Dr. Andrew Shaul

The applicant sought statutory accident benefits following a motor vehicle accident, specifically claiming attendant care benefits of $29.38 per month and $1,394.50 for assistive devices and an education session.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to establish that the claimed benefits were reasonable and necessary.

The Tribunal preferred the respondent's assessment reports, which indicated the applicant remained independent in his activities of daily living and personal hygiene, over the applicant's reports, which failed to establish a nexus between his impairments and the need for an aide or assistive devices.

Furthermore, the applicant provided no evidence that the attendant care expenses had been incurred.

The applicant sought statutory accident benefits following a motor vehicle accident, including a psychological assessment, driver's rehabilitation assessment, multidisciplinary chronic pain program, and psychological services.

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

The psychological assessment was given no weight as it was conducted by a psychotherapist with minimal involvement from the supervising psychologist.

The driver's rehabilitation assessment was denied because the applicant's licence was suspended due to a criminal conviction.

The Tribunal preferred the evidence of the respondent's psychiatrists over the applicant's medical evidence.

Claims for an award, interest, and costs were also dismissed.

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

The respondent insurer denied treatment plans for physiotherapy, a chronic pain assessment, and a psychological assessment on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and the $3,500 funding limit had been exhausted.

The Licence Appeal Tribunal found that the applicant failed to prove her injuries warranted treatment outside the MIG, noting that the medical evidence from her family doctor did not support the diagnoses of concussion, psychological impairment, or chronic pain syndrome advanced by her assessing experts.

The application was dismissed, along with claims for a special award and costs.

The applicant sought statutory accident benefits following a motor vehicle accident, including five physiotherapy treatment plans, a chronic pain assessment, and a functional impairment evaluation.

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

The Tribunal found that the applicant failed to prove her physical or psychological injuries fell outside the MIG, preferring the respondent's independent medical examination reports over the applicant's experts.

The Tribunal approved the first two physiotherapy treatment plans as reasonable and necessary, subject to the $3,500 MIG limit, but denied the remaining plans and assessments due to a lack of objective medical evidence.

The applicant was awarded interest on the approved plans but denied a special award for unreasonable delay.

The applicant sought medical and rehabilitation benefits and non-earner benefits following a motor vehicle accident.

The respondent denied the claims, arguing the injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found the applicant failed to prove that pre-existing conditions, chronic pain, or psychological impairments warranted removal from the MIG, noting inconsistencies and omissions in her self-reports to medical experts.

The Tribunal also dismissed the claim for non-earner benefits, finding the applicant's evidence regarding her post-accident education and activities unreliable and insufficient to establish a complete inability to carry on a normal life.

The application was dismissed in its entirety.

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

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

The applicant argued for removal from the MIG based on chronic pain, psychological impairment, and a pre-existing condition.

The Tribunal found the applicant failed to prove on a balance of probabilities that his chronic pain adversely affected his well-being, applying the AMA Guides criteria.

The Tribunal also gave little weight to the applicant's psychological evidence and found no documented pre-existing condition preventing maximal recovery.

As the MIG limits were exhausted, the application was dismissed.

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

The respondent denied benefits beyond the $3,500 limit, arguing the injuries fell within the Minor Injury Guideline (MIG).

The applicant contended he suffered from chronic pain and psychological impairments, and had pre-existing conditions warranting removal from the MIG.

The Tribunal found the applicant's evidence insufficient to establish chronic pain or psychological impairment exceeding the MIG, noting inconsistencies and lack of objective evidence.

The Tribunal also found no compelling evidence that pre-existing conditions would prevent maximal recovery within the MIG.

The application for medical benefits and interest was dismissed.

The respondent insurer requested a reconsideration of a previous Tribunal decision that awarded the applicant various medical and rehabilitation benefits, including physical therapy, a chronic pain assessment, a chronic pain program, and a disability certificate.

The insurer alleged several factual and legal errors, including the Tribunal's treatment of expert evidence and the legal test applied.

The adjudicator dismissed the request, finding that while there were minor errors in the original decision, none were significant enough that they would have likely led to a different result.

The adjudicator also clarified that under s. 25(1) of the Schedule, an insurer is not required to request a disability certificate before it becomes payable.

The applicant sought statutory accident benefits for psychological treatment and a chronic pain assessment following a motor vehicle accident.

The adjudicator denied the psychological treatment plans, finding an unexplained gap in treatment and a lack of supporting documentation.

However, the adjudicator granted the chronic pain assessment, concluding that the applicant's ongoing pain complaints and functional limitations made it reasonably possible she suffered from chronic pain syndrome.

The respondent's request for costs was denied as the applicant's conduct was not unreasonable, frivolous, vexatious, or in bad faith.

The applicant was injured in a motor vehicle accident and sought medical and rehabilitation benefits from the respondent insurer.

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

The applicant applied to the Licence Appeal Tribunal, arguing she should be excluded from the MIG due to pre-existing conditions, psychological impairment, and chronic pain.

The Tribunal found insufficient evidence of a pre-existing condition or a psychological impairment resulting from the accident.

The Tribunal concluded the applicant's injuries were predominantly minor and dismissed the application for benefits and interest.

