Dr. Arnold Rubenstein

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

The Licence Appeal Tribunal reviewed multiple treatment plans for physical and psychological therapies, attendant care assessments, and assistive devices.

The Tribunal found the applicant was entitled to partial payment for several treatment plans, including massage, acupuncture, physiotherapy, and psychological treatment, as well as attendant care assessments.

The Tribunal also awarded a $450 special award under s. 10 of O. Reg. 664, finding the insurer unreasonably denied the psychological components of a treatment plan without addressing them in its denial or submissions.

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

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

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

The Tribunal found the applicant's evidence of chronic pain and psychological impairment to be inconsistent, heavily reliant on self-reporting, and contradicted by independent medical examinations showing symptom amplification.

The Tribunal concluded the injuries were predominantly minor, and since the $3,500 MIG limit was exhausted, the disputed treatment plans and expenses were not payable.

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

The respondent denied several treatment plans 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 applicant argued she suffered from chronic pain and psychological impairments warranting removal from the MIG.

The Tribunal found the applicant failed to provide sufficient medical evidence to establish a chronic pain condition or psychological impairment, preferring the respondent's expert medical reports.

As the injuries were predominantly minor and the MIG limit was exhausted, the disputed treatment plans were not payable and the application was dismissed.

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

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

The applicant argued she had a pre-existing back condition, a psychological impairment, and chronic pain that removed her from the MIG.

The Tribunal found insufficient evidence of a pre-existing condition that prevented maximal recovery, and preferred the respondent's psychological assessments showing symptom amplification over the applicant's evidence.

The Tribunal concluded the injuries were predominantly minor, the disputed treatment plans were not payable, and no interest was owed.

The application was dismissed.

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

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

The applicant contended that she suffered from accident-related psychological impairments and chronic pain, warranting removal from the MIG.

The Tribunal found that the applicant failed to prove on a balance of probabilities that she suffered from a psychological impairment or chronic pain with functional impairment that would remove her from the MIG.

As the disputed treatment plans were submitted on the basis that the injuries were outside the MIG, they were not payable.

The application was dismissed.

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

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

The Tribunal found that the applicant failed to prove she sustained a psychological impairment warranting removal from the MIG.

However, the Tribunal held that the insurer's denial notices failed to provide sufficient medical reasons as required by sections 38(8) and 36(4) of the Schedule.

Consequently, the insurer was prohibited from relying on the MIG for the disputed treatment plans, and the treatment plans and non-earner benefits were payable due to the insurer's procedural non-compliance.

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

The insurer denied income replacement benefits (IRBs) and medical benefits, arguing the applicant was not employed at the time of the accident and her injuries fell within the Minor Injury Guideline (MIG).

The Licence Appeal Tribunal found the applicant failed to prove she was employed pre-accident, dismissing the IRB claim.

However, the Tribunal determined the applicant sustained a concussion, removing her from the MIG.

The Tribunal denied a chiropractic treatment plan as not reasonable and necessary, but approved a psychological assessment treatment plan, reducing the hourly rate to comply with FSCO Guidelines, and awarded $1,847.46 plus interest.

The applicant sought statutory accident 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 Licence Appeal Tribunal found that the applicant failed to meet the burden of proving that his physical or psychological injuries fell outside the MIG.

The Tribunal preferred the evidence of the respondent's psychological assessor and the applicant's treating family physician over the applicant's psychological expert.

As the injuries were predominantly minor, the application for disputed treatment plans, interest, and a special award was dismissed.

The applicant was involved in a motor vehicle accident and sought medical benefits for physiotherapy, massage therapy, and a psychological assessment.

The respondent denied the benefits on the basis that the applicant's injuries fell within the Minor Injury Guideline and the $3,500 limit had been reached.

The Tribunal found that the applicant's injuries were predominantly minor and that she failed to establish a pre-existing medical condition that would prevent maximal recovery under the Guideline.

The application for benefits and an award for unreasonable delay was dismissed.

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

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

The Tribunal found that the applicant's physical and psychological injuries, including soft tissue injuries, were predominantly minor and did not remove her from the MIG.

The Tribunal also rejected the applicant's claim of chronic pain syndrome, noting a lack of supporting medical evidence and functional impairment.

As the injuries fell within the MIG, the treatment plans were not payable and the application was dismissed.

The applicant was injured in a motor vehicle accident and received income replacement benefits until the insurer terminated them at the two-year mark.

The applicant brought a motion for interim benefits pending arbitration.

The arbitrator found that the applicant had demonstrated a strong case for ongoing entitlement and severe financial hardship.

The arbitrator also excluded video surveillance evidence proffered by the insurer due to late and incomplete disclosure under Rule 40 of the Dispute Resolution Practice Code.

The motion for interim benefits was granted.