Dr. Allan Kopyto

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).

As a preliminary issue, the respondent argued the application was barred by res judicata because a previous Tribunal decision had already determined the applicant was subject to the MIG.

The adjudicator found res judicata did not apply because the previous decision addressed whether the applicant had a pre-existing condition, whereas the current application argued for removal from the MIG based on chronic pain and psychological impairment.

On the substantive issues, the adjudicator found the applicant's chronic neck pain and headaches pre-dated the accident and her psychological complaints were related to this pre-existing pain.

Consequently, the applicant's injuries were deemed predominantly minor, and she was not entitled to the disputed treatment plan or an award.

The applicant sought accident benefits following a motor vehicle accident, claiming his injuries, including chronic pain and whiplash-associated disorder, warranted removal from the Minor Injury Guideline (MIG).

The respondent denied the claim, relying on insurer's examinations indicating the injuries were minor soft-tissue strains and the applicant maintained a high level of functionality, working full-time as a dentist.

The Tribunal found the applicant failed to demonstrate his injuries fell outside the MIG or that he suffered from chronic pain with functional impairment.

As the $3,500 MIG limit was exhausted, the disputed treatment plan for chiropractic services was not payable.

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

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

The applicant argued for removal from the MIG due to a pre-existing degenerative disc condition and accident-related psychological impairments.

The Tribunal found that the applicant failed to prove the pre-existing condition would prevent maximal recovery within the MIG, relying on the insurer's medical assessment.

The Tribunal also gave little weight to the psychological diagnoses provided by a chiropractor and preferred the insurer's psychological assessment.

The application was dismissed, and the applicant was found not entitled to the disputed treatment plans or interest.

The applicant sought various medical and rehabilitation benefits under the Statutory Accident Benefits Schedule following a motor vehicle accident.

The respondent insurer denied the treatment plans based on insurer examinations.

The Tribunal found that the applicant failed to meet his burden of proving the treatment plans were reasonable and necessary, placing greater weight on the contemporaneous insurer examination reports which concluded the applicant had reached maximum medical recovery and had no ongoing accident-related impairments.

The application was dismissed in its entirety.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming he should be removed from the Minor Injury Guideline (MIG) due to a concussion and psychological injuries.

The Licence Appeal Tribunal found that the applicant failed to meet his burden of proof, as the contemporaneous medical evidence primarily indicated musculo-skeletal injuries and did not support the claimed concussion or psychological impairments.

The Tribunal gave little weight to the applicant's expert reports because they were authored nearly three years after the accident.

Consequently, the applicant remained subject to the MIG limit, and his claims for various treatment plans, interest, and an award were dismissed.

The respondent insurer requested a reconsideration of a Tribunal decision granting the applicant entitlement to a chronic pain assessment.

The insurer argued the Tribunal erred by finding that only psychologists and psychiatrists could provide expert opinion evidence on chronic pain, thereby improperly discounting the evidence of its general practitioner and orthopaedic surgeon.

The Vice-Chair granted the reconsideration, finding the Tribunal erred in its treatment of the medical experts.

Upon rehearing the issue, the Vice-Chair weighed the competing medical evidence and concluded that the applicant's ongoing reports of pain and diagnosis of somatic symptom disorder provided reasonable grounds to warrant a chronic pain assessment.

The treatment plan was deemed reasonable and necessary.

The applicant sought statutory accident benefits following a motor vehicle accident, which were denied by the respondent insurer.

The Licence Appeal Tribunal found that the applicant met her burden of proving that a neurological assessment, a chronic pain assessment, and chiropractic services were reasonable and necessary.

The Tribunal preferred the evidence of the applicant's treating practitioners and experts over the insurer's examiners, noting that the insurer's general practitioner was not qualified to opine on chronic pain and that the insurer's psychologist lacked specific findings to support claims of symptom exaggeration.

The application was granted, and the respondent was ordered to pay the disputed amounts with interest.

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

The adjudicator found that the applicant should be removed from the Minor Injury Guideline due to chronic pain with functional impairment.

However, the applicant was not entitled to a non-earner benefit because he did not suffer a complete inability to carry on a normal life, as he continued to work part-time and perform some daily activities.

The adjudicator approved several treatment plans for physiotherapy and an in-home assessment because the insurer failed to provide valid denial notices under s. 38(8) of the Schedule.

Claims for a chiropractic examination, an award, and costs were 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 argued for removal from the MIG on the basis of chronic pain with functional impairment.

The Tribunal found that the applicant failed to meet the evidentiary burden to prove chronic pain, noting significant gaps in reports of pain, lack of functional limitation, and failure to meet the AMA Guides criteria.

As the applicant's injuries were predominantly minor and the $3,500 MIG limit was exhausted, the claims for additional treatment plans, interest, and a section 10 award were dismissed.

The applicant sought a non-earner benefit, interest, and an award under the Statutory Accident Benefits Schedule following a motor vehicle accident.

The Tribunal applied the Heath framework and found that the applicant failed to prove a complete inability to carry on a normal life.

The applicant did not provide sufficient evidence of the frequency and time commitments of his pre-accident activities to allow for a proper comparison with his post-accident abilities.

The Tribunal preferred the respondent's insurer examination reports, which concluded the applicant did not suffer a complete inability to carry on a normal life from either a musculoskeletal or psychological perspective.