The applicant sought various statutory accident benefits following a motor vehicle accident, including attendant care benefits and multiple treatment plans for psychological and physical injuries.

The Licence Appeal Tribunal denied the claim for attendant care benefits because the applicant failed to prove the expenses were incurred.

However, the Tribunal ordered the insurer to pay for several treatment plans, including a psychological assessment and physical therapy, because the insurer failed to provide proper medical reasons for its denials as required by section 38(8) of the Schedule.

The Tribunal also approved a chronic pain assessment and shockwave therapy based on medical evidence of ongoing pain, but denied other treatment plans for lack of evidence of reasonableness and necessity.

The claim for a special award was dismissed.

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

The respondent denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) limit, which had been exhausted.

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

The Tribunal found insufficient evidence of a psychological impairment or chronic pain, noting the applicant's post-accident life and functional capacity remained largely unchanged.

The Tribunal concluded the injuries were minor and fell within the MIG.

Claims for an award and costs were also dismissed.

The applicant was injured in a motor vehicle accident and sought various medical and rehabilitation benefits, which the respondent insurer denied.

The applicant applied to the Licence Appeal Tribunal for dispute resolution.

The adjudicator found that the applicant was entitled to a comprehensive chiropractic treatment plan, an attendant care assessment, a chronic pain assessment, and a psychological assessment, as they were reasonable and necessary given the applicant's ongoing pain and psychological impairments.

However, two duplicative chiropractic treatment plans were denied.

The adjudicator also awarded interest on overdue payments but denied the applicant's requests for a special award and costs, finding no evidence of unreasonable conduct by the respondent.

The applicant sought payment for various treatment and assessment plans following a motor vehicle accident.

The insurer denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) and the $3,500 coverage limit had been exhausted.

The Tribunal found that the applicant sustained predominantly minor injuries, specifically neck and back strains, and that her ongoing pain was attributable to pre-existing degenerative disc disease and osteoarthritis rather than the accident.

The Tribunal rejected the applicant's claims of chronic pain and psychological impairment, preferring the insurer's expert evidence.

As the applicant did not meet the criteria for a pre-existing condition exception, she remained subject to the MIG limit, and her claims for further benefits, interest, and a special award were dismissed.

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

The respondent insurer denied the benefits on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and the claimed benefits exceeded the $3,500 limit.

The applicant argued he should be removed from the MIG due to a pre-existing condition, psychological injuries, and chronic pain.

The Tribunal found the applicant's evidence, including expert reports, to be contradictory and unsupported by the objective medical records.

The Tribunal concluded the injuries were minor and dismissed the application, including claims for an award under Regulation 664.

The applicant sought statutory accident benefits following a motor vehicle accident, including a non-earner benefit and funding for chiropractic services and a chronic pain assessment.

The Licence Appeal Tribunal dismissed the claim for a non-earner benefit, finding that surveillance evidence and inconsistencies in the applicant's self-reporting undermined her claim of a complete inability to carry on a normal life.

However, the Tribunal granted the medical benefits, concluding that the applicant suffered from an accident-related pain condition and that the proposed treatments were reasonable and necessary to address her physical and psychological impairments.

The respondent's request for costs was denied.

The applicant sought various medical and rehabilitation benefits following a motor vehicle accident.

The respondent insurer removed the applicant from the Minor Injury Guideline (MIG) due to psychological impairments but denied several treatment plans.

The Tribunal found that the physical treatment plans were not reasonable and necessary as the physical injuries were predominantly minor.

However, the Tribunal approved the psychological treatment and assessments at reduced rates in accordance with the Professional Fee Guideline, and approved a chronic pain assessment to investigate the connection between the applicant's subjective pain and psychological diagnoses.

The applicant was injured in a motor vehicle accident and sought various medical and rehabilitation benefits from her insurer under the Statutory Accident Benefits Schedule.

The insurer denied several treatment plans, including physiotherapy, psychological and neurological assessments, and a chronic pain program.

The Licence Appeal Tribunal found that the applicant continued to suffer from significant accident-related pain and granted entitlement to the physiotherapy, neurological assessment, disability certificate, chronic pain assessment, chronic pain program, and a portion of the shockwave therapy.

Claims for further psychological assessment and treatment were denied as duplicative or unnecessary given previously approved funding.

The Tribunal declined to order a special award or costs, finding the insurer's adjusting of the file was reasonable.

The applicant sought medical and rehabilitation benefits following a motor vehicle accident.

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

The adjudicator found that the applicant failed to meet the burden of proving his physical, psychological, or chronic pain impairments removed him from the MIG.

The adjudicator preferred the respondent's psychological assessment over the applicant's due to the use of an interpreter, and relied on surveillance evidence that contradicted the applicant's claims of chronic pain.

The application was dismissed.

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

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

The Tribunal found that the applicant's pre-existing psychological condition was exacerbated by the accident, removing her psychological impairments from the MIG and entitling her to a psychological assessment.

However, the applicant failed to prove her physical injuries were outside the MIG, so her claims for physiotherapy and an attendant care assessment were denied.

The claim for an award for unreasonable withholding of benefits was also dismissed.