Dr. Ahmad Belfon

The applicant sought medical benefits for chiropractic and physiotherapy treatment plans following a motor vehicle accident.

The applicant argued the insurer failed to provide proper notice of denial under s. 38(8) of the Statutory Accident Benefits Schedule.

The Tribunal found the insurer's denials were timely and contained sufficient medical reasons.

On the merits, the Tribunal held the applicant failed to meet his evidentiary burden to establish the treatment plans were reasonable and necessary, noting a lack of medical evidence and a failure to account for a post-accident shoulder fracture.

The claims for benefits, an award, and costs were dismissed.

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

The respondent denied chiropractic treatment, a psychological assessment, and a chronic pain assessment on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant suffered from meralgia paresthetica and chronic pain as a result of the accident, removing him from the MIG.

In an addendum decision, the Tribunal found the chiropractic treatment and chronic pain assessment to be reasonable and necessary, subject to the $2,000 cap for assessments.

The psychological assessment was denied as not reasonable and necessary.

The applicant was awarded interest on overdue payments but denied an award under O. Reg. 664.

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

The respondent denied the benefits on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant suffered from meralgia paresthetica and chronic pain as a result of the accident, which removed him from the MIG.

However, the Tribunal concluded that the applicant did not suffer a psychological impairment.

Because the applicant failed to submit the disputed treatment plans (OCF-18s) into evidence, the Tribunal could not determine whether the claimed medical benefits and examination costs were reasonable and necessary, and allowed the applicant 30 days to submit them.

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

The insurer denied treatment plans for a psychological assessment and chiropractic services, arguing the appellant's injuries fell within the Minor Injury Guideline (MIG).

The Licence Appeal Tribunal found that the appellant sustained predominantly minor injuries and failed to prove that she suffered from chronic pain that would take her out of the MIG.

The Tribunal further held that the disputed treatment plans were not reasonable and necessary, relying on insurer examinations that found no psychological diagnosis and no need for further facilities-based treatment.

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 Licence Appeal Tribunal found that the applicant failed to prove her injuries were more than soft tissue in nature or that she had a pre-existing condition warranting removal from the MIG.

The Tribunal preferred the respondent's psychological assessment, which found no psychological impairment, over the applicant's evidence.

The application for benefits was dismissed.

The applicant sought a non-earner benefit and a rehabilitation benefit following a motor vehicle accident.

The adjudicator excluded late-filed medical reports submitted by the applicant in reply, finding their admission would prejudice the respondent.

Applying the Heath test, the adjudicator found the applicant failed to prove a complete inability to carry on a normal life, as evidence showed she continued to perform most of her pre-accident caregiving and household activities.

The claim for the rehabilitation benefit was dismissed for lack of evidence that it was reasonable and necessary.

Claims for interest, costs, and a special award were also dismissed.