Dr. Deborah Rabinovitch

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 applicant argued for removal from the MIG due to chronic pain, a pre-existing rotoscoliosis condition, concussion symptoms, and psychological impairment.

The Tribunal found that the applicant failed to provide compelling medical evidence to establish any of these conditions warranted removal from the MIG.

As the applicant remained within the MIG, the disputed treatment plans were not assessed, and the application was dismissed.

The applicant and the respondent insurer, Aviva, both requested reconsideration of a Licence Appeal Tribunal decision regarding statutory accident benefits.

The applicant alleged procedural fairness breaches and errors of law regarding the denial of attendant care benefits and the reliance on an untested expert report.

The Tribunal dismissed the applicant's request, finding no procedural unfairness as the applicant had not properly summonsed the expert, and no error in the adjudicator's requirement for detailed invoices to prove expenses were incurred.

Aviva's request for reconsideration was granted in part to correct a mathematical error in the calculation of a bad faith award, reducing the quantum to $7,263.45.

The applicant's request for costs was denied.

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

The Licence Appeal Tribunal considered entitlement to multiple treatment plans for psychological, optometric, dietary, and physical rehabilitation services.

The Tribunal granted the plans for optometric services and a dietary assessment, finding them reasonable and necessary based on the medical evidence and the applicant's positive response to vision therapy.

The Tribunal denied the remaining plans, including psychological and physical therapy, finding that the applicant either failed to prove they were reasonable and necessary, failed to exhaust collateral benefits, or incurred expenses prior to submitting a plan.

The claim for a special award was dismissed, but interest was awarded on overdue benefits.

The applicant sought statutory accident benefits following a motor vehicle accident, including a non-earner benefit and funding for various treatment plans.

The Licence Appeal Tribunal found that the applicant was not entitled to the non-earner benefit because he failed to prove a complete inability to carry on a normal life.

However, the Tribunal approved treatment plans for occupational therapy services, an occupational therapy assessment, and psychological assessments, finding them reasonable and necessary due to the applicant's accident-related psychological impairments.

A claim for physiotherapy services was denied as the applicant had reached maximum therapeutic benefit.

The Tribunal also awarded interest on the overdue payments but declined to order a special award under s. 10 of Reg. 664.

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 failed to prove a psychological impairment warranting removal from the MIG, preferring the respondent's psychological assessment over the applicant's pre-screening report.

The Tribunal also dismissed the claim for an income replacement benefit because the applicant failed to identify the essential tasks of his employment.

As the MIG limits were exhausted, the claims for treatment plans and expenses were dismissed.

The applicant sought various statutory accident benefits following a November 2019 motor vehicle accident.

The Tribunal found the applicant was statute-barred from proceeding with a claim for an orthopaedic assessment due to her failure to attend a scheduled insurer's examination without a reasonable explanation.

Regarding the substantive claims, the Tribunal denied the majority of the disputed treatment plans for chiropractic services, massage therapy, and assistive devices, finding the applicant failed to prove they were reasonable and necessary on a balance of probabilities.

The Tribunal awarded $200 for documentation support activity with interest, but denied the claim for a section 10 award.

The applicant sought $1,710 for chiropractic services following a 2019 motor vehicle accident.

The respondent denied the treatment plan based on a section 44 physiatry assessment.

The Tribunal found that the applicant failed to prove the treatment was reasonable and necessary, as the supporting medical evidence predated the treatment plan by over a year and the contemporaneous section 44 assessment concluded the applicant had reached maximum medical improvement.

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

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

The applicant relied exclusively on procedural arguments, claiming the respondent failed to comply with notice provisions under the Schedule.

The Tribunal found the applicant remained in the Minor Injury Guideline and was not entitled to the disputed treatment plan, as he failed to lead substantive evidence and the respondent's notices regarding the treatment plan were compliant.

However, the Tribunal found the respondent's notice requiring an insurer's examination for the non-earner benefit was deficient under section 44(5) of the Schedule.

Consequently, the respondent was ordered to pay the non-earner benefit pursuant to section 36(6).

The claim for an award was dismissed.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that denied her entitlement to six physiotherapy treatment plans and an occupational therapy assessment.

The applicant argued the adjudicator made errors of fact and law in weighing the medical evidence and in finding that section 38(8) of the Schedule did not apply because an OCF-1 was not in evidence.

The Tribunal dismissed the request, finding that the applicant was attempting to re-litigate the case and introduce new evidence without explaining why it was not previously available.

The Tribunal concluded there were no errors of fact or law in the original decision's weighing of the medical reports or its findings on the treatment plans.

The applicant sought various statutory accident benefits following a motor vehicle accident, including six treatment plans for physiotherapy, an orthopaedic assessment, an occupational therapy assessment, and a psychological assessment.

The Tribunal found that the insurer's denials complied with the medical reasons requirement under s. 38(8) of the Schedule.

On the merits, the Tribunal dismissed the claims for physiotherapy, finding that the applicant's pain was attributable to a somatic symptom disorder rather than a physical impairment, and physiotherapy was not a reasonable treatment for a psychological condition.

The occupational therapy assessment was also denied for lack of evidence linking it to attendant care needs.

However, the Tribunal granted the orthopaedic assessment, as it was reasonable for the applicant to investigate her pain prior to her psychological diagnosis, and the psychological assessment, as it was necessary and not duplicative.

