Dennis Polygenis

The applicant sought statutory accident benefits following a 2013 motor vehicle accident.

The respondent brought a preliminary motion to dismiss the application as an abuse of process, arguing the applicant had withdrawn an identical application and refiled it to avoid an evidentiary ruling.

The adjudicator dismissed the motion, finding no legislative restriction on withdrawing and refiling an application before a decision is rendered.

On the substantive issues, the adjudicator denied the applicant's claims for a physiotherapy treatment plan and catastrophic impairment assessments, finding the medical evidence did not support that the treatments and assessments were reasonable and necessary as a result of the accident.

The adjudicator ordered the respondent to refund $1,000 in costs the applicant had paid under a previously cancelled motion order.

The applicant sought income replacement benefits (IRBs) and medical benefits following a motor vehicle accident.

The Licence Appeal Tribunal found that the applicant failed to prove a substantial inability to perform the essential tasks of his employment as an Uber driver, noting he continued to work full-time.

The Tribunal also held that the applicant's injuries were predominantly minor and subject to the Minor Injury Guideline (MIG) limit of $3,500.

The applicant failed to establish that his pre-existing chronic pain or alleged psychological injuries warranted removal from the MIG.

Consequently, the claims for IRBs, disputed treatment plans, and interest 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 Tribunal found that the applicant's injuries were predominantly minor and that he failed to provide compelling medical evidence of a pre-existing condition, psychological impairment, or chronic pain syndrome that would warrant removal from the MIG.

As the remaining MIG limit was insufficient to cover the proposed chronic pain assessment, and the assessment was not reasonable and necessary, the claim was dismissed.

No interest was awarded as no benefits were overdue.

The applicant was involved in a rear-end motor vehicle accident and sought statutory accident benefits, including income replacement benefits and funding for physiotherapy and psychological assessments.

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

The Tribunal found that the applicant failed to provide objective medical evidence that his physical or psychological injuries fell outside the MIG, or that he met the AMA Guides criteria for chronic pain.

The Tribunal also found the applicant did not prove a substantial inability to perform the essential tasks of his pre-accident employment, relying on the clinical notes of his treating physician which lacked mention of accident-related symptoms or inability to work during the disputed period.

The application was dismissed.

The applicant sought various medical and rehabilitation benefits under the Statutory Accident Benefits Schedule following a motor vehicle accident.

The Licence Appeal Tribunal found that the proposed cognitive training was reasonable and necessary based on a functional cognitive assessment.

However, the Tribunal dismissed the claims for a driver reintegration assessment, psychological services, and chiropractic treatment, preferring the respondent's medical evidence that the applicant's psychological and soft tissue injuries had resolved.

The Tribunal awarded interest on the overdue cognitive training benefit but declined to make a special award, finding no egregious conduct by the insurer.

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) and the $3,500 limit had been exhausted.

The applicant argued he should be removed from the MIG due to pre-existing conditions (gout and a plantar spur), chronic pain syndrome, and psychological injuries.

The Tribunal found that the applicant failed to provide compelling medical evidence that his pre-existing conditions prevented maximal recovery within the MIG.

Furthermore, the applicant did not meet the AMA Guides criteria for chronic pain syndrome and lacked a formal psychological diagnosis.

Consequently, the Tribunal held that the applicant's injuries were predominantly minor, the MIG limit was exhausted, and the disputed treatment plans, interest, and an award under Regulation 664 were not payable.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to income replacement benefits (IRBs), psychological treatment, and assessment costs.

The adjudicator found that the applicant suffered soft tissue injuries, fractured ribs, and psychological injuries, but failed to prove a substantial inability to perform the essential tasks of his pre-accident employment after January 21, 2020.

The claims for psychological treatment were dismissed because the treatment plans did not comply with the Schedule, as they listed a psychological associate as the provider while the services were actually provided by an unsupervised psychotherapist.

The adjudicator also found the requested 1.5-hour sessions were not reasonable or necessary compared to the 1-hour sessions recommended by the respondent's assessor.

