Dr. Charanjit Sandhu

The applicant sought entitlement to various chiropractic and psychological treatment plans following a motor vehicle accident, as well as an award for unreasonable delay.

The Tribunal found all disputed treatment plans to be reasonable and necessary, noting consistent medical reporting and rejecting the insurer's credibility concerns.

The Tribunal also granted an award under s. 10 of Regulation 664, finding the insurer unreasonably withheld benefits, particularly by denying psychological services despite agreement between its own assessor and the applicant's assessor.

The award was set at 10% for psychological services and 5% for chiropractic services.

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 that MRI evidence of a disc herniation warranted the applicant's removal from the MIG.

The Tribunal approved two physiotherapy treatment plans as reasonable and necessary, supported by contemporaneous medical recommendations.

However, other treatment plans for physiotherapy, a psychological assessment, and an orthopaedic assessment were denied due to a lack of supporting evidence or availability through OHIP.

The claim for an award for unreasonable withholding of benefits was dismissed.

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

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

As a preliminary issue, the Tribunal exercised its discretion under s. 55(2) of the Schedule to allow the applicant to proceed with a claim for a psychological assessment despite her failure to attend scheduled insurer's examinations.

On the substantive issues, the Tribunal found that the applicant failed to establish chronic pain with functional impairment or a psychological condition sufficient to remove her from the MIG.

Consequently, the applicant was not entitled to the disputed treatment plans, interest, or an award under s. 10 of Reg. 664.

The application was dismissed.

The applicant sought accident benefits following a motor vehicle accident, claiming entitlement to a non-earner benefit, various treatment plans, and removal from the Minor Injury Guideline (MIG) due to psychological impairment and chronic pain.

The Licence Appeal Tribunal found that the applicant's psychological evidence was unpersuasive as it contradicted the clinical notes of his family doctor, and that his physical injuries were soft tissue in nature, resolving within expected timeframes.

The Tribunal concluded the applicant did not suffer a complete inability to carry on a normal life and remained within the MIG.

All claims for benefits, an award, 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 applicant argued her injuries fell outside the MIG due to chronic pain and psychological impairments.

The Tribunal found that the applicant failed to establish chronic pain with functional impairment or a diagnosed psychological impairment that would warrant removal from the MIG.

The Tribunal preferred the respondent's medical evidence over the applicant's chiropractor's disability certificate.

As the applicant remained within the MIG, the disputed treatment plans beyond the $3,500 limit were not payable.

Claims for an award and interest were also dismissed.

The applicant sought accident benefits following a motor vehicle accident, claiming physical and psychological impairments warranted removal from the Minor Injury Guideline (MIG) and entitlement to income replacement benefits (IRBs).

The Tribunal found the applicant's physical injuries were predominantly minor and gave limited weight to the applicant's psychological assessment due to reliability issues and lack of contemporaneous medical records.

The Tribunal concluded the applicant failed to prove removal from the MIG or a substantial inability to perform the essential tasks of his pre-accident employment as a chef.

The application was dismissed.

The applicant sought $4,093.00 for a physiotherapy treatment plan following a motor vehicle accident.

The respondent denied the plan based on insurer's examinations by a physician and a neurologist, who concluded the treatment was not reasonable and necessary.

The Tribunal found the applicant failed to provide compelling contemporaneous medical evidence to support the plan, noting the family doctor's records did not mention the accident and the chiropractic records lacked follow-up.

The Tribunal accepted the insurer's examinations and dismissed the application, including claims for interest and an award.

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

The applicant claimed entitlement to income replacement benefits (IRBs), various treatment plans, an IRB report, and an award for unreasonable delay.

The Tribunal found that the applicant's physical and psychological injuries were predominantly minor and did not warrant removal from the MIG, dismissing the claims for treatment plans beyond the $3,500 limit.

The Tribunal also dismissed the claim for IRBs, finding insufficient medical evidence to prove a substantial inability to perform essential employment tasks.

However, the Tribunal ordered the respondent to pay $2,034.00 for an IRB report, finding it reasonable and necessary to calculate the quantum of the claimed benefit, along with applicable interest.

The claim for an award was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to treatment plans beyond the $3,500 Minor Injury Guideline (MIG) limit due to post-concussion syndrome and dysthymic mood.

The Tribunal found the applicant failed to establish a causal connection between the accident and the alleged psychological or concussive conditions, noting a lack of pre-accident medical records and a significant gap before symptoms were reported.

Relying on the respondent's section 44 assessment, the Tribunal concluded the applicant sustained predominantly minor injuries.

The application was dismissed, and no further benefits or interest were awarded.

The self-represented applicant sought statutory accident benefits following a July 2021 motor vehicle accident, including income replacement benefits (IRBs), a physiotherapy treatment plan, and medication expenses.

The Licence Appeal Tribunal dismissed the application.

The Tribunal found the applicant was not entitled to pre-104 week IRBs as he continued to work in various roles after the accident and failed to provide medical evidence of a substantial inability to perform his essential tasks.

Consequently, he did not qualify for post-104 week IRBs.

