Dr. Davar Nikneshan

The applicant sought various medical and rehabilitation benefits, out-of-pocket expenses, interest, and an award following a motor vehicle accident.

The Tribunal found the applicant partially entitled to the balance of three treatment plans for chiropractic and massage therapy services, plus interest, as the medical evidence supported ongoing physical complaints and the need for treatment.

However, the Tribunal denied the claims for psychological assessments and services, orthopaedic shoes, and out-of-pocket expenses due to a lack of supporting evidence and failure to establish statutory entitlement.

The claim for an award under s. 10 of Reg. 664 was also dismissed as the applicant made no submissions on the issue.

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

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

The Tribunal found the applicant demonstrated a chronic pain condition with functional impairment, satisfying the AMA Guides criteria, and removed him from the MIG.

The Tribunal approved the disputed treatment plans for chiropractic services, psychological services, and various assessments, finding them reasonable and necessary based on the treating practitioners' records and s. 25 assessments.

The claim for a special award under s. 10 of Reg. 664 was dismissed, as the respondent reasonably relied on its expert reports.

The applicant sought statutory accident benefits following a motor vehicle accident in August 2022, claiming entitlement to a non-earner benefit and two physiotherapy treatment plans.

The respondent denied the benefits, arguing the applicant's impairments stemmed from a prior 2019 accident and that he did not suffer a complete inability to carry on a normal life.

The Tribunal found the applicant's evidence highly inconsistent regarding his pre- and post-accident functioning and employment status.

Relying on the consistent evidence of the respondent's assessors and the applicant's own treating records, the Tribunal concluded the applicant failed to prove his entitlement to the non-earner benefit or the treatment plans.

The application was dismissed, and the respondent's request for costs due to late service of documents was also denied.

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

The respondent denied benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) and sought repayment of $4,000 in Income Replacement Benefits (IRBs) alleging wilful misrepresentation of employment status.

The Tribunal found the applicant was removed from the MIG because medical evidence established he suffered a concussion.

The Tribunal dismissed the respondent's claim for IRB repayment, finding insufficient evidence that the applicant was working during the specific period the benefits were paid.

The applicant was awarded treatment plans for occupational therapy and psychological assessments, as they were deemed reasonable and necessary.

The claim for a special award under s. 10 of Regulation 664 was dismissed, as the respondent's reliance on its assessors was not unreasonable.

The applicant sought a determination of catastrophic impairment and entitlement to attendant care benefits and income replacement benefits following a motor vehicle accident.

The Licence Appeal Tribunal found that the applicant did not meet the criteria for catastrophic impairment under either Criterion 7 (55% whole person impairment) or Criterion 8 (mental and behavioural disorders).

The Tribunal preferred the evidence of the respondent's experts, noting significant validity concerns and sub-maximal effort during the applicant's assessments.

Consequently, the applicant was not entitled to enhanced attendant care benefits, having exhausted her non-catastrophic limits.

The Tribunal also dismissed the claim for income replacement benefits, finding the applicant failed to prove a substantial inability to perform the essential tasks of her pre-accident employment as a personal support worker.

The applicant sought statutory accident benefits following a motor vehicle accident, disputing the respondent's denial of multiple treatment and assessment plans, medication expenses, and parking costs.

The Tribunal found that the applicant failed to prove on a balance of probabilities that the proposed in-home, attendant care, neurological, concussion, chiropractic, physiotherapy, and psychological plans were reasonable and necessary, preferring the objective findings of the respondent's assessors over the subjective reporting relied upon by the applicant's assessors.

The Tribunal awarded the cost of one prescription medication and interest on overdue payments, but denied the remaining expenses and the claim for a special award under s. 10 of Reg. 664.

The applicant was injured in a bicycle/motor vehicle collision and sought attendant care benefits and an award for unreasonably delayed treatment plans.

The Tribunal found the applicant was not entitled to attendant care benefits as she had regained independence in her activities of daily living.

However, the Tribunal found the insurer unreasonably delayed approving four treatment plans by keeping the applicant in the Minor Injury Guideline despite receiving a neurologist's report diagnosing a concussion.

The Tribunal awarded 25% of the value of the delayed plans ($2,657.54) plus interest.

The applicant was involved in a motor vehicle accident and sought statutory accident benefits, including a non-earner benefit, attendant care benefits, medical and rehabilitation benefits, and an award for unreasonably withheld payments.

The respondent insurer denied the benefits.

The Tribunal found that the applicant did not suffer a complete inability to carry on a normal life, as the evidence showed he was largely independent with self-care and his pre-accident functional status was already limited by prior injuries.

The Tribunal denied the claims for a non-earner benefit, attendant care, physiotherapy, and a functional abilities evaluation, preferring the evidence of the respondent's assessors.

However, the Tribunal awarded $555.28 for specific assistive devices (long-handled cleaning tools, handheld showerhead, heating pad) and the cost of the treatment plan, along with interest on overdue payments.

The request for an award under s. 10 of O. Reg. 664 was dismissed.