Harry Adamidis

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

The respondent denied benefits on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant argued she suffered psychological injuries and a concussion, which would warrant removal from the MIG.

The Tribunal found insufficient evidence linking the applicant's psychological complaints to the accident, noting they were attributed to family and work stress.

The Tribunal also found the medical evidence did not support a concussion diagnosis.

Consequently, the Tribunal held the applicant's injuries were predominantly minor and she was not entitled to the disputed treatment plan or interest.

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

The respondent denied the benefits on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant argued for removal from the MIG due to chronic pain and psychological impairments.

The Tribunal found the applicant's evidence of functional limitations inconsistent with his treating physician's clinical notes and gave little weight to his expert's psychological diagnosis.

The Tribunal concluded the injuries were predominantly minor, dismissing the claims for treatment plans, assessments, interest, and a section 10 award.

The applicant sought payment for occupational therapy and life skills training following a motor vehicle accident.

The adjudicator found the treatment plans were not reasonable and necessary, noting that the applicant had continued to work in a physically demanding job as a server, which contradicted the functional limitations reported by the occupational therapist.

The application for benefits and interest was dismissed.

The applicant sought accident benefits following a motor vehicle accident, claiming entitlement to an income replacement benefit and various treatment plans.

The respondent denied the benefits on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant failed to prove her pre-existing low back pain was exacerbated by the accident or that she sustained a psychological injury.

The Tribunal preferred the respondent's psychiatric assessment over the applicant's psychological report, which contained factual misstatements regarding her pre-accident employment and the timing of her husband's death.

The application was dismissed, as the injuries were predominantly minor and the applicant failed to establish a substantial inability to perform the essential tasks of her employment.

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

The respondent denied various treatment plans on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant argued for removal from the MIG due to chronic pain syndrome.

The Tribunal found that the applicant's injuries were predominantly minor, noting that he worked full-time, was independent with self-care, and did not use pain medication.

As the applicant remained within the MIG limit, the disputed treatment plans, interest, and an award under s. 10 of O. Reg. 664 were denied.

The applicant requested a reconsideration of a previous Tribunal decision which found she was not catastrophically impaired and denied certain benefits.

The applicant argued the Tribunal made errors of law and fact regarding the interpretation of marked versus moderate impairment, concentration, persistence and pace, social functioning, attendant care, and occupational therapy.

The Tribunal dismissed the request, finding no errors of law or fact and noting that the reconsideration process is not an opportunity to re-weigh evidence or re-litigate the case.

The applicant requested a reconsideration of a decision finding she was not catastrophically impaired and not entitled to a catastrophic impairment assessment.

She argued the adjudicator ignored evidence from orthopedic experts regarding causation and failed to apply the correct legal test for the assessment.

The Tribunal dismissed the request, finding no errors of law or fact.

The adjudicator had properly weighed the evidence, preferring the respondent's expert who found the impairments were caused by degenerative changes rather than the motor vehicle accident, and correctly applied the test requiring the applicant to show a catastrophic impairment finding was probable.

The applicant sought a non-earner benefit and various medical benefits following a motor vehicle accident.

The Tribunal found the applicant did not suffer a complete inability to carry on a normal life, noting his ability to complete activities of daily living and his pre-existing conditions.

Most medical benefits were denied as not reasonable and necessary, or as duplicative.

However, a psychological assessment was approved based on evidence of accident-related adjustment disorder and anxiety.

The applicant's late request for an award was not adjudicated, and the respondent's request for costs was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming her chronic pain and psychological injuries warranted removal from the Minor Injury Guideline (MIG).

The Licence Appeal Tribunal found that the applicant's injuries were predominantly minor.

The Tribunal preferred the evidence of the insurer's examiners, noting that the applicant's experts failed to explain how her pain improved over time and then worsened years later, and that her psychological assessment was conducted by a panel lacking a qualified psychologist or psychiatrist.

As the applicant had exhausted her $3,500 MIG limit, her claims for further medical benefits, an award, and interest were dismissed.

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

The Tribunal found that the applicant's injuries were predominantly minor and subject to the Minor Injury Guideline (MIG) limits, as she failed to provide compelling evidence of chronic pain with functional impairment or a psychological injury.

The applicant was also barred from proceeding with a claim for a non-earner benefit due to non-compliance with section 33(6) of the Schedule.

As the remaining MIG limits were insufficient to cover the disputed treatment plans, the application was dismissed.

The respondent insurer requested a reconsideration of a Tribunal decision which found that the applicant was not catastrophically impaired and could change her election from a non-earner benefit to an income replacement benefit.

The insurer argued the Tribunal made errors of fact and law in finding the initial election invalid.

