Harouna Saley Sidibé

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

The respondent denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant argued that pre-existing conditions, including cervical radiculopathy and carpal tunnel syndrome, prevented her recovery within the MIG framework.

The Tribunal found that while the applicant had documented pre-existing conditions, there was no medical evidence demonstrating that these conditions precluded her recovery within the MIG.

Consequently, the applicant's impairments were deemed predominantly minor, and her claims for a physiotherapy treatment plan, a psychological assessment, and interest were dismissed.

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

The respondent denied benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant failed to establish psychological impairments or chronic pain with functional impairment sufficient to warrant removal from the MIG.

The Tribunal also dismissed the claim for a non-earner benefit, finding the applicant did not meet the high threshold of demonstrating a complete inability to carry on a normal life.

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

The applicant sought a non-earner benefit (NEB), interest, and an award under s. 10 of Reg. 664 following a motor vehicle accident.

The Tribunal found that the applicant suffered a complete inability to carry on a normal life, as her injuries continuously prevented her from engaging in pre-accident childcare and housekeeping activities.

The Tribunal preferred the evidence of the applicant's physiatrist over the insurer's section 44 assessors.

The applicant was awarded the NEB and interest, but the claim for a section 10 award was dismissed as the insurer's conduct did not rise to the level of being unreasonable.

The applicant, who suffered a lower limb amputation in a motor vehicle accident, sought $8,000.49 for assistive devices including an adjustable bed, platform bed, and specialty bedding.

The respondent had partially approved the treatment plan for a memory foam mattress but denied the remaining items.

The Tribunal found that the applicant failed to prove the disputed items were reasonable and necessary.

Relying on the respondent's in-home occupational therapy assessment, the Tribunal concluded the applicant could safely transfer using his existing bedframe and that comfort alone did not satisfy the statutory criteria for funding.

The applicant sought statutory accident benefits following a motor vehicle accident, specifically a chronic pain assessment.

The respondent denied the benefit, arguing the applicant's fibromyalgia predated the accident and she was not in active treatment.

Procedurally, the adjudicator dismissed the respondent's motion to admit late insurer examination reports, finding it would prejudice the applicant.

The adjudicator also denied the respondent's request to file a sur-reply.

On the merits, the adjudicator found the chronic pain assessment to be reasonable and necessary, preferring the evidence of the applicant's pain management specialist and noting that the respondent's own multidisciplinary assessment corroborated the applicant's symptoms.

The adjudicator awarded the disputed treatment plan with interest, but declined to award costs to either party, finding no unreasonable or bad faith conduct.

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

The insurer denied several treatment plans, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found the applicant was removed from the MIG due to pre-existing lupus and chronic pain that prevented maximal recovery.

The Tribunal approved treatment plans for a chronic pain assessment and a multidisciplinary chronic pain program, finding them reasonable and necessary given the applicant's clinical deterioration and diagnosis of chronic pain syndrome.

Claims for chiropractic services, a psychological assessment, prescription medications, and a non-earner benefit were dismissed due to lack of evidence.

The Tribunal declined to order an award against the insurer or costs against the applicant.

The applicant sought statutory accident benefits for two chiropractic treatment plans following a 2019 motor vehicle accident.

The respondent insurer denied the plans based on insurer examinations concluding the applicant had reached maximum medical improvement from soft tissue injuries.

The Tribunal found the applicant failed to prove the treatment was reasonable and necessary, noting that her own treating practitioners had not recommended chiropractic treatment and the chronic pain specialist's report was given limited weight.

The claims for the treatment plans, interest, and a special award were dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, disputing the respondent's denial of various treatment plans, an income replacement benefit (IRB) deficit, and seeking an award for unreasonable delay.

The Licence Appeal Tribunal found that the proposed treatment plans for physiotherapy, optometric services, concussion therapy, occupational therapy, and pharmacotherapy were reasonable and necessary, preferring the evidence of the applicant's treating specialists over the respondent's independent examiners.

However, the Tribunal dismissed the claims for the IRB deficit and the outstanding balance for psychological therapy due to insufficient evidence.

The request for an award under s. 10 of Regulation 664 was also dismissed, as the respondent's conduct did not meet the threshold of being unreasonable.

The applicant sought a determination of catastrophic impairment following a motor vehicle accident, claiming entitlement under Criteria 6, 7, and 8 of the Statutory Accident Benefits Schedule.

The Tribunal found that the applicant did not meet the threshold for catastrophic impairment, preferring the respondent's multidisciplinary assessments which were supported by objective evidence, including surveillance footage and employment records showing the applicant had returned to full-time work.

The Tribunal also dismissed the applicant's claims for the outstanding balance of a catastrophic impairment assessment plan, finding that clinical file reviews were subject to the $2,000 cap per assessment and that transportation expenses were not proven to exceed the 50-kilometre deductible.

Claims for interest and an award for unreasonable withholding of benefits were consequently dismissed.

