Dr. Dima Rozen

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

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

The Tribunal found that the applicant's injuries were not predominantly minor, as medical evidence established he suffered from chronic pain with functional impairment.

The Tribunal approved a treatment plan for psychological services, finding it reasonable and necessary to address the applicant's ongoing psychological symptoms.

However, the Tribunal denied treatment plans for a chronic pain assessment and a psychological assessment, concluding that their stated goals were therapeutic rather than diagnostic.

The applicant was awarded interest on overdue benefits.

The applicant sought entitlement to statutory accident benefits for chiropractic services and an orthopaedic assessment following a 2018 motor vehicle accident.

The respondent denied the treatment plans, arguing the applicant's shoulder impairment was not caused by the accident.

The Tribunal found that the applicant's shoulder instability emerged three years post-accident and was caused by an intervening event at home.

Relying on the insurer's examination and clinical notes, the Tribunal concluded the treatment plans were not reasonable and necessary.

The application was dismissed.

The applicant sought payment for six treatment plans (OCF-18s) for chiropractic, massage, and physiotherapy following a 2018 motor vehicle accident.

The respondent insurer denied the benefits.

The Licence Appeal Tribunal dismissed the application, finding the applicant failed to prove the treatments were reasonable and necessary.

The Tribunal concluded the applicant's lower back pain was caused by age-related degenerative changes rather than the accident, and that the proposed treatments could not reasonably achieve the goal of pain reduction for his shoulder, neck, and head injuries.

Claims for interest and costs were also dismissed.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for a chronic pain assessment, chronic pain treatment, and transportation expenses.

The respondent insurer denied the treatment plans.

The Licence Appeal Tribunal found the chronic pain assessment and treatment plans were reasonable and necessary, preferring the evidence of the applicant's assessor over the insurer's assessor, who failed to review the applicant's clinical notes and records.

The Tribunal ordered the respondent to pay for the assessment and treatment plans, plus interest.

The claim for transportation expenses was dismissed for lack of supporting evidence.

The applicant sought entitlement to statutory accident benefits following a motor vehicle accident, specifically claiming costs for a chronic pain assessment and a chronic pain program.

The Tribunal found that the treatment plans were not reasonable and necessary, preferring the recent insurer's examination report over the applicant's older medical report.

The Tribunal noted the applicant was fully functional, working full-time, and had not utilized previously approved treatment.

The application was dismissed, and claims for interest and a special award were denied.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to medical benefits and examination costs for psychological, neurological, and chronic pain assessments.

The respondent denied the claims on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and raised causation issues, attributing her symptoms to a pre-existing multiple sclerosis (MS) condition.

The Tribunal found that the applicant's physical and psychological complaints were largely attributable to her pre-existing MS, which was not aggravated by the accident.

The Tribunal concluded that the applicant failed to establish a psychological impairment, concussion, or chronic pain that would warrant removal from the MIG.

Consequently, the disputed treatment plans were deemed not reasonable and necessary, and the application was dismissed.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that found his accident-related injuries fell within the Minor Injury Guideline (MIG).

The applicant argued the Tribunal erred in its application of the pre-existing condition test, its assessment of his degenerative changes, its weighing of a chronic pain assessment, and by failing to mention certain clinical records.

The Vice-Chair dismissed the reconsideration request, finding no errors of law, fact, or procedural fairness.

The Tribunal correctly concluded that the applicant failed to provide compelling medical evidence that his pre-existing conditions would prevent maximal recovery within the MIG limit, and properly weighed the medical evidence before it.

The applicant sought medical benefits for injuries sustained in a motor vehicle accident.

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

The applicant argued he suffered from chronic pain and had pre-existing conditions that justified removal from the MIG.

The Tribunal found the medical evidence established only minor, soft tissue injuries.

The Tribunal rejected the applicant's chronic pain assessment as it was conducted virtually and unsupported by objective evidence.

The applicant also failed to provide compelling evidence that his pre-existing conditions would prevent his recovery within the MIG.

The application was dismissed.

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

The respondent insurer denied the claims, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) and were subject to the $3,500 limit.

The applicant argued for removal from the MIG based on a pre-existing knee condition, chronic pain, and psychological impairments.

The Tribunal found insufficient evidence that the pre-existing condition would prevent maximal recovery.

Relying on the respondent's independent medical examinations, the Tribunal concluded the applicant did not suffer from chronic pain or a psychological impairment caused by the accident.

The injuries were deemed predominantly minor, and the claims for chiropractic services were denied.

The applicant sought statutory accident benefits for chiropractic treatment and a chronic pain assessment following a motor vehicle accident.

The respondent denied the benefits, arguing the injuries fell within the Minor Injury Guideline and that a subsequent accident caused the chronic pain.

The Tribunal dismissed the application, finding one treatment plan was statute-barred as it was appealed beyond the two-year limitation period without justification for an extension.

The Tribunal further held the remaining chiropractic plans were not reasonable and necessary, as previous similar treatments had been ineffective and the applicant failed to prove his impairments extended beyond minor soft tissue injuries.

Finally, the request for a chronic pain assessment was denied because the applicant failed to establish causation linking the chronic pain to the first accident rather than the second.

The applicant was injured in a motor vehicle accident and sought medical benefits for chiropractic treatment under the Statutory Accident Benefits Schedule.

The respondent insurer initially denied the benefits under the Minor Injury Guideline, but later conceded the applicant's injuries were non-minor based on a psychological assessment.

The applicant argued that pre-existing lower back pain and chronic pain syndrome necessitated further chiropractic care.

The adjudicator found that the applicant failed to provide objective medical evidence to support the treatment plans, noting that her own treating physicians recommended physiotherapy rather than chiropractic treatment.

The application for medical benefits, interest, and costs was dismissed.