Claims for an award were dismissed, but interest was awarded on the approved plans.

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

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

The Tribunal found that the applicant's right shoulder pain had developed into a chronic pain condition, satisfying three criteria under the AMA Guides, thereby warranting removal from the MIG.

The Tribunal approved treatment plans for a psychological assessment and for massage and chiropractic services, finding them reasonable and necessary.

However, a proposed chronic pain assessment was denied as the applicant was already under the care of a pain specialist.

Interest was awarded on the overdue benefits.

The applicant sought payment for a chronic pain program following a motor vehicle accident, which the respondent insurer partially denied.

The Tribunal found the physical rehabilitation sessions were reasonable and necessary based on the applicant's established chronic pain syndrome and the recommendations of her family physician and orthopaedic surgeon.

However, the applicant failed to prove the necessity of the remaining proposed services, including educational procedures and transportation costs.

The Tribunal awarded $5,785.50 for the physical rehabilitation sessions with interest, but declined to order a special award, finding the insurer did not act unreasonably in its handling of the claim.

The applicant sought payment for various treatment plans (OCF-18s) and expenses (OCF-6) following a motor vehicle accident, which the respondent insurer denied.

The Tribunal first rejected the applicant's preliminary argument that the psychological treatment plans should be deemed approved under s. 38(11) of the Schedule, finding the insurer's non-medical reasons for denial were sufficient under s. 38(8).

On the merits, the Tribunal approved three treatment plans for psychological discharge reports, finding them distinct from formal reassessments.

However, the Tribunal denied the remaining plans for physical therapies and relaxation CDs, relying on an insurer's examination by a physiatrist and surveillance evidence showing the applicant had reached maximum therapeutic benefit and was engaging in activities inconsistent with his claimed impairments.

The applicant sought statutory accident benefits following a motor vehicle accident, specifically claiming $3,821.15 for physiotherapy and $2,460.00 for a neurological assessment.

The respondent denied the claims.

The Tribunal found that the applicant failed to prove the treatments were reasonable and necessary, noting that the applicant had returned to full-time work and had pre-existing conditions that contradicted the expert reports submitted on her behalf.

The application was dismissed.

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

The Licence Appeal Tribunal found that the applicant failed to provide objective medical evidence to prove his injuries warranted removal from the MIG.

Relying on the insurer's physiatry assessment, the Tribunal concluded the applicant sustained soft tissue injuries that were predominantly minor.

As the applicant remained within the MIG and had exhausted the $3,500 limit, his claims for additional treatment plans, interest, and an award were dismissed.

The applicant sought entitlement to various statutory accident benefits, including psychological, chiropractic, yoga, massage, chronic pain, nutritional, and in-vehicle assessments, following a 2019 motor vehicle accident.

The Licence Appeal Tribunal dismissed all claims, finding that the applicant failed to demonstrate the treatment plans were reasonable and necessary.

The Tribunal relied on the respondent's insurer examination reports, which concluded the applicant had reached maximum therapeutic benefit for her minor soft tissue injuries and did not suffer from functional impairments or chronic pain requiring further assessments.

The applicant sought a medical benefit of $1,812.52 for physiotherapy treatment following a 2014 motor vehicle accident.

The respondent denied the benefit, arguing the treatment was not reasonable and necessary.

The Tribunal found that the applicant failed to meet his burden of proving the treatment plan was reasonable and necessary, noting a lack of evidence that previous physiotherapy had been beneficial and that the applicant had reached maximum medical improvement.

The application was dismissed.

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

The respondent denied several medical and rehabilitation benefits, arguing the applicant's injuries were predominantly minor and subject to the $3,500 limit under the Minor Injury Guideline (MIG).

The Tribunal found that the applicant's right knee chondrosis, confirmed by an MRI, was caused by the accident and constituted a non-minor injury, removing him from the MIG.

The Tribunal rejected the respondent's medical assessors' opinions that the knee injury was minor, noting they were based on incorrect factual premises regarding the applicant's functional impairments.

While the applicant was removed from the MIG, he only established that proposed Depo-Medrol injections for his knee were reasonable and necessary.

Claims for physiotherapy, chiropractic, massage, and psychological services were dismissed for lack of supporting evidence.

The Tribunal denied a claim for a special award under s. 10 of Regulation 664, finding the respondent's reliance on a flawed medical report did not amount to bad faith or unreasonable conduct.

The applicant sought income replacement benefits and approval for three physiotherapy treatment plans following a motor vehicle accident.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to prove a substantial inability to perform the essential tasks of her sedentary employment as an insurance agent.

The Tribunal preferred the respondent's medical evidence, which found no organic pathology preventing her return to work and concluded that further passive facility-based treatment was not reasonable and necessary.

The applicant was injured in a rear-end motor vehicle accident and sought medical and attendant care benefits from the respondent insurer.

The adjudicator denied the claim for attendant care benefits, finding the applicant failed to incur the expenses.

However, the adjudicator granted entitlement to four physiotherapy treatment plans, a psychological treatment plan, a functional impairment assessment, and a chronic pain assessment, finding them reasonable and necessary.

The adjudicator also awarded a 20% special award under Regulation 664 regarding the functional impairment assessment, concluding the insurer unreasonably withheld approval by relying on an assessor's unconvincing change of opinion.