Dr. Aghamohseni

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

The insurer denied treatment plans for psychological and chiropractic services, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant argued he sustained a psychological impairment warranting removal from the MIG and relied on a psychological report.

The Tribunal found the psychological report unreliable due to methodological flaws and inconsistencies with contemporaneous clinical records.

The Tribunal concluded the applicant failed to prove his injuries fell outside the MIG and dismissed the claims for the disputed treatment plans.

The Tribunal also found the insurer's denial letters complied with the notice requirements under s. 38(8) of the Schedule.

The applicant was injured in a motor vehicle accident and sought removal from the Minor Injury Guideline (MIG) due to chronic pain and a psychological condition, as well as approval for a $2,200 psychological assessment.

The Tribunal found that the applicant failed to provide compelling medical evidence of a more than minor injury, chronic pain with functional impairment, or a psychological condition warranting removal from the MIG.

The Tribunal preferred the respondent's psychological assessment over the applicant's, finding no reliable evidence of an accident-related psychological impairment.

The application 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 claimed his injuries, including a concussion, psychological impairments, and chronic pain, warranted removal from the MIG.

The Tribunal found insufficient objective medical evidence to support a concussion or psychological impairment diagnosis.

Applying the AMA Guides, the Tribunal also found the applicant's chronic pain did not result in a functional impairment.

The Tribunal concluded the injuries were predominantly minor and subject to the MIG limits, which had been exhausted.

The application 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 Tribunal found that the applicant failed to prove his pre-existing conditions, chronic pain, or psychological impairments warranted removal from the MIG.

The Tribunal also dismissed the claims for income replacement benefits, finding the applicant did not demonstrate a substantial or complete inability to perform the essential tasks of his self-employment.

Claims for attendant care benefits, treatment plans, interest, and an award were also dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to psychological and physiotherapy services outside the Minor Injury Guideline (MIG).

The applicant argued that pre-existing back pain, psychological impairments, and chronic pain warranted removal from the MIG.

The adjudicator found that the applicant failed to prove a pre-existing condition precluded recovery within the MIG.

Relying on the respondent's medical experts, the adjudicator concluded the applicant's psychological symptoms were related to non-accident stressors (unemployment, diabetes) and that his physical injuries were soft tissue in nature, not chronic pain syndrome.

As the MIG limits were exhausted, the disputed treatment plans were not payable, and claims for an award and interest were dismissed.

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 vehicular phobia and depressive disorder, warranted removal from the MIG.

The Tribunal approved the initial psychological assessment and the first block of psychotherapy sessions as reasonable and necessary.

However, subsequent treatment plans for additional psychotherapy were denied because the applicant had already made substantial gains and the new plans did not reflect his improved condition.

The applicant sought statutory accident benefits following a motor vehicle accident, including medical and rehabilitative benefits, a non-earner benefit, and an attendant care benefit.

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

The Licence Appeal Tribunal found that the applicant's physical injuries were predominantly minor and that he failed to establish psychological impairments or chronic pain warranting removal from the MIG.

The Tribunal also dismissed the claims for non-earner and attendant care benefits, concluding the applicant did not suffer a complete inability to carry on a normal life and was precluded from attendant care benefits due to the minor injury classification.

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

The Licence Appeal Tribunal found that the applicant was entitled to the cost of a neurological assessment, as his treating physician diagnosed a nerve injury and the insurer's assessors lacked access to those medical records.

However, the Tribunal dismissed the claims for a chronic pain assessment, a Functional Ability Evaluation, psychological treatment, and transportation costs for an orthopaedic assessment, finding them not reasonable and necessary due to pre-existing conditions, lack of contemporaneous evidence, and unpersuasive expert reports.

The claim for a special award under Regulation 664 was also dismissed.

The applicant sought income replacement benefits (IRB) and attendant care benefits (ACB) following a motor vehicle accident.

The Tribunal found that while the accident exacerbated the applicant's pre-existing psychological impairments, she did not suffer a substantial inability to perform the essential tasks of her employment.

The Tribunal preferred the respondent's medical evidence, which showed no acute physical changes and stable psychological conditions post-accident.

The applicant also failed to meet the post-104 weeks complete inability test for IRB and did not establish that the claimed ACB was reasonable and necessary.

The application was dismissed.

The insurer requested reconsideration of a decision awarding the applicant non-earner benefits, a psychological assessment, and a special award.

The adjudicator admitted late correspondence from the insurer as new evidence.

Based on this new evidence, the adjudicator varied the start date for the non-earner benefits from September 22, 2016, to October 25, 2016, and rescinded the special award regarding the non-earner benefits, finding the insurer's conduct was not unreasonable.

The adjudicator dismissed the insurer's arguments regarding the psychological assessment, finding no error in giving little weight to an insurer's examination report that was not in existence when the treatment plan was denied.

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

The adjudicator found that the applicant's physical injuries were soft-tissue in nature and that she failed to demonstrate functionally disabling pain or a diagnosable psychological condition requiring treatment beyond the MIG.

The adjudicator preferred the respondent's expert reports, noting the applicant continued to work full-time and lacked corroborating medical evidence for her claims.

As the injuries fell within the MIG and the limits were exhausted, the claims for attendant care, medical benefits, and an award for unreasonable delay were dismissed.

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

The insurer raised a preliminary issue that the applicant was barred from proceeding due to non-attendance at insurer examinations; the Tribunal found the notice of examination was deficient and allowed the claim to proceed.

On the merits, the Tribunal held that the applicant's psychological impairments removed him from the Minor Injury Guideline (MIG).

The Tribunal approved the psychological assessment and treatment plans as reasonable and necessary, but denied the claims for attendant care benefits, physiotherapy, and chiropractic treatment.

The claim for a special award was also dismissed.

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

The respondent denied treatment plans for a psychological assessment and psychological services, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant argued he suffered a psychological impairment removing him from the MIG and that the respondent failed to provide compliant notice under s. 38(8) of the Schedule.

The Tribunal found the applicant's injuries were predominately minor and he did not suffer a psychological impairment, preferring the respondent's psychological expert over the applicant's.

However, the Tribunal found the respondent was initially non-compliant with s. 38(8) notice requirements, entitling the applicant to payment for any expenses incurred during the non-compliance periods.

The treatment plans were otherwise found not reasonable or necessary, and the claim for an award under Regulation 664 was dismissed.