Dr. C.B. Paitich

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to treatment plans for chiropractic services, a chronic pain program, and an orthopaedic assessment outside the Minor Injury Guideline (MIG).

The applicant argued that a concussion, chronic pain syndrome, and psychological impairments warranted removal from the MIG.

The Tribunal preferred the respondent's expert evidence, finding that the applicant's dizziness pre-dated the accident, his pain complaints were likely degenerative, and his psychological testing was normal.

The Tribunal concluded the applicant's injuries were predominantly minor, and since the MIG limit was exhausted, the disputed treatment plans were not payable.

Claims for an award and interest were also 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 suffered from psychological impairments and chronic pain that warranted removal from the MIG.

The Tribunal found the applicant failed to provide compelling evidence of an accident-related psychological impairment or functional impairment resulting from chronic pain.

Consequently, the applicant's injuries were deemed predominantly minor, and she was not entitled to the disputed physiotherapy treatment plan or interest.

The applicant was injured in a head-on motor vehicle collision, sustaining a severe ankle fracture that developed into progressive post-traumatic arthritis.

He sought post-104 income replacement benefits, funding for three treatment plans, and a special award for unreasonable delay.

The Tribunal found that the applicant was not entitled to post-104 income replacement benefits because he had successfully retrained and was working as a real estate agent, failing to meet the "complete inability" test.

However, the Tribunal approved the disputed treatment plans, finding them reasonable and necessary to manage the applicant's chronic pain and progressive arthritis.

Finally, the Tribunal ordered the respondent to pay a special award of $1,211.40 under s. 10 of O. Reg. 664, finding that the respondent's repeated delays in responding to treatment plans and incorrect demands for repayment constituted excessive and imprudent behavior.

The applicant sought a determination of catastrophic impairment and entitlement to attendant care benefits, cost of examinations, interest, and an award following a 2007 motor vehicle accident.

The Licence Appeal Tribunal found the applicant sustained a catastrophic impairment under Criterion 8, specifically a Class 4 Marked impairment in the domain of Activities of Daily Living due to chronic pain and psychological impairments.

The Tribunal awarded attendant care benefits at $507.03 per month for feeding, along with the costs of an occupational therapy situational assessment and an in-home attendant care assessment.

Claims for a triage assessment, an award under Regulation 664, and costs were dismissed.

The applicant sought a determination of catastrophic impairment and entitlement to attendant care benefits and cost of examinations following a 2007 motor vehicle accident.

The Licence Appeal Tribunal found that the applicant sustained a catastrophic impairment under Criterion 8, specifically a Class 4 Marked impairment in the domain of Activities of Daily Living due to chronic pain and psychological impairments.

The Tribunal awarded attendant care benefits at $507.03 per month retroactively to October 2009, along with interest.

The applicant was also awarded the costs of specific occupational therapy and attendant care assessments.

Claims for a triage assessment, a Regulation 664 award, and costs were dismissed.

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

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

The applicant contended that her post-April 2016 impairments, including lower back issues requiring surgery, were caused by the accident and thus her injuries were not predominantly minor.

The Tribunal found that the applicant's later impairments were the result of pre-existing degenerative conditions, not the accident, relying on the uncontroverted opinion of the respondent's orthopedic assessor.

The Tribunal concluded the applicant's injuries were subject to the MIG and dismissed her claims for medical expenses, interest, and a special award.

The Applicant was injured in a motor vehicle rollover accident and applied for a determination of catastrophic impairment.

The Insurer disputed the claim.

At arbitration, multiple medical experts testified regarding the Applicant's physical, mental, and behavioural impairments.

The arbitrator found that the Applicant sustained a Class 4 (marked) impairment in Concentration, Pace and Persistence, and Adaptability, relying on the Applicant's neuropsychologist.

The arbitrator also found that the Applicant would have met the 55% Whole Person Impairment threshold based on a combination of physical and psychological ratings.

The arbitrator concluded that the Applicant sustained a catastrophic impairment within the meaning of the Statutory Accident Benefits Schedule.

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

The Licence Appeal Tribunal found the applicant suffered a complete inability to engage in any employment for which he was reasonably suited, entitling him to a post-104 week income replacement benefit.

The Tribunal also determined the applicant sustained a catastrophic impairment, as his combined physical, neurocognitive, and mental/behavioural impairments met the 55% whole person impairment threshold under the AMA Guides.