The applicant was awarded $50.39 for the cost of preparing one treatment plan due to an improper denial, with interest.

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

The respondent insurer denied the claims and sought a preliminary determination on whether an 'accident' occurred and whether the applicant wilfully misrepresented material facts.

The applicant failed to attend the hearing.

Relying on engineering reports and crash data retrieval showing the other vehicle was parked and the applicant's airbags did not deploy, the adjudicator found the collision was a staged accident.

The adjudicator concluded the applicant was not involved in an 'accident' under s. 3(1) of the Schedule, wilfully misrepresented material facts, and ordered the applicant to repay $558.55 in benefits.

The applicant sought an income replacement benefit (IRB) and a medical treatment plan following a 2017 motor vehicle accident.

The insurer paid IRBs until February 2018 based on the applicant's reported income to the CRA, but denied further benefits based on section 44 assessments.

The Tribunal found the insurer correctly calculated the IRB quantum using the CRA reported income, as the Schedule prohibits relying on unreported income.

The Tribunal also found the applicant failed to prove ongoing substantial inability to perform the essential tasks of his pre-accident employment, and failed to prove the treatment plan was reasonable and necessary.

The application was dismissed.

The applicant sought accident benefits following a motor vehicle accident.

The insurer determined the injuries fell within the Minor Injury Guideline (MIG) and terminated income replacement benefits (IRBs).

The Tribunal found that the applicant sustained a psychological injury (anxiety) as a result of the accident, removing him from the MIG.

However, the applicant failed to prove a substantial inability to perform the essential tasks of his pre-accident employment within 104 weeks, or a complete inability to engage in any employment thereafter.

The claim for IRBs and interest was dismissed.

The applicant was injured in a motor vehicle accident and received income replacement benefits until they were terminated by the insurer.

The applicant applied to the Licence Appeal Tribunal for ongoing benefits.

The insurer argued the application was statute-barred, but the Tribunal found it was commenced within the applicable time limits.

On the merits, the Tribunal found the applicant lacked credibility, noting he had returned to work as a superintendent for two different employers without disclosing this to the insurer or his own doctors.

Relying on the insurer's assessors and the applicant's employment records, the Tribunal concluded the applicant did not suffer a substantial inability to perform the essential tasks of his employment and dismissed the application.

The applicant was injured in a motor vehicle accident and sought income replacement benefits (IRBs).

The respondent insurer terminated IRBs after initially paying them, arguing the applicant could return to her pre-accident employment as a furniture salesperson.

The Tribunal found that the applicant's physical impairments, including exacerbated pre-existing degenerative conditions, and psychological impairments rendered her substantially unable to perform the essential tasks of her employment, which included prolonged standing, walking, and lifting furniture.

The Tribunal ordered the respondent to pay the weekly IRB of $336.45 from the date of termination, plus interest.

The applicant sought income replacement benefits (IRBs) following a motor vehicle accident.

The insurer terminated IRBs on April 15, 2014.

The Tribunal first determined that the application was not statute-barred, as the applicant was caught in the transition period between FSCO and the LAT.

On the merits, the Tribunal found the applicant lacked credibility, noting documentary evidence that he had returned to work as a superintendent for two different employers during the period he claimed to be substantially unable to work.

Relying on the insurer's expert assessments and the applicant's employment records, the Tribunal concluded the applicant did not suffer a substantial inability to perform the essential tasks of his employment.

The application was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, disputing the insurer's determination that her injuries fell within the Minor Injury Guideline (MIG).

The Licence Appeal Tribunal found that while the applicant's physical injuries were minor, her psychological impairments, including depression and anxiety, placed her outside the MIG.

The Tribunal denied five treatment plans for facility-based physical rehabilitation, finding the applicant had reached maximal recovery for her physical injuries.

However, the Tribunal approved the cost of a social work assessment up to the $2,000 statutory limit, finding it reasonable and necessary to address her ongoing psychological impairments.

Both parties' requests for costs were denied.