Dr. Behzad Mansouri

The applicant requested reconsideration of a Licence Appeal Tribunal decision that denied several treatment plans following a motor vehicle accident.

The Vice-Chair granted the reconsideration in part, finding a material breach of procedural fairness regarding the assistive devices treatment plan because the original decision failed to adequately address the applicant's argument that the insurer's denial notice violated s. 38(8) of the Schedule.

The Vice-Chair varied the decision to find the denial non-compliant, entitling the applicant to payment of the assistive devices plan.

The requests for reconsideration regarding the neuro-ocular therapy and chronic pain assessment treatment plans were dismissed.

The applicant sought entitlement to various statutory accident benefits following a motor vehicle accident, including multiple treatment plans and attendant care benefits.

The Tribunal found that the applicant failed to meet her onus to prove that the majority of the treatment plans and the attendant care benefits were reasonable and necessary.

However, the Tribunal ordered the respondent to pay $2,013.20 for occupational services because the respondent's denial notice failed to provide sufficient medical reasons as required by section 38(8) of the Schedule.

Claims for a section 10 award and the cost of an OCF-3 were dismissed.

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

The respondent denied the benefits, arguing 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, a concussion, and psychological impairments.

The Tribunal found insufficient medical evidence to establish that the applicant suffered from accident-related chronic pain resulting in functional impairment, a concussion, or a psychological impairment.

The Tribunal concluded the applicant's injuries were predominantly minor and subject to the $3,500 MIG limit.

As the applicant remained in the MIG and had exhausted most of the limit, the disputed treatment plans were not reasonable and necessary.

The Tribunal also denied the claim for incurred expenses because the applicant failed to submit treatment plans prior to incurring them, as required by section 38(2) of the Schedule.

The application was dismissed.