However, the applicant's claims for specific medical and rehabilitation benefits were dismissed for lack of evidence proving they were reasonable and necessary.

The applicant was injured in a motor vehicle accident and sought a determination of catastrophic impairment.

The insurer's assessors concluded he did not meet the threshold, and the applicant sought funding for rebuttal reports.

The insurer denied funding, arguing the new SABS eliminated this right and the applicant failed to meet the timelines under the old SABS.

The arbitrator found the applicant was not entitled to substantive interim benefits for the reports under either SABS.

However, applying the 'whole case approach,' the arbitrator awarded $10,500 as an interim expense to fund the rebuttal reports, citing the applicant's financial distress and the need for procedural fairness to answer the insurer's expert reports.

The appellant appealed an arbitrator's decision denying her claims for income replacement benefits, medical and rehabilitation benefits, and housekeeping expenses following a motor vehicle accident.

The Director's Delegate dismissed the appeal, finding that the arbitrator's decision was well-reasoned and supported by the evidence, particularly the DAC reports which contradicted the appellant's expert.

Furthermore, the Director's Delegate ordered the appellant's representative to personally pay the respondent's appeal expenses of $3,000, finding that the representative pursued the appeal to validate an assessment method for his own personal agenda, thereby causing expenses to be incurred unreasonably.

The applicants, Bikram and Amarjit Mann, were injured in a rear-end motor vehicle accident and claimed statutory accident benefits from their insurer, Allstate.

They sought payment for chiropractic, massage, rehabilitation, and acupuncture treatments, as well as the cost of mental health and in-home assessments.

Allstate disputed the claims, relying on insurer examinations and DAC assessments, and sought repayment of benefits paid pending the dispute.

The arbitrator found that a portion of the claimed physical treatments were reasonable and necessary, awarding specific amounts for chiropractic, massage, rehabilitation, and acupuncture sessions.

However, the claims for mental health and in-home assessments were dismissed for want of proof, as the applicants failed to establish the qualifications of the assessor or the breakdown of costs.

The claims for interest and Allstate's claim for repayment were also dismissed.

Each party was ordered to bear its own arbitration expenses.

The applicant was injured in two motor vehicle accidents and claimed caregiver, housekeeping, and medical benefits following the second accident.

The insurer terminated caregiver and housekeeping benefits in December 2000.

The arbitrator found that the applicant was entitled to caregiver and housekeeping benefits up to February 23, 2001, based on DAC assessments indicating she had substantially recovered to her pre-second-accident baseline by that date.

The arbitrator also awarded $600 for a massage therapy treatment plan to address an exacerbation of her fibromyalgia, rejecting the insurer's reliance on an outdated orthopaedic assessment.

The applicant was injured in a motor vehicle accident and sought income replacement benefits, claiming the accident aggravated pre-existing neck, back, and shoulder injuries from a prior accident.

The insurer denied the claim, arguing the applicant's disability stemmed entirely from his pre-existing conditions.

The arbitrator dismissed the claim, finding that the applicant's pre-existing conditions were the principal cause for him leaving his pre-accident job weeks before the subject accident.

The arbitrator concluded that the subject accident did not appreciably change or worsen the applicant's pre-existing disabilities.

The insurer appealed an arbitration decision reinstating the insured's income replacement benefits, arguing the Arbitrator failed to apply the 'crumbling skull' rule to the insured's pre-existing heart condition.

The Director's Delegate dismissed the appeal, finding the Arbitrator correctly applied the 'significant or material contribution' test from Athey v. Leonati.

The Arbitrator's factual finding that the insured's heart condition did not deteriorate significantly after the accident and did not impact his functional ability was supported by the evidence and not reviewable as an error of law.

The applicant was injured in a motor vehicle accident and received income replacement benefits until the insurer terminated them based on a disability assessment.

The applicant sought ongoing benefits, arguing that accident-related headaches, neck, and back pain prevented him from working full-time as a travel agent.

The arbitrator found that the applicant suffered a substantial inability to perform the essential tasks of his pre-accident employment due to chronic pain from soft-tissue injuries and aggravated pre-existing conditions.

The arbitrator ordered the insurer to pay ongoing income replacement benefits but denied the applicant's claim for a special award, finding the insurer's termination of benefits was not unreasonable.