Monica Ciriello

The applicant sought reconsideration of a Licence Appeal Tribunal decision that denied her entitlement to various medical and rehabilitation benefits, including psychological, chiropractic, and chronic pain assessments.

The applicant argued the Tribunal breached procedural fairness and failed to consider evidence regarding her psychological injuries, post-concussive diagnosis, and chronic pain.

The Vice Chair dismissed the request, finding no breach of procedural fairness and noting that the original decision had explicitly considered the medical evidence and applied the AMA Guides for chronic pain.

The request for reconsideration was 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 applicant argued she should be removed from the MIG due to physical and psychological impairments, chronic pain, and a pre-existing condition.

The Tribunal found that the applicant failed to prove on a balance of probabilities that her injuries warranted removal from the MIG.

The medical evidence supported that she suffered predominantly soft tissue injuries.

Consequently, the disputed treatment plans and claim for interest were dismissed.

The applicant sought accident benefits following a motor vehicle accident, disputing the respondent's determination that her injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the medical evidence, including orthopedic and psychological assessments, demonstrated only soft tissue injuries and no psychological impairment.

The applicant failed to prove a complete inability to carry on a normal life, as she had returned to her pre-accident housekeeping activities.

Consequently, the claims for removal from the MIG, non-earner benefits, a disputed treatment plan, and interest were all dismissed.

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

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

The applicant applied to the Licence Appeal Tribunal.

The Tribunal found that the applicant suffered from psychological impairments, including PTSD and major depressive disorder, which warranted removal from the MIG.

The Tribunal ordered the respondent to pay for the disputed psychological services and assessment, along with interest.

The applicant's claim for a special award for unreasonable delay was 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) and the $3,500 limit had been exhausted.

The applicant argued she should be removed from the MIG due to accident-related chronic pain with functional impairment.

The Tribunal found that while the applicant had been diagnosed with chronic pain, there was insufficient evidence that the pain caused severe distress accompanied by functional impairment or disability.

The Tribunal noted the applicant self-reported not taking medication and being independent with self-care.

As the applicant failed to prove her injuries warranted removal from the MIG, the disputed treatment plans, interest, and an award for unreasonable delay were denied.

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

The respondent denied the claims, arguing the injuries were soft tissue in nature and resolved prior to a subsequent workplace accident.

The Tribunal found that the applicant failed to prove causation, as medical evidence indicated her motor vehicle accident injuries had resolved before the workplace incident.

The Tribunal also rejected the applicant's psychological and chronic pain claims, preferring the corroborating medical evidence that showed no such impairments prior to the workplace accident.

The application was dismissed, and the applicant was not entitled to the disputed treatment plans, an award, or interest.

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

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

The Tribunal found that the applicant failed to prove on a balance of probabilities that his physical or psychological injuries warranted removal from the MIG.

As the applicant had already exhausted the $3,500 MIG limit, the disputed treatment plans were not payable.

The application was dismissed.

The applicant sought accident benefits following a rear-end motor vehicle accident.

The respondent denied various treatment plans for chiropractic services 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 physical injuries and chronic pain.

The Tribunal found that the applicant failed to meet the evidentiary burden to prove his injuries warranted removal from the MIG, noting a lack of corroborating medical evidence and inconsistencies in the chronic pain diagnosis.

The application was dismissed, and the applicant was found not entitled to the disputed treatment plans, interest, or an award.

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

The respondent denied the benefits and requested several in-person insurer's examinations under section 44 of the Schedule.

The applicant failed to attend the scheduled and re-scheduled examinations, arguing that the assessments should be conducted via paper review or by previously seen assessors to protect her privacy.

The Tribunal found that the respondent provided proper notice and that the applicant failed to provide a reasonable explanation for her non-attendance.

Consequently, the applicant is barred from proceeding with her application before the Tribunal pursuant to section 55(1)2 of the Schedule.

The applicant sought various medical and rehabilitation benefits following a motor vehicle accident, which were denied by the respondent insurer.

The Tribunal excluded the applicant's late-filed written submissions due to non-compliance with the case conference report and order, finding that admitting them would breach procedural fairness and prejudice the respondent.

Relying on the respondent's insurer examination reports, the Tribunal found the applicant failed to meet her evidentiary burden to establish that the proposed treatment plans for visual therapy, occupational therapy, psychological services, and chiropractic/massage treatment were reasonable and necessary.

The application was dismissed in its entirety, with no entitlement to an award or interest.

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

The respondent denied the benefits, arguing the injuries fell within the MIG.

The Tribunal found that the applicant failed to meet her evidentiary burden to prove her injuries warranted removal from the MIG.

