Dr. A.H. Rubenstein

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

The respondent denied several treatment plans, and the applicant applied to the Licence Appeal Tribunal.

The Tribunal found that the applicant was statute-barred from disputing four treatment plans because she failed to apply within the two-year limitation period under s. 56 of the Schedule, and declined to extend the time under s. 7 of the LAT Act.

On the substantive issues, the Tribunal held that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant failed to prove that a pre-existing condition, chronic pain, or psychological impairment warranted removal from the MIG.

Consequently, the remaining treatment plan for chiropractic services was denied, and no interest was payable.

The application was dismissed.

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

The insurer determined the injuries fell within the Minor Injury Guideline (MIG) and denied a physiotherapy treatment plan and income replacement benefits (IRBs).

The Tribunal found the applicant's physical and psychological injuries were minor and did not warrant treatment outside the MIG, dismissing the claim for physiotherapy.

However, the Tribunal awarded IRBs for a closed period because the insurer failed to comply with the procedural requirements of section 36(4) of the Schedule when responding to the applicant's disability certificate, entitling the applicant to benefits until a clear and unequivocal denial was issued.

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

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

The Tribunal found that the applicant's physical injuries fell within the definition of a minor injury and that she failed to establish a pre-existing condition, chronic pain, or psychological impairment warranting removal from the MIG.

The Tribunal accepted the respondent's expert evidence, which raised significant validity concerns regarding the applicant's presentation, over the applicant's evidence.

The Tribunal also dismissed the claim for ongoing income replacement benefits, finding the applicant failed to prove a substantial inability to perform the essential tasks of her employment.

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

The respondent insurer limited the applicant to the Minor Injury Guideline (MIG) and denied several treatment plans.

The Tribunal found that the applicant suffered a right knee meniscus tear caused by the accident, which falls outside the MIG definition, and removed him from the MIG.

The Tribunal approved a $2,000 chronic pain assessment but denied other treatment plans for chiropractic services, a medical assessment, and a psychological assessment as they were either duplicative, premature, or not reasonable and necessary.

The applicant's claim for an award for unreasonable withholding of benefits was dismissed.

The applicant was injured in a motor vehicle accident and sought medical benefits for physiotherapy and costs of examination for orthopaedic, attendant care, and psychological assessments.

The insurer denied the benefits, arguing the applicant's injuries had resolved or were related to a subsequent accident.

The Licence Appeal Tribunal dismissed the application, finding the applicant failed to prove the treatments and assessments were reasonable and necessary.

The Tribunal gave significant weight to the insurer's examination reports and noted the applicant's lack of candor regarding a second motor vehicle accident.

The minor applicant was involved in a motor vehicle accident and sought approval for an EEG assessment recommended by her treating psychologist.

The respondent insurer denied the treatment plan on the basis that the applicant had not been diagnosed with a concussion.

The Tribunal found that the applicant's reported symptoms, including headaches and hitting her head on the car window, supported the need for the assessment.

The Tribunal ordered the respondent to pay the $1950.00 for the EEG and denied the respondent's request for costs, finding no evidence that the applicant acted frivolously or in bad faith.