The Tribunal dismissed the request, finding no error of fact, as the applicant qualified for the income replacement benefit and thus did not meet the criteria for the non-earner benefit.

Furthermore, the Tribunal found no error of law in its determination that the insurer's failure to comply with the mandatory 10-day notice requirement under s. 35(1) of the Schedule rendered the applicant's election not final.

The applicant sought entitlement to 13 treatment plans for chiropractic, psychological, and assessment services following a motor vehicle accident.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to prove the treatment plans were reasonable and necessary.

The Tribunal preferred the evidence of the respondent's insurer's examinations, which indicated the applicant's soft tissue injuries had healed and his psychological condition had improved, over the applicant's evidence.

The applicant sought entitlement to statutory accident benefits for a chronic pain assessment and various physiotherapy treatment plans following a 2016 motor vehicle accident.

The Licence Appeal Tribunal dismissed the application, finding that the chronic pain assessment was a duplication of previous assessments and therefore not reasonable and necessary.

The Tribunal also denied the physiotherapy claims, noting discrepancies in the treatment times invoiced versus the sign-in sheets, and finding the applicant failed to meet her burden of proof for the remaining treatment plan.

The applicant sought income replacement benefits and approval for various treatment plans following a motor vehicle accident.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to prove on a balance of probabilities that he suffered a substantial inability to perform the essential tasks of his employment or a complete inability to engage in any employment.

The Tribunal preferred the respondent's medical evidence, noting inconsistencies in the applicant's expert reports and relying on the applicant's successful completion of a three-month accounting work placement.

The claims for treatment plans, an award, and interest were also dismissed.

The applicant sought entitlement to several treatment plans for injuries allegedly sustained in a motor vehicle accident, as well as an award and interest.

The respondent denied the plans based on Insurer's Examinations (IEs) which concluded the injuries were either minor, resolved, or attributable to a prior accident.

The Tribunal found that the applicant failed to meet her burden of proving the treatment plans were reasonable and necessary, often relying on brief clinical notes that did not address causation or adequately contradict the detailed IE reports.

The application was dismissed in its entirety.

The applicant sought payment for chiropractic, occupational therapy, and social work treatment plans following a motor vehicle accident.

The respondent insurer denied the plans based on insurer's examinations concluding the applicant had no accident-related impairments.

The Tribunal found that the applicant failed to meet his onus to prove the treatments were reasonable and necessary, noting a lack of contemporaneous medical evidence and failure to disclose medical records.

The application for accident benefits was dismissed.

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

The respondent denied a treatment plan for physiotherapy, citing insufficient medical evidence to justify removal from the Minor Injury Guideline (MIG).

The applicant argued the respondent failed to provide adequate medical reasons for the denial under s. 38(8) of the Schedule, and thus was prohibited from relying on the MIG limits under s. 38(11)(1).

The Tribunal found the respondent's request for further medical documentation constituted sufficient medical reasons.

As the applicant did not otherwise prove the treatment was reasonable and necessary, the application was dismissed.

The applicant sought a determination that she sustained a catastrophic impairment under the ambulatory mobility criterion following a motor vehicle accident.

While the Tribunal accepted that the accident caused a severe and permanent alteration to the structure and function of her right leg, it rejected the SCIM scoring methodologies presented by both parties' experts.

The applicant's experts improperly scored her using a wheeled walker without a swing gait, and the respondent's expert improperly substituted his hand for a cane.

Without valid SCIM scoring evidence, the applicant failed to meet her burden of proof.

Claims for a walker and a CAT assessment were also dismissed as the applicant made no submissions to establish they were reasonable and necessary.

The applicant was receiving an income replacement benefit (IRB) following a motor vehicle accident.

The applicant subsequently withdrew his application for dispute resolution, but the respondent insurer proceeded with the hearing to seek repayment of the IRB due to wilful misrepresentation.

Relying on video surveillance showing the applicant performing physical chores, running errands, and attending a job site, the Tribunal found the applicant had misrepresented his functional limitations to medical assessors.

The Tribunal ordered the applicant to repay $10,988.42 for the period following the misrepresentation, but denied the respondent's claim for interest as it had not been claimed in the repayment notice.

The applicant sought statutory accident benefits following a 2017 motor vehicle accident, claiming entitlement to a chronic pain treatment program, a neurological examination, and a psychological examination.

The respondent denied the treatment plans, arguing the applicant had reached maximum medical recovery and had no ongoing impairments.

The Tribunal found that the applicant's functional abilities, normal gait, and lack of reliance on pain medication undermined the need for the chronic pain program.

Furthermore, previous assessments had already concluded the applicant suffered no neurological or psychological impairments.

The application was dismissed in its entirety.