Dr. Alex McKee

The applicant sought statutory accident benefits following a motor vehicle accident, specifically a $1,696.00 treatment plan for physiotherapy.

The respondent denied the plan, arguing the applicant sustained minor soft tissue injuries that had healed.

The Tribunal found the treatment plan reasonable and necessary, preferring the applicant's physiatrist's evidence that the treatment provided pain relief for ongoing musculoskeletal injuries.

The Tribunal ordered the respondent to pay for the treatment plan plus interest, but declined to order an award under s. 10 of Reg. 664 as the applicant provided no submissions to justify it.

The applicant sought statutory accident benefits following a 2017 motor vehicle accident.

The respondent denied treatment plans for a neuro-optometric assessment, prolotherapy, and psychological services.

The Tribunal found the neuro-optometric assessment was not reasonable and necessary, as the supporting medical reports were either not contemporaneous or did not recommend further assessments.

The Tribunal approved the prolotherapy plan, preferring the in-person assessment of the applicant's physiatrist over the respondent's remote assessment.

The claim for the balance of psychological services was dismissed, as the applicant failed to justify the need for an updated assessment or the higher hourly rate for a psychotherapist.

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 sought income replacement benefits (IRB) and two treatment plans following a motor vehicle accident.

The respondent denied the benefits, relying on multiple independent medical examinations.

The Tribunal found that the applicant met the tests for both pre-104 and post-104 IRB, as he suffered from a substantial inability to perform the essential tasks of his employment and a complete inability to engage in any employment for which he was reasonably suited.

The Tribunal preferred the evidence of the applicant's experts, noting that the respondent's assessors evaluated the applicant in silos and failed to provide an integrated assessment of his physical and psychological impairments.

The treatment plans for chiropractic services and a psychological assessment were deemed reasonable and necessary.

The claim for an award under s. 10 of O. Reg. 664 was dismissed, as the respondent's conduct was not found to be unreasonable.

The applicant sought statutory accident benefits for physiotherapy, an in-home functional assessment, and a psychological assessment following a motor vehicle accident.

The insurer denied the treatment plans, arguing the applicant's impairments were a natural progression of pre-existing conditions.

The Tribunal found that the accident aggravated the applicant's pre-existing physical and psychological impairments, making the proposed treatment plans reasonable and necessary.

The Tribunal ordered the insurer to pay for the treatment plans with interest, but declined to order a special award under section 10 of Regulation 664, finding the insurer's initial denial was not unreasonable based on the medical evidence it had at the time.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming his injuries fell outside the Minor Injury Guideline (MIG) due to a pre-existing high blood pressure condition, psychological impairment, post-concussion syndrome, and chronic pain.

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

The Tribunal found that the applicant failed to provide compelling medical evidence that his pre-existing condition prevented maximal recovery or that he suffered from a non-minor psychological or physical impairment caused by the accident.

Consequently, the Tribunal held that the applicant's injuries fell within the MIG, limiting his entitlement to medical and rehabilitation benefits to $3,500, and dismissed his claims for attendant care benefits, various assessments, and an award for unreasonably delayed payments.

The applicant was injured in a motor vehicle accident and sought medical benefits and Income Replacement Benefits (IRB) beyond what the insurer approved.

The insurer capped medical benefits at $3,500 under the Minor Injury Guideline (MIG) and terminated IRB, arguing the applicant no longer suffered a substantial inability to perform her pre-accident employment.

The Tribunal found that the applicant's injuries were predominantly minor soft tissue injuries and that she failed to provide compelling evidence of a pre-existing condition or chronic pain syndrome that would warrant exceeding the MIG cap.

Furthermore, relying on the insurer's multidisciplinary assessments, the Tribunal concluded the applicant was capable of performing the essential tasks of her employment and dismissed the claim for IRB.