Christopher Climo

The applicant was injured in a motor vehicle accident and sought payment for a physiotherapy treatment plan (aqua therapy) under the Statutory Accident Benefits Schedule.

The respondent insurer denied the benefit, arguing the applicant had reached maximum medical improvement and the treatment was for pre-existing fibromyalgia.

The Tribunal found the treatment plan reasonable and necessary, noting it was recommended by the applicant's family doctor and an orthopaedic surgeon for accident-related injuries.

The applicant was awarded the cost of the treatment plan and interest on overdue payments.

The applicant's request for costs under Rule 19 was dismissed, as the Tribunal found the respondent did not act unreasonably or in bad faith.

The applicant sought statutory accident benefits following a motor vehicle accident, including a declaration that her injuries exceeded the Minor Injury Guideline (MIG) and entitlement to a chiropractic treatment plan.

The respondent brought a preliminary motion to dismiss the application on the basis of res judicata, arguing the MIG issue had been decided in a previous Tribunal hearing.

The Tribunal found that the preconditions for issue estoppel were met regarding the MIG issue and declined to waive the doctrine, as the applicant's new medical records did not constitute fresh evidence that would conclusively impeach the original result.

Because the applicant remained within the MIG, the Tribunal did not consider the reasonableness and necessity of the treatment plan, which proposed amounts outside the MIG limit.

Claims for an award, interest, and costs were dismissed.

The applicant sought statutory accident benefits for medical marijuana and a physiatry assessment following a motor vehicle accident.

The Tribunal found that the medical marijuana was not reasonable and necessary, as the applicant had used it for an extended period without meaningful improvement in pain, sleep, or psychological symptoms.

Consequently, the physiatry assessment to review the treatment plan was also not payable.

The application was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident.

The respondent insurer denied several treatment plans, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) and that disputes regarding three of the plans were statute-barred.

The Tribunal found that the applicant was statute-barred from disputing three of the treatment plans because the application was commenced more than two years after the insurer provided valid written denials, and there were no grounds to extend the limitation period under the Manuel factors.

However, the Tribunal removed the applicant from the MIG based on psychological impairments, preferring the evidence of the applicant's psychologist over the insurer's assessor.

The Tribunal also found that the remaining physiotherapy and chiropractic treatment plans were reasonable and necessary to treat the applicant's chronic back pain, and ordered the insurer to pay those benefits with interest.

The applicant sought statutory accident benefits following a motor vehicle accident, specifically claiming $3,821.15 for physiotherapy and $2,460.00 for a neurological assessment.

The respondent denied the claims.

The Tribunal found that the applicant failed to prove the treatments were reasonable and necessary, noting that the applicant had returned to full-time work and had pre-existing conditions that contradicted the expert reports submitted on her behalf.

The application was dismissed.

The applicant sought removal from the Minor Injury Guideline (MIG) following a motor vehicle accident, claiming a psychological impairment.

The Tribunal found the applicant's psychological evidence unpersuasive, noting inconsistencies in the expert report and standard test results indicating minimal depression and anxiety.

The Tribunal concluded the applicant failed to prove a psychological impairment warranting removal from the MIG and denied the disputed treatment plans beyond the $3,500 limit.

The applicant was injured in a motor vehicle accident and sought payment for a psychological counselling treatment plan under the Statutory Accident Benefits Schedule.

The respondent partially approved the plan based on an insurer's examination, leading to a dispute over the remaining $1,945.00 for additional sessions.

Despite noting credibility issues with the applicant's self-reporting, the Tribunal found the full treatment plan reasonable and necessary based on the treating psychologist's progress notes showing positive response to treatment.

The Tribunal ordered the respondent to pay the balance of the treatment plan along with interest on the overdue benefits.