The application was dismissed.

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

The respondent insurer held that the applicant's injuries fell within the Minor Injury Guideline (MIG) and denied several treatment plans.

The applicant applied to the Licence Appeal Tribunal, arguing her injuries warranted removal from the MIG due to chronic pain and psychological impairment.

The Tribunal found that the applicant failed to demonstrate injuries outside the MIG, preferring the respondent's insurer examination reports over the applicant's medical evidence, which lacked objective support and was inconsistent with clinical records.

The application was dismissed, and the applicant remained subject to the $3,500 MIG limit.

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

The respondent denied various treatment plans on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and the $3,500 limit had been exhausted.

The Tribunal found that the applicant failed to provide compelling evidence of a pre-existing psychological condition or chronic pain syndrome that would prevent maximal medical recovery within the MIG.

Relying on clinical notes, prescription records, and independent medical examinations, the Tribunal concluded the injuries were minor.

As the MIG limits were exhausted, the disputed treatment plans and interest were denied.

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

The Tribunal found the applicant's injuries were predominantly minor soft-tissue injuries, rejecting the applicant's psychological expert evidence due to reliance on self-reporting and symptom magnification.

The Tribunal also held that the insurer's denial notices were compliant with the Schedule, and the disputed treatment plans were not payable.

The application was dismissed, and the respondent's request for costs due to the applicant's late filing of submissions was denied.

The applicant was injured in a motor vehicle accident and sought payment for two treatment plans (OCF-18s) for physiotherapy and massage therapy services, which the respondent insurer denied.

The Licence Appeal Tribunal found that the applicant failed to prove the treatments were reasonable and necessary.

The medical evidence, including the applicant's own treating practitioners, recommended active rehabilitation and home exercise programs rather than the passive therapies proposed in the disputed plans.

The Tribunal also accepted the respondent's insurer's examination report concluding the applicant had reached maximum medical recovery.

The application was dismissed.

The applicant was injured in a rear-end motor vehicle collision and sought statutory accident benefits.

The respondent insurer denied further treatment and non-earner benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant's injuries fell outside the MIG due to chronic pain syndrome, relying on the applicant's credible testimony and the evidence of a chronic pain specialist.

Applying the Heath framework, the Tribunal also found the applicant suffered a complete inability to carry on a normal life and awarded non-earner benefits.

The disputed treatment plans for physiotherapy and a chronic pain assessment were deemed reasonable and necessary and were approved with interest.

The applicant sought statutory accident benefits following a 2016 motor vehicle accident, claiming catastrophic impairment due to mental/behavioural disorders and physical impairments.

The Licence Appeal Tribunal found the applicant was not catastrophically impaired, as her psychological symptoms and knee osteoarthritis were pre-existing and not caused by the accident.

Claims for a non-earner benefit and various assessments were dismissed.

However, the Tribunal granted a treatment plan for chiropractic services, finding the applicant sustained permanent back injuries in the accident.

A claim for an award under Regulation 664 was dismissed, but interest was awarded on the overdue chiropractic benefits.

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

The Tribunal found that the applicant was self-employed and a 50% owner of a cleaning business.

Applying section 4(3) of the Schedule, the Tribunal calculated her pre-accident income based on her last completed taxation year.

Because the business continued to generate significant profit post-accident, the insurer was entitled to deduct 70% of her share of the post-accident self-employment income under section 7(3)(b), reducing her IRB entitlement to nil.

The Tribunal also dismissed the claims for the treatment plans, finding they were not proven to be reasonable and necessary and that the applicant had exhausted her medical rehabilitation limits.

The applicant sought statutory accident benefits following a minor parking lot collision.

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

The Tribunal found the applicant failed to prove a complete inability to carry on a normal life, noting inconsistencies in his testimony and a lack of corroborating medical evidence.

The Tribunal also found the applicant's injuries were predominantly minor and subject to the MIG, as he did not demonstrate any pre-existing condition warranting removal.

The disputed treatment plans were denied as they proposed treatment beyond the MIG limits.

The applicant sought statutory accident benefits following a motor vehicle accident, including a non-earner benefit, lost educational expenses, and various treatment plans.

The Licence Appeal Tribunal dismissed the application in its entirety.

The Tribunal found the applicant failed to prove a complete inability to carry on a normal life, preferring the respondent's multidisciplinary assessments over the applicant's self-reported evidence.

Claims for lost educational expenses were denied as academic transcripts showed the applicant continued his studies and improved his grades post-accident.

The disputed treatment plans were found not to be reasonable and necessary, and the requested hourly rate for a social worker exceeded the applicable Guideline maximum.

The applicant sought medical and rehabilitation benefits following a motor vehicle accident, including a cannabis prescription, physiotherapy, occupational therapy, and assistive devices.

The insurer denied the cannabis prescription pending a section 44 assessment, which the applicant refused to attend, arguing it was unreasonable and not permitted for prescription drugs.

The Tribunal held that the applicant was barred from proceeding with the cannabis claim because the insurer's request for a section 44 assessment was reasonable and properly noticed.

The Tribunal further dismissed the claims for physiotherapy, occupational therapy, and a rollator walker, finding that the applicant failed to prove the treatment plans were reasonable and necessary, preferring the evidence of the insurer's assessors who found the applicant's soft tissue injuries were uncomplicated.