9 total
Applicant's injuries deemed minor and subject to MIG limits; claims for chronic pain and psychological impairment dismissed.
The applicant sought statutory accident benefits following a motor vehicle accident.
The respondent denied various treatment and assessment plans on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).
The applicant argued that he should be removed from the MIG due to a psychological impairment (Generalized Anxiety Disorder) and chronic pain with central sensitization.
The Tribunal found that the applicant failed to establish a psychological impairment, noting that his family doctor consistently recorded his mental health as stable and he did not attend referred group counselling.
The Tribunal also rejected the chronic pain claim, finding that the applicant did not meet the AMA Guides criteria for chronic pain syndrome and that surveillance evidence showed him performing physical activities inconsistent with functional impairment.
As the injuries were deemed predominantly minor and the MIG limit was exhausted, the disputed treatment plans and interest were denied.
Insurer liable for treatment plans beyond MIG limits due to defective denial notices.
The respondent denied several treatment plans on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and the limits were exhausted.
The Tribunal found that the applicant failed to prove his injuries fell outside the MIG, as he did not provide compelling medical evidence of a pre-existing condition or a psychological impairment.
However, the Tribunal found that the respondent failed to provide compliant notices under s. 38(8) of the Schedule for several of the denied treatment plans.
As a result, the respondent was ordered to pay for the treatment plans incurred after the 11th business day following their submission, up until compliant notices were issued, along with applicable interest.
Tribunal denies physiotherapy plan but partially approves psychological treatment plans for accident benefits.
The applicant was injured in a motor vehicle accident and sought statutory accident benefits for physiotherapy and psychological services.
The respondent denied the treatment plans, and the applicant applied to the Licence Appeal Tribunal.
The Tribunal found that the applicant failed to prove the physiotherapy plan was reasonable and necessary, as the medical evidence did not corroborate the need for the proposed treatments and the applicant had reported physiotherapy made her worse.
However, the Tribunal partially approved the psychological treatment plans, finding the requested time for mental health testing and completing the OCF-18 form to be reasonable, while reducing the time claimed for session preparation and notetaking.
The applicant was awarded $274.81 for psychological services plus interest.
Reconsideration dismissed; no error of law in Tribunal's weighing of expert evidence regarding Minor Injury Guideline.
The applicant requested a reconsideration of a Licence Appeal Tribunal decision which found her injuries fell within the Minor Injury Guideline (MIG) and denied a treatment plan for a chronic pain assessment.
The applicant argued the Tribunal erred in law by improperly weighing the expert evidence and failing to qualify her expert.
The adjudicator dismissed the reconsideration request, finding no error of law.
The original decision appropriately gave less weight to the applicant's expert report because it lacked an Acknowledgement of Expert's Duty form and the chronic pain diagnosis was unsupported by other medical evidence.
Application for accident benefits dismissed; injuries found to fall within the Minor Injury Guideline.
The applicant sought statutory accident benefits following a motor vehicle accident, claiming her injuries warranted removal from the Minor Injury Guideline (MIG) due to pre-existing conditions, chronic pain, and psychological impairment.
The Licence Appeal Tribunal found the applicant's injuries were predominantly minor and treatable within the MIG, noting a lack of compelling medical evidence to support chronic pain or a psychological impairment caused by the accident.
The application for a chronic pain assessment, an award for unreasonable delay, and interest was dismissed.
The respondent's request for costs was also denied.
Application for accident benefits dismissed; injuries found to be minor and non-earner test not met.
The respondent denied certain benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).
The Tribunal found that the applicant's physical and psychological injuries were predominantly minor, preferring the evidence of the respondent's independent medical examiners over the applicant's assessors.
The Tribunal also dismissed the claim for non-earner benefits, finding the applicant failed to establish a complete inability to carry on a normal life, as his pain was manageable and did not practically prevent him from engaging in his pre-accident activities.
The application was dismissed.
Psychological injury removes applicant from Minor Injury Guideline; insurer penalized for unreasonably withholding psychological benefits.
The applicant sought statutory accident benefits following a rear-end motor vehicle collision.
The respondent insurer denied several treatment plans on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).
The Tribunal found that the applicant's diagnosed psychological injury (Adjustment Disorder) removed them from the MIG, despite the applicant's reported disinterest in psychological treatment.
While the Tribunal approved the psychological assessment and treatment plans, it denied the physiotherapy, assistive devices, and chronic pain plans, finding them not reasonable and necessary based on the medical evidence.
The Tribunal also ordered the respondent to pay an award of $1,110.95 under O. Reg. 664 for unreasonably withholding the psychological benefits by misinterpreting the Schedule.
Costs fixed at $170,000 for fees and $98,800 for disbursements following a pre-trial settlement.
The parties settled a personal injury action arising from a motor vehicle accident six days before trial for $775,000 plus costs.
The plaintiff sought partial and substantial indemnity costs totalling approximately $246,000 in fees and $157,500 in disbursements.
The defendant argued the amounts were excessive.
The court reviewed the claimed fees and disbursements, noting some duplication and excessive preparation time.
Applying the principle of reasonableness, the court fixed the plaintiff's fees at $170,000 plus HST and disbursements at $98,800 inclusive of HST.
Dangerous offender appeal dismissed; appellant's affidavit found not credible and expert bias claim rejected.
The appellant appealed his conviction and sentence, including a dangerous offender finding.
He alleged bias regarding the appointed expert and relied on his own affidavit.
The Court of Appeal found the appellant's affidavit not credible and concluded that trial counsel's agreement to the expert's appointment was justified.
The appeal was dismissed, and the conviction appeal was dismissed as abandoned.