The Tribunal also denied the physiotherapy treatment plan due to a lack of corroborating medical evidence demonstrating it was reasonable and necessary.

Finally, the Tribunal found the claimed medication expenses had already been paid in full by the respondent.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming that his psychological injuries warranted removal from the Minor Injury Guideline (MIG).

The respondent denied the treatment plans, arguing the injuries were predominantly minor.

The adjudicator preferred the respondent's psychological assessment, which found no clinically significant psychological condition, over the applicant's expert, whose diagnoses were not supported by objective psychometric testing.

The adjudicator concluded the applicant's injuries fell within the MIG, dismissing the claims for treatment plans, interest, and an award for unreasonable delay.

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

The applicant claimed physical and psychological impairments warranted removal from the MIG, relying solely on his own testimony.

The Tribunal found the applicant failed to meet his burden of proof, noting the absence of objective medical evidence and the presence of expert reports attributing his impairments to prior workplace injuries and trauma.

The Tribunal concluded the applicant remained within the MIG, denied the disputed treatment plans, and declined to award costs to the respondent.

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

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

The Tribunal found that the applicant's psychological impairments, including anxiety and sleep disturbances, removed her from the MIG.

The Tribunal ordered the insurer to pay for a physiotherapy treatment plan and a psychological assessment, finding both reasonable and necessary.

The applicant's requests for a special award and costs due to the insurer's late disclosure of documents were denied, as the conduct did not meet the high threshold for unreasonableness or bad faith.

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 applicant argued for removal from the MIG based on chronic pain, psychological impairment, and pre-existing conditions (degenerative disc disease, scoliosis, and kyphosis).

The Tribunal found that the applicant failed to prove on a balance of probabilities that he suffered from chronic pain or a psychological impairment caused by the accident.

The Tribunal also found no compelling evidence that his pre-existing conditions prevented his recovery within the MIG limits.

The application for disputed treatment plans and interest was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, arguing his injuries warranted removal from the Minor Injury Guideline (MIG) due to a pre-existing condition, chronic pain, and a psychological condition.

The Tribunal found the applicant failed to provide compelling medical evidence of a pre-existing condition that would preclude recovery within the MIG.

Furthermore, the Tribunal gave little weight to the applicant's psychological assessment and found no evidence of chronic pain with functional impairment.

As the injuries were predominantly minor, the applicant was subject to the MIG limit, and the application for additional treatment plans and interest was dismissed.

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

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

The applicant sought removal from the MIG based on a pre-existing condition and chronic pain.

The Tribunal found the applicant failed to prove her injuries fell outside the MIG, as she did not provide compelling evidence that her pre-existing conditions prevented maximal recovery within the MIG, nor did she establish chronic pain with functional impairment.

As the MIG limit was exhausted, the treatment plans were denied.

Claims for interest and a special award were also dismissed.

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

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

The applicant argued that the respondent's denial notices were deficient under s. 38(8) of the Schedule, rendering the s. 44 assessment reports void and triggering mandatory payment under s. 38(11).

The Tribunal found that while some initial notices were deficient, the applicant was not entitled to the treatment plans because they were not incurred prior to the deficient notice being cured.

The Tribunal rejected the argument that attending an assessment after a deficient notice waives the right to benefits.

The application was dismissed as the applicant failed to prove his injuries warranted removal from the MIG.

The applicant sought statutory accident benefits following a motor vehicle accident, arguing his injuries warranted removal from the Minor Injury Guideline (MIG) due to chronic pain and a pre-existing back condition.

The Tribunal found the applicant failed to establish chronic pain syndrome under the AMA Guides, noting insufficient evidence of medication abuse, excessive dependence on family, or failure to restore pre-injury function.

The Tribunal also found no compelling medical evidence that his pre-existing low back pain precluded recovery within the MIG.

As the injuries were predominantly minor and the MIG limit was exhausted, the claims for additional treatment plans, interest, and a special award were dismissed.

The applicant sought various statutory accident benefits following a motor vehicle accident, including attendant care benefits, assistive devices, chiropractic services, and multiple assessments.

The Tribunal denied the claim for attendant care benefits, finding that the applicant's significant functional limitations were attributable to an intervening stroke rather than the accident.

The Tribunal partially approved the claim for assistive devices and fully approved the claims for chiropractic services, finding them reasonable and necessary for the applicant's accident-related neck and back injuries.

The claims for neurological, orthopaedic, attendant care, and SIE/FAE assessments were denied for lack of supporting medical evidence.

Interest was awarded on overdue payments for incurred assistive devices and chiropractic services.

The applicant was injured in a motor vehicle accident and sought medical benefits from her insurer.

The insurer denied the benefits on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) limit of $3,500.

The arbitrator found that the applicant had a documented pre-existing back injury and psychological issues that prevented her from achieving maximal recovery within the MIG limits.

The arbitrator ordered the insurer to pay the disputed treatment plans and interest, but dismissed the applicant's claim for a special award, finding the insurer's conduct was not sufficiently unreasonable to warrant punitive measures.