Dr. Andrew Shaul

The applicant sought statutory accident benefits for psychological services following a 2016 motor vehicle accident.

The insurer denied the treatment plan based on an insurer's examination which concluded the applicant suffered no accident-related psychiatric impairment.

The Tribunal found that the applicant failed to prove the treatment was reasonable and necessary, noting that the applicant's expert reports related to a previous 2012 accident, there was a lack of psychological complaints to his family doctor, and the applicant successfully completed a realtor program despite alleged concentration issues.

The application was dismissed.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for physiotherapy and a chronic pain assessment.

The respondent insurer denied the benefits, arguing the applicant had reached maximum medical recovery.

The Licence Appeal Tribunal found that the applicant continued to suffer from ongoing impairments and had not reached maximum medical recovery.

The Tribunal held that both the physiotherapy treatment and the chronic pain assessment were reasonable and necessary.

The applicant was awarded the disputed benefits and interest, but her claim for a special award for unreasonable delay was dismissed due to a lack of evidence.

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

The respondent insurer denied several treatment plans, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) and were subject to the $3,500 limit.

The Tribunal found that the applicant's physical injuries were soft tissue in nature and his psychological symptoms did not meet the criteria for a formal diagnosis that would remove him from the MIG.

The Tribunal also rejected the applicant's claim of chronic pain syndrome due to a lack of objective medical evidence and functional impairment.

The application was dismissed.

The applicant was injured in a motor vehicle accident and sought medical benefits for physiotherapy.

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

The Licence Appeal Tribunal found that while the applicant did not establish a psychological impairment, his physical injuries fell outside the MIG due to chronic pain and nerve injuries.

The Tribunal concluded that the two physiotherapy treatment plans were reasonable and necessary, and ordered the respondent to pay the benefits with interest.

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

The insurer denied treatment plans for a psychological assessment, psychological treatment, physical therapy services, and a chronic pain assessment.

The Licence Appeal Tribunal found the psychological assessment and chronic pain assessment to be reasonable and necessary, noting ongoing complaints of driving anxiety and persistent pain.

The Tribunal partially approved the physical therapy plan for massage therapy and a functional exercise program based on the applicant's self-reports of pain relief.

However, the claim for psychological treatment was denied because the supporting psychological report was given no weight due to contradictory statements and lack of clarity regarding the author's diagnosis.

The applicant was injured in a rear-end motor vehicle accident and sought income replacement benefits, various treatment plans, and a chronic pain assessment from her insurer.

The Licence Appeal Tribunal found that the applicant did not suffer a substantial inability to perform the essential tasks of her pre-accident employment, relying on surveillance evidence that contradicted her self-reported limitations.

The Tribunal approved treatment plans for physiotherapy and massage therapy as reasonable and necessary, but denied plans for drive counselling, a treadmill, and a chronic pain assessment due to insufficient medical evidence and inconsistencies in the applicant's presentation.

Claims for an award for unreasonably delayed payments were also dismissed.

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

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

The Tribunal found that while the applicant's soft tissue injuries were minor, she suffered from a chronic pain condition that removed her from the MIG.

The Tribunal also held the insurer liable to pay for four disputed treatment plans because it failed to provide proper notice under s. 38(8) of the Schedule.

However, the applicant's claims for non-earner benefits and visitor expenses were dismissed for lack of evidence.

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

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

The applicant argued she should be removed from the MIG due to chronic pain and psychological impairments.

The Tribunal found the applicant's evidence regarding chronic pain to be inconsistent and preferred the respondent's psychological expert over the applicant's.

The Tribunal concluded the applicant's injuries were predominantly minor and she was not removed from the MIG.

As the $3,500 MIG limit was exhausted, the treatment plans were not payable.

The respondent's request for costs was denied.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for psychological assessments, psychological treatment, and physiotherapy.

The respondent insurer denied the benefits.

The Licence Appeal Tribunal found that the applicant failed to discharge the burden of proving that the proposed treatments and assessments were reasonable and necessary.

The Tribunal preferred the evidence of the respondent's experts, who found minimal psycho-emotional distress and no objective evidence of physical impairment, over the conflicting and inconsistent reports of the applicant's experts.

The application was dismissed.

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

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

The Tribunal found that the applicant's pre-existing psychological issues were exacerbated by the accident, resulting in diagnoses of depression and anxiety that removed her from the MIG.

