Melanie Malach

The applicant sought entitlement to statutory accident benefits following a motor vehicle accident, specifically claiming costs for physiotherapy, psychological services, and a multi-disciplinary catastrophic impairment assessment.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to provide sufficient medical evidence or submissions to prove the treatment plans were reasonable and necessary.

The Tribunal preferred the respondent's psychological assessment, which concluded the applicant had reached maximum recovery, over the applicant's evidence.

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

The applicant sought statutory accident benefits for chiropractic services and an occupational therapy assessment following a motor vehicle accident.

The respondent denied the treatment plans, arguing the applicant suffered an intervening second accident and failed to prove the disputed treatments were reasonable and necessary.

The Tribunal found that the applicant failed to establish causation, noting medical evidence of a second accident and a lack of documentation connecting the current complaints to the initial accident.

The Tribunal also found the treatment plans were not reasonable and necessary, relying on independent medical assessments.

The application was dismissed.

The applicant sought non-earner benefits following a motor vehicle accident.

The adjudicator found that the applicant failed to prove on a balance of probabilities that he suffered a complete inability to carry on a normal life, as he provided insufficient evidence regarding his pre-accident activities and time commitments.

The adjudicator preferred the respondent's multidisciplinary assessment report, which concluded the applicant did not meet the test.

The application was dismissed.

The applicant, who was struck by a vehicle as a pedestrian at age 11, sought entitlement to a chronic pain management program and six physiotherapy treatment plans under the Statutory Accident Benefits Schedule.

The respondent insurer denied the benefits based on insurer's examinations.

The Tribunal found that the applicant met her burden of proving the treatment plans were reasonable and necessary, relying on the reports of her treating practitioners which documented ongoing pain and functional limitations.

The Tribunal ordered the respondent to pay the treatment plans and interest on overdue benefits.

The applicant's claims for a special award under s. 10 of Regulation 664 and for costs were dismissed.

The applicant was injured in a motor vehicle accident and sought $1,779.60 for a physiotherapy treatment plan under the Statutory Accident Benefits Schedule.

The respondent denied the claim based on an insurer's examination report.

The Tribunal admitted late medical records from the applicant but ultimately found the treatment plan was not reasonable and necessary.

The applicant failed to provide corroborating medical evidence, there was a two-year gap in treatment records, and no evidence was provided to counter the insurer's examination report.

The application was dismissed.

The applicant sought the unapproved balance of two treatment plans for psychological services provided by a social worker following a motor vehicle accident.

The dispute centered on whether the social worker should be paid the enhanced hourly rate of $149.61, commensurate with a psychologist or psychotherapist, rather than the $99.75 rate approved by the respondent.

The Tribunal found that the applicant failed to provide sufficient evidence that the social worker was under the active supervision of a psychologist or possessed specialized training in psychotherapy.

Consequently, the Tribunal deemed the $99.75 hourly rate reasonable and dismissed the claims for the unapproved balances, interest, and an award under s. 10 of Reg. 664.

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

The respondent denied the claims 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 pre-existing knee and psychological conditions, as well as accident-related chronic pain and psychological impairment.

The Tribunal found insufficient medical evidence to establish that any pre-existing condition would prevent maximal medical recovery within the MIG, nor was there sufficient evidence of chronic pain with functional impairment or a psychological injury.

The application was dismissed, and the disputed treatment plans were denied.

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

The respondent denied the claims, arguing the injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant failed to prove on a balance of probabilities that he suffered from chronic pain or a psychological impairment that would remove him from the MIG.

The medical evidence was outdated, and the psychological report was incomplete.

Consequently, the applicant was not entitled to the disputed treatment plans or interest.