The Tribunal preferred the respondent's medical evidence, which included in-person assessments, over the applicant's virtual assessments and uncorroborated claims.

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

The applicant sought entitlement to a $2,200 psychological assessment, a special award, and interest following a motor vehicle accident.

The Licence Appeal Tribunal dismissed the application, finding the treatment plan was not reasonable and necessary.

The Tribunal rejected the applicant's psychological evidence, noting it relied on self-reporting that was contradicted by surveillance footage showing the applicant driving frequently and engaging in various activities.

The Tribunal accepted the respondent's insurer examination, which found no psychological symptoms warranting further investigation.

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

The respondent denied the benefits, arguing the injuries were predominantly minor soft tissue injuries.

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

The Tribunal preferred the respondent's medical assessments, noting the applicant had returned to full-time work and had not reported psychological symptoms to his treating physicians.

The application was dismissed, and the disputed treatment plans were found not payable as they exceeded the $3,500 MIG limit.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits, which were denied by the respondent insurer.

The applicant applied to the Licence Appeal Tribunal to dispute the denial of several treatment plans for chiropractic services.

The central issue was whether the applicant's injuries warranted removal from the Minor Injury Guideline (MIG) $3,500 funding limit.

The Tribunal found that the applicant failed to provide compelling medical evidence that his left rotator cuff tear was caused by the accident or that he suffered from a pre-existing condition preventing maximal recovery within the MIG.

Consequently, the applicant's injuries were deemed predominantly minor, and the disputed treatment plans were not payable as they exceeded the MIG limit.

The application was dismissed.

The applicant was involved in a motor vehicle accident and sought statutory accident benefits for various treatment plans and assessments.

The respondent denied the benefits on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and the $3,500 limit had been exhausted.

The applicant argued for removal from the MIG due to pre-existing conditions, psychological impairments, and chronic pain.

The Tribunal found that the applicant failed to provide compelling medical evidence to demonstrate that her physical, psychological, or pre-existing conditions warranted removal from the MIG.

As the applicant remained within the MIG limit, the disputed treatment plans were not payable, and claims for interest and an award were dismissed.

The applicant sought entitlement to various statutory accident benefits, including psychological, chiropractic, yoga, massage, chronic pain, nutritional, and in-vehicle assessments, following a 2019 motor vehicle accident.

The Licence Appeal Tribunal dismissed all claims, finding that the applicant failed to demonstrate the treatment plans were reasonable and necessary.

The Tribunal relied on the respondent's insurer examination reports, which concluded the applicant had reached maximum therapeutic benefit for her minor soft tissue injuries and did not suffer from functional impairments or chronic pain requiring further assessments.

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

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

The Tribunal found that the applicant failed to prove on a balance of probabilities that his physical injuries, pre-existing conditions, alleged psychological impairments, or chronic pain warranted removal from the MIG.

Relying on the respondent's section 44 medical assessments, the Tribunal concluded the injuries were predominantly minor.

As the $3,500 MIG limit had been exhausted, the disputed treatment plans were not payable, and claims for interest and an award were dismissed.

The respondent insurer requested a reconsideration of a Licence Appeal Tribunal decision, arguing that the Tribunal violated the rules of procedural fairness by failing to consider its submissions.

The respondent provided evidence that it had properly filed its submissions via the Tribunal's electronic system in compliance with a prior order.

The Vice-Chair found that the Tribunal had indeed proceeded without the respondent's submissions due to an administrative error and confusing communication from the Tribunal.

The request for reconsideration was granted, and a re-hearing was ordered.

The applicant sought various medical and rehabilitation benefits under the Statutory Accident Benefits Schedule following a motor vehicle accident.

The Licence Appeal Tribunal found that the proposed cognitive training was reasonable and necessary based on a functional cognitive assessment.

However, the Tribunal dismissed the claims for a driver reintegration assessment, psychological services, and chiropractic treatment, preferring the respondent's medical evidence that the applicant's psychological and soft tissue injuries had resolved.

The Tribunal awarded interest on the overdue cognitive training benefit but declined to make a special award, finding no egregious conduct by the insurer.

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

The respondent denied benefits beyond the $3,500 Minor Injury Guideline (MIG) limit.

The applicant argued that her physical injuries, pre-existing alopecia, psychological impairments, and chronic pain warranted removal from the MIG.

The Tribunal found that the applicant's physical injuries were uncomplicated soft-tissue injuries.

The Tribunal preferred the respondent's medical evidence, noting that the applicant's psychological and chronic pain diagnoses were not supported by her family physician's clinical notes and records, and that her experts failed to review fulsome medical documentation.

The application was dismissed, and the disputed treatment plans were found not payable.