Dr. Andrzej Gwardjan

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

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

The applicant argued the respondent's denial notices did not comply with s. 38(8) of the Schedule.

The Tribunal found the applicant failed to provide evidence to warrant removal from the MIG.

While the respondent's initial denial letter was non-compliant with s. 38(8), a subsequent letter relying on an insurer's examination report cured the deficiency.

Because the applicant did not prove the disputed treatment plans were incurred during the period of non-compliance, they were not payable.

The application was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming his injuries—including a concussion, chronic pain, and a psychological condition—warranted removal from the Minor Injury Guideline (MIG).

The Licence Appeal Tribunal found that the applicant failed to prove on a balance of probabilities that he sustained injuries falling outside the MIG.

The Tribunal preferred the respondent's expert medical evidence, which concluded the applicant suffered only minor injuries such as whiplash and a sprained shoulder.

Consequently, the applicant remained subject to the $3,500 MIG limit, and his claims for additional treatment plans, interest, and a special award were dismissed.

The applicant was injured in a motor vehicle accident and sought payment for four treatment plans for chiropractic and physiotherapy services under the Statutory Accident Benefits Schedule.

The respondent insurer denied the plans, arguing the applicant's physical injuries fell under the Minor Injury Guideline and relying on an insurer's examination report.

The Tribunal found that the applicant had been removed from the Minor Injury Guideline for psychological injuries, which did not preclude treatment for physical injuries.

Relying on clinical notes and records that consistently documented the applicant's ongoing neck, back, and shoulder pain, the Tribunal concluded all four treatment plans were reasonable and necessary.

The applicant was awarded the cost of the treatment plans plus interest.

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

The Tribunal found the applicant's injuries warranted removal from the Minor Injury Guideline (MIG) due to chronic back and neck pain.

The applicant was awarded funding for two physiotherapy treatment plans because the insurer's denial notices failed to comply with the procedural requirements of s. 38(8) of the Schedule.

However, a third physiotherapy plan was denied as not reasonable and necessary.

The Tribunal also dismissed the claim for non-earner benefits, finding the applicant failed to demonstrate a complete inability to carry on a normal life, and declined to order an award for unreasonable delay.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including income replacement benefits (IRB), attendant care benefits (ACB), and various treatment plans.

The Licence Appeal Tribunal found the applicant was entitled to an IRB for the pre-104 week period, as his accident-related low back pain caused a substantial inability to perform the essential tasks of his employment as an electrician.

However, the Tribunal denied the post-104 week IRB, finding the applicant failed to prove a complete inability to perform less physically demanding work for which he was reasonably suited.

The claim for ACB was dismissed because the applicant provided no evidence that the services were incurred.

The Tribunal approved treatment plans for an in-home attendant care assessment and physical therapy, but denied plans for an occupational therapy assessment and vestibular physiotherapy due to a lack of evidence connecting the symptoms to the accident.

The applicant was awarded interest on overdue benefits but denied a special award.

The applicant sought entitlement to statutory accident benefits for physiotherapy services following a 2018 motor vehicle accident.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to prove the proposed treatment plans were reasonable and necessary.

The Tribunal preferred the evidence of the respondent's insurer's examination assessors, who concluded that further facility-based physical treatment was unlikely to provide any additional therapeutic benefit for the applicant's left elbow injury and chronic pain.

As no benefits were payable, claims for interest and a section 10 award were also dismissed.

The applicant sought statutory accident benefits for physiotherapy and ambulance services following a motor vehicle accident.

The respondent denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) and that the ambulance fee had not been submitted to the applicant's extended health care provider.

The Tribunal found that the applicant failed to demonstrate the physiotherapy treatments were reasonable and necessary, accepting the respondent's physiatrist report that the injuries were minor.

The Tribunal also denied the ambulance fee because the applicant did not prove it was submitted to his collateral benefits provider.

The application was dismissed.

The applicant was struck by a vehicle as a pedestrian, sustaining a fractured toe.

He sought statutory accident benefits for psychological treatment, orthotics, a chronic pain assessment, and a physiatry assessment.

The insurer denied the treatment plans.

The Tribunal found the orthotics and physiatry assessment to be reasonable and necessary, noting the applicant's ongoing altered gait and need for custom footwear.

The claims for psychological treatment and a chronic pain assessment were dismissed due to insufficient evidence and the applicant's disinterest in further psychological care.

The Tribunal also found the insurer's initial denial notices for two plans were deficient under s. 38(8) of the Schedule, making the insurer liable for services incurred during the period of deficiency, but declined to order an award under s. 10 of O. Reg. 664.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for chiropractic services and a neurological assessment, which the insurer denied.

The Licence Appeal Tribunal found that the applicant's pre-existing fibromyalgia was exacerbated by the accident, making the chiropractic treatment plan reasonable and necessary for pain management.

However, the Tribunal denied the neurological assessment, relying on an insurer's examination and the applicant's own treating neurologists who found no neurological structural disease.

The applicant was awarded the cost of the chiropractic services and interest.

The applicant sought accident benefits following a motor vehicle accident.

The insurer determined the injuries fell within the Minor Injury Guideline (MIG) and terminated income replacement benefits (IRBs).

The Tribunal found that the applicant sustained a psychological injury (anxiety) as a result of the accident, removing him from the MIG.

However, the applicant failed to prove a substantial inability to perform the essential tasks of his pre-accident employment within 104 weeks, or a complete inability to engage in any employment thereafter.

The claim for IRBs and interest was dismissed.