Khizer Anwar

The applicant sought income replacement benefits (IRBs) and medical benefits following a motor vehicle accident.

The adjudicator found the applicant's testimony credible regarding the heavy physical demands of his pre-accident employment as a drywaller and steel framer.

Relying on the applicant's evidence and his treating chronic pain specialist, the adjudicator concluded the applicant suffered a substantial inability to perform the essential tasks of his employment due to pain, and awarded IRBs.

However, the claims for medical benefits and the cost of an examination were dismissed because the applicant failed to submit the disputed treatment plans into evidence.

The claim for a special award was also dismissed as the insurer reasonably relied on its own medical experts.

The applicant was injured in a motor vehicle accident and sought income replacement benefits (IRBs) and medical benefits from his insurer.

The insurer denied the benefits based on its assessors' reports.

The Licence Appeal Tribunal found the applicant's testimony regarding his heavy physical labour as a drywaller and his debilitating pain to be credible, supported by his treating chronic pain specialist and the insurer's own kinesiologist.

The Tribunal awarded IRBs of $400 per week.

However, the claims for medical benefits and examination costs were dismissed because the applicant failed to enter the disputed treatment plans into evidence.

The Tribunal declined to award costs or a special award, finding the insurer did not act in bad faith.

The applicant sought income replacement benefits (IRBs) following a motor vehicle accident, claiming a substantial inability to perform the essential tasks of her employment as a personal support worker.

The respondent denied the IRBs and sought repayment for an alleged overpayment.

The Tribunal found that the applicant failed to prove a substantial inability to work, as the medical evidence indicated she was engaging in modified work duties and failed to delineate her essential tasks.

The Tribunal also dismissed the respondent's claim for repayment, finding insufficient evidence to prove the overpayment was actually advanced and received.

Both the applicant's claim and the respondent's claim for repayment were dismissed.

The applicant sought non-earner benefits, attendant care benefits, and the cost of a chronic pain assessment following a motor vehicle accident.

The adjudicator found the applicant was barred from pursuing the chronic pain assessment due to her failure to attend section 44 insurer examinations without a valid reason.

The claims for non-earner and attendant care benefits were dismissed because the applicant failed to establish a complete inability to carry on a normal life or that the attendant care expenses were incurred, with the adjudicator preferring the respondent's medical evidence and noting inconsistencies in the applicant's self-reporting and treating physician's records.

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

The respondent denied funding for attendant care benefits and various treatment plans, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant's injuries, particularly chronic pain, removed him from the MIG.

The Tribunal partially approved the treatment plans for physical therapy and assistive devices, and approved the cost of a chronic pain assessment.

However, claims for attendant care benefits, psychological treatment, psychological assessment, and a special award were dismissed.

Interest was awarded on overdue payments.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for physiotherapy, chiropractic services, and an orthopaedic assessment.

The respondent insurer denied the treatment plans, arguing the applicant suffered only soft tissue injuries and had reached maximum medical recovery.

The Tribunal found the treatment plans reasonable and necessary, noting the accident aggravated the applicant's pre-existing chronic pain and arthritis, and accepting the diagnosis of chronic pain syndrome by the applicant's orthopaedic expert.

The Tribunal awarded the medical benefits and the cost of the orthopaedic assessment (capped at $2,000 plus HST), but denied the cost of a redundant OCF-3 and a special award under s. 10 of O. Reg. 664.

The applicant, an elderly woman, was injured in a motor vehicle accident and sought statutory accident benefits for physiotherapy, chiropractic services, psychological services, and an orthopaedic assessment.

The respondent insurer denied most of the treatment plans, arguing the injuries were minor soft-tissue injuries and the applicant had received sufficient treatment.

The Licence Appeal Tribunal found the treatment plans for physical and psychological therapy, as well as the orthopaedic assessment, to be reasonable and necessary, accepting the applicant's diagnosis of chronic pain syndrome and severe psychological impairments.

The Tribunal ordered the respondent to pay the disputed medical benefits and assessment costs, along with interest, but denied the request for a special award and the cost of a redundant disability certificate.

The applicant sought statutory accident benefits after slipping and falling on slush in a parking lot while walking towards her parked car to clear snow off the side view mirror.

The respondent denied benefits, arguing the incident was not an 'accident' under the Statutory Accident Benefits Schedule.

The Licence Appeal Tribunal held a preliminary issue hearing and found that the applicant failed both the purpose and causation tests.

The Tribunal concluded that the use of the vehicle had ended prior to the fall, and the slush on the ground was an intervening cause.

The application was dismissed.

The applicant was injured in a motor vehicle accident and sought medical and rehabilitation benefits beyond the $3,500 Minor Injury Guideline (MIG) cap, claiming chronic pain and psychological impairments.

The Licence Appeal Tribunal found that the applicant failed to meet the onus of proving entitlement beyond the cap.

The Tribunal gave little weight to the applicant's psychological evidence, which was based solely on a telephone interview, and preferred the respondent's in-person psychological assessment.

The Tribunal concluded the applicant suffered predominantly minor injuries and dismissed the appeal.

The applicant, a tow truck driver, sought statutory accident benefits after sustaining injuries while opening a garage bay door at a mechanic's shop.

The respondent denied benefits, arguing the incident was not an 'accident' under section 3(1) of the Statutory Accident Benefits Schedule.

The Tribunal applied the purpose and causation tests, finding that the use of the tow truck had ended prior to the incident and did not directly cause the impairment.

The Tribunal concluded the applicant was not involved in an accident and dismissed the appeal.

The applicant was injured in a motor vehicle accident and sought medical and rehabilitation benefits, as well as the cost of a vocational assessment, from her auto insurer.

The insurer denied the claims, arguing the injuries were uncomplicated soft tissue injuries and not related to the accident.

The Licence Appeal Tribunal found that the objective medical evidence, including CT and MRI scans, established that the applicant suffered from disc herniation and radiculopathy caused by the accident.

The Tribunal concluded that the requested physiotherapy, chiropractic, psychological services, and vocational assessment were reasonable and necessary.

The applicant was awarded the claimed benefits with interest, and no costs were awarded to either party.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for physiotherapy and chiropractic services.

The respondent denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) and were subject to the $3,500 cap.

The Tribunal found that the applicant's soft tissue injuries fell within the definition of minor injuries under the Schedule.

The applicant failed to provide objective medical evidence of chronic pain or a pre-existing condition that would prevent maximal recovery under the MIG.

Consequently, the Tribunal held the applicant was not entitled to treatment beyond the MIG cap, and dismissed the claims for the disputed treatment plans and interest.

The respondent's request for costs was also denied.