The Tribunal preferred the evidence of the applicant's psychologist over the respondent's insurer examination psychologist.

Consequently, the Tribunal ordered the respondent to pay for the disputed physical treatment, psychological assessment, and psychological treatment, finding them all to be reasonable and necessary, along with interest on overdue payments.

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

The insurer paid for treatment up to the $3,500 limit under the Minor Injury Guideline (MIG) but denied further funding for physiotherapy and a psychological assessment.

The Tribunal found that the applicant's injuries were predominantly minor and that there was no compelling evidence of a psychological injury to warrant removing the applicant from the MIG.

The claims for additional benefits, interest, a special award, and costs were dismissed.

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

The central issue was whether the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant's medical experts opined that he suffered from chronic pain and psychological impairments outside the MIG.

However, the adjudicator preferred the insurer's medical examination and the applicant's own statements, which confirmed he was working full-time, attending school, and maintaining his social life.

The adjudicator concluded the injuries were predominantly minor and dismissed the application for benefits beyond the MIG cap, as well as claims for interest and a special award.

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

The respondent denied funding for attendant care benefits and various treatment plans, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant's injuries, particularly chronic pain, removed him from the MIG.

The Tribunal partially approved the treatment plans for physical therapy and assistive devices, and approved the cost of a chronic pain assessment.

However, claims for attendant care benefits, psychological treatment, psychological assessment, and a special award were dismissed.

Interest was awarded on overdue payments.

The Applicant sought statutory accident benefits following a motor vehicle accident, claiming catastrophic impairment, attendant care benefits, and medical benefits.

The Insurer denied the claims, arguing the Applicant's ongoing issues were related to pre-existing conditions and that he was malingering.

The Arbitrator found the Applicant and his family members lacked credibility, noting significant inconsistencies between their testimony, the Applicant's pre-accident medical history, his receipt of ODSP benefits, and surveillance evidence showing him performing normal daily activities.

The Arbitrator preferred the evidence of the Insurer's medical experts, who found the Applicant was malingering and that his impairments were not caused by the accident.

The claims for catastrophic impairment, attendant care benefits, and medical benefits were dismissed.

The applicant was injured in a motor vehicle accident and sought various medical and rehabilitation benefits, which the respondent insurer denied on the basis that the injuries fell within the Minor Injury Guideline (MIG).

The adjudicator found that the applicant's psychological impairments (adjustment disorder and specific phobia) removed him from the MIG.

The adjudicator ordered the respondent to pay for several chiropractic and physiotherapy treatment plans, finding them reasonable and necessary, and noting the insurer's failure to comply with the 10-day notice requirement under s. 38(8) of the Schedule for some plans.

Claims for a driving re-integration assessment and a chronic pain assessment were dismissed as not reasonable and necessary.

The applicant was awarded interest on overdue payments, but both parties' claims for costs under Rule 19.1 were dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, which the respondent denied on the basis that the injuries fell within the Minor Injury Guideline.

The Tribunal found that the applicant's psychological impairments, including adjustment disorder and specific phobia, removed her from the Guideline.

The Tribunal preferred the evidence of the applicant's psychologist over the respondent's assessor, noting the respondent's own testing showed the applicant tended to minimize her distress.

The Tribunal awarded the costs of examinations for psychological and chronic pain assessments, along with interest, but denied the claims for physiotherapy treatment plans as the applicant failed to prove they were reasonable and necessary.

The claim for costs was also denied.

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

The adjudicator excluded late-filed medical reports submitted by the applicant in reply, finding their admission would prejudice the respondent.

Applying the Heath test, the adjudicator found the applicant failed to prove a complete inability to carry on a normal life, as evidence showed she continued to perform most of her pre-accident caregiving and household activities.

The claim for the rehabilitation benefit was dismissed for lack of evidence that it was reasonable and necessary.

Claims for interest, costs, and a special award were also dismissed.

The applicant sought income replacement benefits and the cost of medical examinations following a motor vehicle accident.

The applicant failed to attend the arbitration hearing.

The arbitrator proceeded in his absence and found that the applicant had returned to full-time employment and earned in excess of the claimed benefit amount.

The arbitrator accepted the insurer's independent medical examination and rejected the applicant's medical reports due to factual errors and omissions.

The application was dismissed, and the applicant was ordered to pay the insurer's legal expenses.