Dr. Alireza Kachooie

The applicant sought income replacement benefits (IRBs) and medical and rehabilitation benefits following a motor vehicle accident.

The adjudicator found that the applicant failed to prove she suffered a substantial inability to perform the essential tasks of her pre-accident employment, noting inconsistencies in her reported employment and a lack of supportive medical evidence linking her physical and psychological impairments to the accident.

Furthermore, the applicant was found non-compliant with section 33 of the Schedule for failing to provide requested employment and income documentation.

The adjudicator also dismissed the claims for physiotherapy, psychological services, and a chronic pain program, finding the applicant did not establish that the treatments were reasonable and necessary or that she suffered from accident-related chronic pain.

The application was dismissed in its entirety.

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

The respondent denied several treatment plans and a non-earner benefit, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant suffered from chronic pain with functional impairment, removing him from the MIG.

The Tribunal approved treatment plans for physiotherapy, a psychological assessment, and a chronic pain assessment, but denied a treatment plan for psychological services.

The claim for a non-earner benefit was barred because the applicant failed to submit an Election of Benefits form (OCF-10).

A claim for an award under s. 10 of O. Reg. 664 was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to Non-Earner Benefits (NEBs) and removal from the Minor Injury Guideline (MIG) due to chronic pain and psychological impairments.

The Tribunal found that the applicant failed to prove a complete inability to carry on a normal life, noting he had resumed working as an Uber driver.

The Tribunal also found insufficient evidence to warrant removal from the MIG, preferring the respondent's medical assessments which found no significant functional or psychological impairments.

The application was dismissed.

The applicant sought statutory accident benefits following a rear-end motor vehicle collision.

The insurer denied various medical benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant claimed chronic pain and psychological impairments warranted removal from the MIG.

The Tribunal found the applicant's evidence of chronic pain and psychological impairment to be inconsistent, heavily reliant on self-reporting, and contradicted by independent medical examinations showing symptom amplification.

The Tribunal concluded the injuries were predominantly minor, and since the $3,500 MIG limit was exhausted, the disputed treatment plans and expenses were not payable.

The applicant sought enhanced statutory accident benefits, claiming he sustained a catastrophic impairment from a motor vehicle accident.

He argued the accident caused or exacerbated conditions leading to a fall and seizure weeks later.

The Tribunal found the applicant failed to prove on a balance of probabilities that his present impairments, including a traumatic brain injury and psychological issues, were caused by the accident rather than his extensive pre-existing medical conditions, such as diabetic neuropathy and a history of syncope.

As the applicant did not meet the catastrophic impairment threshold and his standard policy limits were exhausted, all claims for medical, rehabilitation, attendant care, and housekeeping benefits were dismissed, along with claims for interest and a special award.

The applicant sought a determination that he sustained a catastrophic impairment following a motor vehicle accident, claiming a whole person impairment of 55% or more.

The Tribunal reviewed extensive medical evidence and expert testimony regarding the applicant's physical and psychological impairments, including gait derangement, spine impairment, traumatic brain injury, and mental/behavioural disorders.

The Tribunal concluded the applicant's combined whole person impairment was 41%, falling short of the 55% threshold.

Consequently, claims for attendant care beyond the 104-week limit were dismissed.

The Tribunal partially approved treatment plans for a chronic pain program, chiropractic spinal manipulation, and psychotherapy, subject to remaining policy limits.

Claims for a special award and costs were dismissed.

The applicant was injured in a motor vehicle accident and sought various medical benefits under the Statutory Accident Benefits Schedule, which were denied by the respondent insurer.

The applicant applied to the Licence Appeal Tribunal to dispute the denials of treatment plans for acupuncture, physiotherapy, chiropractic treatment, chronic pain programs, a functional abilities evaluation, and disability certificates.

The Tribunal found that the applicant proved the reasonableness and necessity of the acupuncture, physiotherapy, chiropractic treatment, functional abilities evaluation, and the psychological components of the chronic pain programs.

The physical components of the chronic pain programs and the disability certificates were denied.

Furthermore, the Tribunal awarded the applicant a 25 percent special award under O. Reg. 664 for the insurer's unreasonable delay and withholding of specific benefits, noting the insurer failed to properly consider all available medical information, including its own assessors' reports.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits.

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

The Licence Appeal Tribunal found that the applicant sustained a psychological injury and chronic pain syndrome, removing her from the MIG.

The Tribunal awarded medical benefits for a chronic pain program and one chiropractic/massage treatment plan, as well as the costs of psychological and orthopaedic assessments.

The applicant was also awarded pre-104 week income replacement benefits (IRBs) due to her inability to perform her heavy pre-accident work as a machine operator, but her claim for post-104 week IRBs was dismissed for lack of evidence regarding alternative suitable employment.

A claim for a special award for unreasonable delay was dismissed.

The applicant was injured in a motor vehicle accident in 2007 and sought payment for a physical therapy treatment plan proposed in 2014.

The insurer denied the claim based on an insurer's examination which concluded that the applicant had already received appropriate facility-based treatment and required no further treatment.

The Licence Appeal Tribunal found that the applicant's medical evidence was outdated and insufficient to prove that the proposed treatment was reasonable and necessary seven years post-accident.

The application for the medical benefit was dismissed.

The applicant was injured in a motor vehicle accident and sought income replacement, rehabilitation, housekeeping, and transportation benefits from his insurer.

The insurer terminated income replacement benefits after medical assessments found no objective physical impairment and noted signs of exaggerated pain.

The arbitrator dismissed the claims for income replacement, housekeeping, and transportation expenses, finding insufficient medical evidence to support a substantial inability to perform essential tasks.

However, the arbitrator ordered the insurer to pay $2,030 for a portion of the claimed rehabilitation expenses, finding that specific physiotherapy program was reasonable and necessary.

The applicant was injured in a motor vehicle accident and, two weeks later, was assaulted and robbed at her workplace.

She claimed ongoing statutory accident benefits, arguing her disability stemmed from the car accident, while the insurer argued her ongoing issues were caused by the robbery.

The arbitrator found that both events significantly contributed to her condition, satisfying the causation requirement for accident benefits.

The applicant was awarded weekly income benefits for the first 156 weeks, as she was substantially disabled from her pre-accident employment.

However, she was denied benefits beyond 156 weeks because she was capable of engaging in suitable alternative employment.

The insurer was granted a credit for W.C.B. benefits the applicant received.

The applicant was injured in a motor vehicle accident and received statutory accident benefits until July 1991.

She claimed ongoing entitlement to weekly income benefits, childcare benefits, and housekeeping expenses due to a right ulnar nerve problem that developed months after the accident.

The insurer denied ongoing benefits and claimed an overpayment, arguing that the applicant's pre-existing workers' compensation pension should have been deducted from her weekly benefits.

The arbitrator found that the applicant failed to establish on a balance of probabilities that her ulnar neuropathy was caused by the motor vehicle accident, as there was no evidence of direct trauma to her elbow.

Consequently, her claims for ongoing benefits were dismissed.

However, the arbitrator also held that the applicant's workers' compensation pension for a permanent partial disability was not a payment for loss of income under section 13(3) of the No-Fault Benefits Schedule, and therefore was not deductible.

The insurer's claim for repayment of the alleged overpayment was dismissed.