Christin Carmichael Greb

The applicant sought statutory accident benefits following a motor vehicle accident, arguing her injuries fell outside the Minor Injury Guideline (MIG) due to chronic pain and psychological impairment.

The Licence Appeal Tribunal found the applicant did not meet the burden of proving chronic pain with functional impairment under the AMA Guides criteria, nor did she establish a psychological condition warranting removal from the MIG.

As the applicant remained subject to the MIG limit, the disputed treatment plan for physiotherapy was not payable.

Claims for an award for unreasonable delay and interest were also dismissed.

The applicant sought payment for outstanding balances on two chiropractic treatment plans and an MRI following a motor vehicle accident.

The Licence Appeal Tribunal dismissed the application, finding that the adjusted hourly rate for the chiropractic services was correct under the Professional Services Guideline and the cost of gloves was not payable.

The Tribunal also found the MRI was not reasonable and necessary as it was reasonably available through OHIP.

Claims for interest and an award for unreasonable delay were consequently dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to a chiropractic treatment plan and the unapproved portions of four psychological treatment plans.

The Tribunal found that the applicant failed to meet the burden of proving the treatments were reasonable and necessary, noting a lack of supporting medical evidence and a failure to address the insurer's reasons for partial denials.

The Tribunal also held that the insurer's denial notices complied with s. 38(8) of the Schedule.

The application was dismissed, and claims for an award and interest were denied.

The applicant sought payment for various treatment and assessment plans following a motor vehicle accident, including a chronic pain assessment, attendant care assessment, neuropsychological assessment, physiotherapy, chiropractic, and massage therapy.

The respondent denied the benefits.

The Tribunal dismissed the application, finding that the applicant failed to meet the burden of proving the plans were reasonable and necessary.

The Tribunal noted a lack of supporting medical evidence, found the chronic pain assessment to be duplicative of existing treatment, and concluded that no interest was payable as no benefits were overdue.

The applicant was involved in a motor vehicle accident and sought statutory accident benefits.

The respondent denied the benefits and argued the applicant was barred from proceeding because he failed to submit an application within the prescribed time limits.

The Tribunal found that the applicant failed to provide a reasonable explanation for his five-month delay in submitting the OCF-1 application.

Consequently, the application was barred under section 55(1)1 of the Schedule and dismissed.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits from the respondent insurer.

The applicant applied to the Licence Appeal Tribunal after the respondent denied treatment plans for chiropractic services, a psychological assessment, and a chronic pain assessment.

The Tribunal found the chiropractic services and chronic pain assessment were reasonable and necessary, as the applicant continued to suffer pain and received short-lived relief from treatments.

However, the Tribunal dismissed the claim for the outstanding balance of the psychological assessment, finding the respondent had correctly applied the hourly rates set out in the Professional Services Guideline.

The applicant was awarded interest on the overdue benefits for the approved plans.

The applicant sought various medical benefits and assessments under the Statutory Accident Benefits Schedule following a motor vehicle accident.

The insurer denied the treatment plans, arguing the applicant's injuries were minor and the plans were not reasonable or necessary.

The Tribunal found that the applicant failed to meet her burden of proving the treatment plans and assessments were reasonable and necessary, noting that the insurer had not breached section 38(8) of the Schedule.

The application was dismissed.

The applicant was injured in a motor vehicle accident and sought $4,400 for a neuropsychological assessment and psychometric testing under the Statutory Accident Benefits Schedule.

The insurer denied the treatment plan.

The Licence Appeal Tribunal found that the applicant failed to demonstrate that the assessment was reasonable and necessary, noting a pre-existing history of depression and headaches, and a lack of evidence that the proposed assessment was required as a result of the accident.

The application was dismissed and no interest was awarded.