Rachel Levitsky

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

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

The Tribunal found that the applicant's psychological impairments, including driving-related anxiety and depression, warranted removal from the MIG, preferring the applicant's psychological expert over the respondent's.

However, the Tribunal dismissed the claims for the specific disputed treatment plans because the applicant failed to provide the actual treatment plans (OCF-18s) or make submissions demonstrating that the proposed treatments were reasonable and necessary.

The applicant sought entitlement to numerous treatment plans for physical and psychological therapy, assistive devices, and assessments following a motor vehicle accident.

The Licence Appeal Tribunal denied the majority of the treatment plans, finding the applicant failed to prove they were reasonable and necessary, largely due to a lack of corroborating medical evidence and inconsistencies in the expert reports provided.

However, the Tribunal granted entitlement to translation services, a chronic pain assessment, and an attendant care assessment.

The Tribunal also ordered the respondent to pay a $250 special award under s. 10 of O. Reg. 664 for unreasonably withholding funding for the applicant's attendant care assessment while funding its own.

The applicant sought statutory accident benefits following a motor vehicle accident, disputing the respondent's denial of three treatment plans for chiropractic, massage, and psychological services.

The Tribunal found that the first treatment plan for physical therapy was reasonable and necessary given the applicant's accident-related sprains and strains.

However, the Tribunal dismissed the remaining treatment plans, finding insufficient evidence to link the ongoing symptoms to the accident rather than pre-existing conditions, and a lack of explanation for additional psychological planning fees.

The applicant was awarded $2,575.22 for the first treatment plan plus interest.

The applicant sought statutory accident benefits following a motor vehicle accident, including chiropractic services, a home exercise program, a psychological assessment, and a chronic pain assessment.

The adjudicator found that the applicant failed to prove the chiropractic services, home exercise program, and chronic pain assessment were reasonable and necessary.

The adjudicator rejected the applicant's argument that the treatment plans were payable due to the respondent's late denial notices, holding that the expenses had not been incurred prior to the notices being delivered.

The psychological assessment was found payable in part, and the claims for a special award and costs were dismissed.

The applicant sought statutory accident benefits for a chronic pain assessment and multidisciplinary chronic pain treatment following a motor vehicle accident.

The respondent denied the benefits.

The Tribunal found that the applicant failed to prove the treatment and assessment were reasonable and necessary, noting her significant pre-accident medical history of fibromyalgia and chronic pain, her return to full-time work, and the lack of corroborating medical evidence beyond a flawed expert report.

The application was dismissed, and claims for interest and an award under O. Reg. 664 were also denied.

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

The insurer denied a $3,500 treatment plan for chiropractic services, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found the applicant failed to prove his injuries fell outside the MIG.

However, the Tribunal ordered the insurer to pay for the treatment plan because the insurer's denial notice was deficient and breached section 38(8) of the Schedule, triggering the mandatory payment consequence under section 38(11).

Interest was also awarded.

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

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 psychological impairments, chronic pain, and headaches.

The Tribunal found that the applicant's psychological symptoms were subclinical, there was no evidence of functional impairment from chronic pain, and the headaches did not warrant removal from the MIG.

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

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

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

The Tribunal found that while the applicant's physical injuries were minor, she suffered from a psychological impairment (anxiety related to driving) that warranted removal from the MIG.

The Tribunal approved a $2,460.00 psychological assessment but denied an attendant care assessment, finding the applicant was independent in her daily activities.

A claim for an award under O. Reg. 664 for unreasonable delay was also dismissed.

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

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

The Tribunal found the applicant failed to prove she suffered from chronic pain syndrome or a pre-existing condition that would remove her from the MIG.

However, the Tribunal held that the respondent's denial letter failed to provide adequate medical and other reasons as required by s. 38(8) of the Schedule, as it merely referred to an unspecified 'list of injuries'.

Consequently, under s. 38(11)2, the treatment plan was payable regardless of the MIG limits.

The applicant was awarded $2,460.00 for the assessment plus interest.

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 psychological conditions and chronic pain warranted removal from the MIG.

The Tribunal found that the applicant failed to provide compelling medical evidence that his pre-existing conditions prevented maximal recovery under the MIG.

The Tribunal accepted the respondent's medical assessment that the injuries were predominantly minor.

The application for additional physiotherapy and interest was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, disputing the respondent's denial of treatment plans for assistive devices, a neuropsychological assessment, and physiotherapy.

The Licence Appeal Tribunal found the applicant was entitled to a robot vacuum, miscellaneous assistive devices, and occupational therapy, but denied the costs associated with a hot tub.

The Tribunal also approved a psychological assessment and physiotherapy, finding them reasonable and necessary based on the medical evidence.

Furthermore, the Tribunal ordered the respondent to pay a special award of $440 under s. 10 of O. Reg. 664 for unreasonably denying the psychological assessment, along with interest on overdue benefits.

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

The respondent insurer 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 pre-existing conditions, a meniscal tear, chronic pain, and psychological impairments.

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

As the $3,500 MIG limit was already exhausted, the claims for additional physiotherapy, psychological services, and a social work assessment were dismissed.

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

The respondent denied the plans.

The Tribunal found that while the applicant's left shoulder symptoms were caused by the accident, his right shoulder issues were not.

The Tribunal concluded that the applicant failed to prove the treatment plans were reasonable and necessary, noting a lack of medical recommendations for chiropractic care and relying on the respondent's section 44 orthopaedic assessment which recommended a self-directed exercise program instead.

The application was dismissed.

The applicant was injured in a motor vehicle accident and sought $5,115.56 for a physical therapy treatment plan under the Statutory Accident Benefits Schedule.

The respondent insurer denied the treatment plan, relying on an insurer's examination which found no physical or structural abnormality.

The Tribunal applied the Violi factors and found the treatment plan reasonable and necessary, noting that pain relief and functional restoration are legitimate goals.

The Tribunal preferred the evidence of the applicant's treating physicians and another insurer's examiner who diagnosed chronic pain, assigning less weight to the respondent's physiatrist due to omissions in his report.

The applicant was awarded the cost of the treatment plan and interest on overdue payments.

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

The Tribunal found the applicant's psychological assessment report unreliable as its authorship was unclear and its severe findings were uncorroborated by contemporaneous medical records.

The Tribunal also noted insufficient evidence of chronic pain impacting function.

Concluding the applicant's injuries fell within the MIG, the Tribunal denied the disputed psychological assessment as not reasonable and necessary, and found no interest payable.