Chris Sewrattan

The applicant was injured in a motor vehicle accident and sought payment for an occupational therapy treatment plan that the insurer denied.

The adjudicator found that the applicant suffered from chronic pain and psychological impairments as a result of the accident.

The adjudicator concluded that the proposed occupational therapy, which focused on pain management and increasing functional activity, was a reasonable and necessary method of treating the applicant's impairments.

The insurer was ordered to pay the treatment plan amount of $3,358.14 plus interest.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for chiropractic and massage therapy, as well as a chronic pain assessment.

The Tribunal found that the applicant failed to prove the chiropractic and massage therapy was reasonable and necessary, citing credibility issues and a lack of objective evidence showing the treatment's effectiveness.

However, the Tribunal approved the chronic pain assessment, finding a reasonable possibility that the applicant's documented physical injuries could result in chronic pain syndrome.

Claims for costs by both parties were dismissed as there was no unreasonable or bad faith conduct.

The applicant was injured in a motor vehicle accident and sought payment for a psychological assessment and physiotherapy services.

The respondent insurer denied the treatment plans on the basis that the applicant's injuries were predominantly minor and subject to the $3,500 cap under the Minor Injury Guideline (MIG).

The Tribunal found that the applicant failed to provide sufficient medical evidence to prove her chronic pain, fibromyalgia, and psychological impairments were caused by the accident or removed her from the MIG.

The application was dismissed, and the applicant was denied the claimed benefits, interest, and costs.

The applicant was injured in a motor vehicle accident and sought income replacement benefits after the respondent terminated them.

The Tribunal found that while the accident caused the applicant's sprains and strains, he failed to prove a substantial inability to perform the essential tasks of his pre-accident employment as a cleaner.

The Tribunal rejected the applicant's medical evidence for failing to link test results to diagnoses, preferring the respondent's medical examiners who found no specific neuromusculoskeletal abnormality.

The application for benefits and costs was dismissed.

The applicant sought an income replacement benefit following a motor vehicle accident, claiming he was substantially unable to perform the essential tasks of his pre-accident employment as an automobile garage owner.

The respondent insurer terminated the benefit and relied on surveillance evidence that contradicted the applicant's self-reported limitations.

The adjudicator found the applicant's medical evidence relied heavily on his self-reports, which were undermined by surveillance showing him walking without a cane, driving, and bending without visible difficulty.

The application was dismissed as the applicant failed to prove on a balance of probabilities that he suffered a substantial inability to perform his essential tasks.

The applicant sought payment for a neurocognitive assessment, a psychological assessment, and various other expenses following a motor vehicle accident.

The Licence Appeal Tribunal found that the neurocognitive assessment was reasonable as it was intended to help the applicant decide whether to bring a claim for catastrophic impairment, but capped the payable amount at $2,000 plus tax.

The claims for the psychological assessment and other expenses were dismissed, as the applicant failed to prove they were reasonable and necessary, and the medical evidence provided by the applicant was found to be inconsistent and lacking credibility.

The applicant was injured in a motor vehicle accident and applied for an income replacement benefit.

The insurer paid the $2,500 statutory maximum for an accounting report, but the applicant sought an additional $268.50 for HST.

The Tribunal dismissed the claim, finding the applicant failed to prove that the statutory cap excluded HST.

The Tribunal also dismissed the applicant's claim for interest on delayed benefit payments, as the delay was caused by the applicant's failure to provide requested information.

Both parties' claims for costs were dismissed, as neither party's conduct was found to be unreasonable, frivolous, vexatious, or in bad faith.

The applicant was injured in a motor vehicle accident and claimed attendant care benefits for services provided by his wife, a professionally qualified personal attendant.

The insurer denied the claim.

The Licence Appeal Tribunal found that the applicant's wife did not provide the services in the course of her ordinary employment, nor did she sustain an economic loss as a result of providing the care.

Consequently, the applicant failed to prove that the attendant care expenses were 'incurred' under section 3(7)(e)(iii) of the Statutory Accident Benefits Schedule.

The appeal for benefits, interest, and costs was dismissed.

The Applicant sought payment for three chiropractic treatment plans and non-earner benefits following a 2015 motor vehicle accident.

The insurer denied the claims on the basis that the Applicant's injuries fell within the Minor Injury Guideline (MIG) and were not reasonable and necessary.

The Tribunal found the Applicant lacked credibility due to inconsistent statements about his employment and failure to disclose a prior 2013 accident with similar injuries.

The Tribunal accepted the insurer's independent medical examinations, concluding the Applicant failed to prove his impairments were directly caused by the 2015 accident or that he met the test for non-earner benefits.

The appeal was dismissed entirely.

The applicant was injured in a motor vehicle accident and sought payment for two treatment plans under the Statutory Accident Benefits Schedule: $3,558.72 for psychological services and $2,772.32 for assistive devices.

The Licence Appeal Tribunal dismissed both claims.

The Tribunal found the applicant failed to prove the psychological services were reasonable and necessary, preferring the respondent's independent examination report.

The claim for assistive devices was also dismissed as the applicant failed to prove the disputed amount was reasonable and necessary beyond the modified amount already paid by the respondent.

The applicant was injured in a motor vehicle accident and sought medical and income replacement benefits.

The insurer denied two treatment plans and adjusted the income replacement benefit.

The Tribunal found that the applicant's injuries, which included possible carpal tunnel syndrome, fell outside the Minor Injury Guideline.

The Tribunal approved the disputed treatment plans as reasonable and necessary, and awarded interest.

The Tribunal also determined the applicant's weekly income replacement benefit to be $280.16, but held that he was not entitled to claim a weekly business loss amount because he was no longer operating his business.

The applicant was injured in two motor vehicle accidents and sought payment for six treatment plans for chiropractic services and massage therapy.

The respondent insurer denied the treatment plans, arguing the injuries were minor and did not require further facility-based treatment, relying on surveillance evidence and an independent medical examination.

The adjudicator found that the applicant suffered a chronic impairment to her thoracic spine and that the proposed treatments were reasonable and necessary to relieve pain and improve function.

The surveillance evidence did not undermine the applicant's credibility regarding her pain.

The insurer was ordered to pay for all six treatment plans.

The Applicant sought costs and an award under s. 10 of O. Reg. 664 after the Insurer approved a treatment plan prior to the case conference.

The Applicant alleged the Insurer acted in bad faith and unreasonably delayed payment by refusing to pay a disbursement fee for medical records.

The Insurer also sought costs, arguing the Applicant's conduct was frivolous and vexatious.

The Tribunal dismissed both costs requests, finding neither party's conduct during the proceeding met the threshold under Rule 19.1.

The Tribunal also denied the Applicant's request for an award, concluding the Insurer acted reasonably in waiting for updated medical records before approving the treatment plan.

The applicant was injured in a motor vehicle accident and sought income replacement benefits (IRB).

The insurer terminated the benefits, arguing the applicant did not meet the test for entitlement.

The Tribunal found that the applicant was employed as a school bus driver at the time of the accident and that the accident caused her right shoulder and back pain.

Preferring the evidence of the applicant's physiatrist over the insurer's, the Tribunal concluded that the applicant's physical limitations rendered her substantially unable to perform the essential tasks of her employment, specifically driving a school bus for extended periods.

The applicant was awarded a weekly IRB of $292.46.

The applicant sought dispute resolution for statutory accident benefits following a motor vehicle accident, claiming entitlement to a medical benefit of $1,747.20 and arguing their injury fell outside the Minor Injury Guideline.

The adjudicator dismissed the appeal entirely because the applicant failed to submit any evidence to support their claims, despite being given an extension to do so.