Dr. A. Marino

The Applicant sought statutory accident benefits following a 2013 motor vehicle accident.

The Tribunal first extended the two-year limitation period under section 7 of the LAT Act, allowing the application to proceed.

On the substantive issues, the Tribunal found the Applicant did not sustain a catastrophic impairment under criterion (f) for mental and behavioural impairments, concluding his limitations were primarily physical due to a herniated disc rather than psychological.

However, the Tribunal found the disputed physiotherapy, chiropractic, and psychological treatment plans to be reasonable and necessary.

The Tribunal also excluded late-filed evidence from the Applicant and rebuttal reports obtained without notice by the Respondent.

The Applicant was awarded interest on overdue payments and a section 10 award of $1,077.43 for the Respondent's unreasonable delay in adjusting the 2017 plans.

No costs were awarded.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including attendant care benefits and various treatment plans.

The respondent denied the benefits, arguing the applicant was bound by the Minor Injury Guideline (MIG).

The Tribunal found the applicant was not bound by the MIG due to psychological injuries, relying on an insurer's examination report.

The Tribunal granted entitlement to the physical treatment plans (physiotherapy and chiropractic) as reasonable and necessary, but denied the attendant care benefits and the unapproved balances of the psychological treatment plans for lack of evidence.

The applicant sought income replacement benefits and funding for a chiropractic treatment plan following a motor vehicle accident.

The adjudicator found that the applicant failed to meet her burden of proving a substantial inability to perform the essential tasks of her pre-accident employment, relying on insurer's examination reports that found no physical or psychological disability.

The adjudicator also denied the treatment plan, finding it was not reasonable and necessary as the applicant had fully recovered from her soft tissue injuries.

The application was dismissed in its entirety.

The applicant, a personal support worker struck by a motor vehicle as a pedestrian, sought statutory accident benefits including an income replacement benefit (IRB), a chronic pain assessment, and psychological treatment.

The Licence Appeal Tribunal dismissed the application.

The Tribunal found the applicant was barred from receiving an IRB for the initial period because she failed to submit a disability certificate until September 2019.

For the subsequent periods, she failed to prove a substantial or complete inability to work, as her family physician's notes indicated she was able to work after November 2018 and she provided no functional abilities evaluation.

The Tribunal also denied the chronic pain assessment and the disputed portion of the psychological treatment plan, finding them not reasonable or necessary based on the medical evidence.

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

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

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

The Tribunal found that the applicant failed to establish a pre-existing condition that precluded recovery within the MIG, noting only sporadic pre-accident reports of back pain and sleep issues.

The Tribunal also rejected the applicant's psychological evidence, preferring the respondent's expert who found no psychological impairment.

Finally, the Tribunal found insufficient evidence of chronic pain causing functional impairment.

The application was dismissed, and the disputed treatment plans and interest were denied.

The applicant sought statutory accident benefits following a motor vehicle accident, arguing her injuries warranted removal from the Minor Injury Guideline (MIG) due to chronic pain and psychological impairments.

The Licence Appeal Tribunal found the applicant's physical injuries were minor and unrelated to the accident, preferring the respondent's medical evidence.

The Tribunal also rejected the applicant's psychological claims, noting inconsistencies, lack of a translator during assessment, and absence of psychological issues in clinical notes.

As the applicant's injuries were deemed minor and the $3,500 MIG limit was exhausted, all disputed treatment plans, interest, and a section 10 award were denied.

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

The respondent denied certain treatment plans, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant argued they suffered from chronic pain syndrome and psychological impairments that removed them from the MIG.

The Tribunal found that the applicant's injuries were predominantly minor, noting that the applicant returned to regular work duties shortly after the accident and did not demonstrate functional impairment.

The Tribunal preferred the evidence of the insurer's examination assessors over the applicant's pain specialist, who relied heavily on self-reporting during a virtual assessment.

The application was dismissed.

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

The respondent insurer denied portions of treatment plans for chiropractic and physiotherapy, as well as a chronic pain assessment.

The Tribunal found that the respondent failed to provide a proper denial with medical and other reasons for the first treatment plan, triggering the consequences of s. 38(11) of the Schedule.

For the remaining treatment plan and assessment, the Tribunal preferred the applicant's medical evidence, finding the respondent's independent medical examination contained internal contradictions.

The Tribunal concluded the treatment and assessment were reasonable and necessary, ordering the respondent to pay the disputed amounts plus interest.

The applicant sought statutory accident benefits following a 2015 motor vehicle accident.

The respondent denied certain treatment plans and assessments, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found the applicant's credibility was undermined by his failure to report a subsequent 2016 accident and pre-existing pain to his expert assessors.

Preferring the respondent's physiatry and psychology experts over the applicant's, the Tribunal concluded the physical injuries were soft tissue strains and there was no diagnosable psychological impairment.

The Tribunal held the injuries were predominantly minor and the disputed treatment plans and assessments were not reasonable and necessary.

The application was dismissed.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for a functional cognitive test battery and a chronic pain assessment, which the respondent insurer denied.

The Licence Appeal Tribunal found that the applicant's pre-existing chronic pain was exacerbated by the accident, making the chronic pain assessment reasonable and necessary.

However, the Tribunal denied the functional cognitive test battery, finding no evidence of a cognitive deficit unrelated to the applicant's psychological impairments.

The Tribunal also denied the applicant's request for an award under Regulation 664, as the insurer's reliance on its independent medical examinations was not unreasonable.

The applicant sought statutory accident benefits following a 2017 motor vehicle accident, disputing the respondent's denial of an ongoing income replacement benefit (IRB), a chronic pain assessment, and psychological services.

The Licence Appeal Tribunal dismissed the claim for ongoing IRB, finding the applicant failed to prove a substantial inability to perform the essential tasks of his employment, relying on a psychological reassessment indicating his driving anxiety had improved.

The Tribunal also denied the disputed psychological services due to a lack of evidence challenging the respondent's partial approval.

However, the Tribunal granted the $2,000 chronic pain assessment, finding it reasonable and necessary given the applicant's consistent pain reporting and objective evidence of meralgia paresthetica.

The applicant sought reconsideration of a decision finding he sustained a minor injury and was not entitled to non-earner benefits.

He argued the adjudicator erred in law by allowing the respondent to file insurer's examination reports and violated procedural fairness by failing to impartially assess his evidence.

The adjudicator dismissed the request, finding no error in law or breach of procedural fairness, as the applicant failed to properly identify the evidence he sought to exclude and failed to meet his burden of proof regarding his entitlement to benefits.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including non-earner benefits and treatment beyond the Minor Injury Guideline (MIG) limit.

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

The Tribunal found that the applicant's physical and psychological injuries fell within the MIG, preferring the respondent's psychological assessment over the applicant's.

The Tribunal also dismissed the claim for non-earner benefits, finding insufficient evidence that the applicant suffered a complete inability to carry on a normal life, noting inconsistencies in the applicant's self-reporting and a lack of supporting medical evidence.