Elena Steinberg

The applicant sought statutory accident benefits for physiotherapy and various assessments following a motor vehicle accident.

The respondent denied the claims on the basis that the treatments were not reasonable and necessary.

The Tribunal dismissed the application, finding that the applicant failed to meet the burden of proof.

The Tribunal entirely rejected the applicant's occupational therapy expert report, finding the assessor was biased, partisan, and provided opinions outside the scope of their expertise.

As no benefits were payable, the claim for interest was also dismissed.

The applicant was injured in a motor vehicle accident and sought income replacement benefits (IRBs) and various medical and rehabilitation benefits under the Statutory Accident Benefits Schedule.

The adjudicator found that the applicant failed to prove she suffered a substantial inability to perform the essential tasks of her employment, noting she returned to work post-accident and was terminated for performance issues.

The adjudicator preferred the respondent's insurer's examination reports, which concluded the applicant had no functional impairments preventing her from working.

The claims for IRBs, treatment plans, and assessments were dismissed.

The applicant was injured in a motor vehicle accident and sought payment for four physiotherapy treatment plans under the Statutory Accident Benefits Schedule.

Although the applicant had been removed from the Minor Injury Guideline for psychological reasons, the adjudicator found that the physical injuries were minor sprains and strains.

The applicant failed to provide objective medical evidence to prove the physical treatments were reasonable and necessary, relying only on a clinic letter and OHIP summary.

The adjudicator accepted the respondent's section 44 medical examination report, which concluded the applicant had reached maximum medical recovery physically.

The application was dismissed.

The respondent insurer requested a reconsideration of a Tribunal decision that removed the applicant from the Minor Injury Guideline (MIG) due to chronic pain.

The respondent argued the Tribunal made significant errors of fact and law regarding the applicant's shoulder pain, participation in treatment, and functionality.

The Vice-Chair found that while the Tribunal did err in attributing the applicant's shoulder pain to the accident and in its analysis of his functionality, these errors would not have changed the ultimate decision.

The medical evidence, including reports from the respondent's own assessor, supported a finding of chronic pain in the applicant's neck and lower back that negatively affected his ability to work.

The request for reconsideration was dismissed.

The applicant sought $2,200 for a chronic pain assessment following a motor vehicle accident.

The respondent insurer denied the benefit.

At the hearing, the respondent brought a preliminary motion to exclude late-filed medical evidence submitted by the applicant.

The adjudicator admitted the evidence but ordered the applicant to pay $300 in costs for breaching the case conference order.

On the substantive issue, the adjudicator found that the applicant failed to prove the chronic pain assessment was reasonable and necessary, noting a pre-existing history of back pain and relying on the respondent's independent medical examination which concluded the applicant did not have chronic pain syndrome.

The application was dismissed.

The applicant sought medical benefits for two physiotherapy treatment plans and the cost of an attendant care assessment following a motor vehicle accident.

The respondent insurer denied the claims on the basis that they were not reasonable and necessary, relying on independent medical examinations which concluded the applicant had reached maximum medical recovery from soft tissue injuries.

The adjudicator dismissed the application, preferring the evidence of the insurer's assessors who conducted physical examinations over the applicant's occupational therapy paper review report.

The adjudicator found the applicant had returned to full-time work, was independent in personal care, and did not require further treatment.

The applicant was injured in a rear-end motor vehicle accident and sought statutory accident benefits for chronic pain and psychological impairments, arguing his injuries fell outside the Minor Injury Guideline (MIG).

The respondent denied the claims, asserting the injuries were predominantly minor.

The Licence Appeal Tribunal found that the applicant's soft tissue injuries and associated chronic back pain were predominantly minor, as there was insufficient evidence of functional impairment or disability.

The Tribunal also found no evidence of psychological injury.

Consequently, the MIG applied, and since the $3,500 limit had been exhausted, the claims for further assessments and treatment were dismissed.

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 suffered from chronic pain, removing him from the MIG.

However, the Tribunal denied the claim for physiotherapy, finding it was not reasonable and necessary as previous identical treatment had not helped.

The Tribunal granted the claim for a chronic pain assessment, finding it reasonable and necessary to investigate the condition further.

The respondent insurer requested a reconsideration of two cost orders issued by the Tribunal, arguing that the parties had settled their respective disputes before the decisions were issued.

The Tribunal found that the applicants' counsel failed to notify the Tribunal of the settlement and instead simply filed Notices of Withdrawal.

Concluding that it would be unfair for the applicants to benefit from the cost orders given the prior settlement, the Executive Chair granted the reconsideration and cancelled the cost orders.

The applicant sought costs against the respondent insurer for failing to comply with two Tribunal orders for the production of documents.

The Tribunal found that the respondent acted unreasonably by ignoring the orders and the applicant's follow-up communications, which necessitated a second production order and delayed the proceedings.

The Tribunal ordered the respondent to pay $250.00 in costs to the applicant to discourage such conduct.

The applicant sought costs against the respondent insurer for failing to comply with two Tribunal orders for the production of documents.

The respondent did not produce the required documents until after a second order was issued and the applicant had requested costs.

The Tribunal found the respondent's conduct to be unreasonable, as it disregarded the Tribunal's orders and delayed the proceedings.

The Tribunal awarded costs of $250.00 to the applicant to discourage such conduct in the future.