges.
Marshall Law said in an email that Kuzma looked after hundreds of patients as a gynecologic oncologist.
After being “very open and candid” with the Gynaecologic Oncology Group Ontario and the Ministry of Health regarding her physical disabilities, Kuzma was worried that her medical condition would affect her employment, her complaint said, alleging the respondents were aware of the ailments and required accommodations but “refused to implement them.”
“(Kuzma’s) physical disability and subsequent need for medical accommodation were factors in the discriminatory treatment in her employment and/or professional association,” the complaint alleges.
The Ministry of Health and the Gynaecologic Oncology Group Ontario responded to Kuzma’s complaint, denying her allegations.
The ministry requested the application “be dismissed,” saying LHSC should be added as a co-respondent, noting the provincial agency has no responsibility under the provincial oncology alternative funding plan agreement for hiring or appointing gynecologic oncologists, distributing funds or allocating work among gynecologic oncologists.
“The applicant alleges that a waiver from the (oncology funding plan agreement) would have allowed her to continue practising gynecologic oncology at (LHSC) and that the ministry’s refusal to provide such a waiver discriminated on the basis of disability,” the ministry said. “Neither assertion is supported by law or evidence.”
LHSC “decided not to renew” Kuzma’s appointment, and said gynecologic oncologists at signatory hospitals, including LHSC, are compensated under the provincial oncology funding plan agreement and not permitted to bill for oncological services on a fee-for-service basis, the ministry said.
“Ontario did not discriminate contrary to the code,” the ministry said, adding its staff “engaged” with Kuzma and LHSC representatives in a “good faith attempt” to find a “voluntary resolution.”
The Gynaecologic Oncology Group Ontario is also seeking to dismiss Kuzma’s application and denies it breached Ontario’s Human Rights Code, requesting the addition of LHSC as a co-respondent, along with the Schulich school of medicine and dentistry.
The application “contains bald assertions” without providing the requisite factual basis or link necessary to prove any ground protected by Ontario’s Human Rights Code was a factor in “any adverse treatment of Kuzma,” the oncology group said in its response.
In Kuzma’s response to the Ministry of Health and the Ontario gynecologic oncology group, she denied LHSC and the Schulich school of medicine and dentistry should be added as co-respondents, as LHSC “attempted to accommodate” Kuzma’s needs around her contract.
Marshall Law said it will likely be another two years before the matter is heard by the tribunal.