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

The respondent denied certain treatment plans, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant's injuries were not predominantly minor, as medical evidence established he suffered from chronic pain with functional impairment.

The Tribunal approved a treatment plan for psychological services, finding it reasonable and necessary to address the applicant's ongoing psychological symptoms.

However, the Tribunal denied treatment plans for a chronic pain assessment and a psychological assessment, concluding that their stated goals were therapeutic rather than diagnostic.

The applicant was awarded interest on overdue benefits.

The applicant sought statutory accident benefits after sustaining hearing loss allegedly caused by a loud backfire from an adjacent vehicle.

The Tribunal found that the incident met the definition of an 'accident' under section 3(1) of the Schedule, as the backfire was a direct result of the use or operation of an automobile.

However, the applicant submitted his application for benefits (OCF-1) seven months after the accident, well beyond the 30-day statutory time limit.

The Tribunal rejected the applicant's argument that a delay in retaining legal counsel constituted a reasonable explanation for the late filing.

The Tribunal also found that the requirements for statutory estoppel under section 131 of the Insurance Act were not met.

Consequently, the application was dismissed as statute-barred.

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

The respondent denied a physiotherapy treatment plan, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant suffered from chronic pain with functional impairment, removing him from the MIG.

The Tribunal ordered the respondent to fund the $2,086.50 physiotherapy treatment plan, finding it reasonable and necessary, and awarded interest on overdue payments.

The applicant sought various statutory accident benefits following a 2020 motor vehicle accident.

The respondent denied the claims and argued the applicant was statute-barred from proceeding due to an expired limitation period and failure to attend insurer examinations.

The Tribunal extended the limitation period under section 7 of the LAT Act, finding the delay was minor and caused no prejudice.

On the merits, the Tribunal denied the claim for non-earner benefits, finding the applicant did not suffer a complete inability to carry on a normal life.

However, the Tribunal approved several treatment plans for chiropractic, massage, and chronic pain services, as well as attendant care and catastrophic impairment assessments, finding them reasonable and necessary.

A claim for a special award was dismissed.

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

The Tribunal found that the applicant's injuries were not predominantly minor due to chronic pain, removing him from the Minor Injury Guideline.

However, the Tribunal denied the claims for income replacement benefits and several physiotherapy treatment plans, finding the applicant did not suffer a substantial inability to perform his pre-accident employment and the physiotherapy was not reasonable and necessary.

A treatment plan for a chronic pain assessment was approved.

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

The respondent denied several treatment and assessment plans, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant suffered from chronic pain with functional impairments, removing her from the MIG.

The Tribunal ordered the respondent to pay for the disputed physiotherapy, psychological, and chronic pain treatment plans, finding them reasonable and necessary.

The applicant's claim for a special award for unreasonable delay was dismissed, but interest on overdue benefits was granted.

The applicant sought statutory accident benefits following a motor vehicle accident, specifically claiming entitlement to chiropractic services, psychological treatment, and a chronic pain assessment.

The respondent denied the benefits, relying on insurer's examinations and surveillance footage.

The Tribunal found that the chiropractic and psychological treatment plans were not reasonable and necessary, placing greater weight on the respondent's medical assessors who concluded the applicant had reached maximum medical improvement and that his self-reported psychological symptoms were unreliable in light of surveillance evidence.

However, the Tribunal approved the chronic pain assessment, noting that despite normal objective findings, the applicant's persistent pain and recommendations from treating specialists warranted further evaluation.

The applicant sought statutory accident benefits for chiropractic services, a concussion assessment, and a neurological assessment following a 2019 motor vehicle accident.

The respondent denied the benefits.

The Tribunal found that the chiropractic treatment plan lacked support from treating medical professionals and objective findings.

The Tribunal also found that the concussion and neurological assessments were not reasonable and necessary, as independent medical examinations found no neurological impairment and the applicant failed to provide sufficient medical evidence to justify the assessments.

The application was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, including $80.68 for assistive devices and $4,067.76 per month for attendant care benefits.

The Licence Appeal Tribunal found that the respondent correctly applied the non-catastrophic limits under the Schedule and the Professional Services Fee Guideline.

The applicant failed to provide evidence or submissions justifying entitlement beyond the statutory caps.

The claims for benefits, interest, and an award for unreasonable delay were dismissed.

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

The respondent denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant failed to establish chronic pain or psychological impairments warranting removal from the MIG.

The Tribunal also dismissed the claim for a non-earner benefit, finding the applicant did not demonstrate a complete inability to carry on a normal life, noting he had returned to work and was pursuing a real estate licence.

All claims, including those for treatment plans, interest, and a section 10 award, were dismissed.

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

The matter proceeded to a written hearing, but the applicant failed to file any submissions or evidence.

The Tribunal found the applicant failed to meet his evidentiary burden and dismissed the claims.

The respondent's request for costs was also dismissed as it failed to provide evidence of unreasonable conduct or specify the requested amount.