Dr. Frank Loritz

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

The Licence Appeal Tribunal found that the applicant was statute-barred from disputing a 2019 physiotherapy treatment plan because she failed to apply within the two-year limitation period, and there were no reasonable grounds to extend the time under s. 7 of the LAT Act.

The Tribunal further held that the applicant's injuries fell within the Minor Injury Guideline (MIG), as she failed to establish that her chronic pain or psychological impairments were caused by the subject accident rather than a prior 2016 accident.

Consequently, the disputed treatment plans were not payable, and claims for interest and a special award were dismissed.

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 the applicant suffered from a psychological impairment and chronic pain, removing her from the MIG.

The Tribunal approved treatment plans for an attendant care assessment, psychological services, physiotherapy, and a lumbar back brace, finding them reasonable and necessary.

A psychological assessment was denied as redundant.

The Tribunal also awarded interest on overdue benefits but dismissed the applicant's claim for a special award, finding the respondent relied on expert opinions and did not unreasonably withhold payments.

The applicant sought statutory accident benefits following a motor vehicle accident, including a non-earner benefit, funding for a psychological assessment, and physiotherapy services.

The respondent denied the benefits.

The Licence Appeal Tribunal found that the applicant failed to prove on a balance of probabilities that she suffered a complete inability to carry on a normal life, noting inconsistencies in her self-reporting and a failure to provide evidence of her pre-accident activities.

The Tribunal assigned little weight to the applicant's expert reports due to methodological flaws and reliance on incomplete medical records.

The claims for the remaining balances of the psychological assessment and physiotherapy services were dismissed as they exceeded the maximum amounts permitted under the Schedule and Guidelines.

The application was dismissed in its entirety.

The applicant sought payment for a $2,421.79 physiotherapy treatment plan following a motor vehicle accident.

The respondent denied the benefit, relying on an insurer's examination report indicating the applicant had reached a treatment plateau.

The adjudicator found that the applicant failed to meet her burden of proving the treatment was reasonable and necessary, as her supporting medical reports were not contemporaneous with the treatment plan request.

The application was dismissed and no interest was payable.

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

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

The applicant applied to the Licence Appeal Tribunal, arguing she should be removed from the MIG due to a concussion, a pre-existing left shoulder injury, chronic pain, and a psychological condition.

The Tribunal found the applicant failed to meet her burden of proving her injuries warranted removal from the MIG.

The medical evidence did not support a concussion diagnosis, chronic pain, or a psychological condition, and there was no compelling evidence that her pre-existing shoulder condition prevented maximal recovery within the MIG limits.

The application was dismissed.

The applicant sought various statutory accident benefits following a motor vehicle accident, including attendant care, occupational therapy, physiotherapy, chiropractic services, medical cannabis, and psychological services.

The Tribunal denied the claims for attendant care, occupational therapy, and physical therapies, finding the applicant's self-reporting unreliable and noting that physical therapies had previously plateaued without lasting benefit.

However, the Tribunal granted the treatment plans for medical cannabis and psychological services, finding them to be reasonable and necessary untrialed interventions for the applicant's accident-exacerbated chronic pain and adjustment disorder.

The applicant's request for costs was denied.

The applicant sought statutory accident benefits following a motor vehicle accident, disputing the denial of treatment plans for physiotherapy, psychotherapy, and multiple assessments.

The Tribunal found that the applicant failed to prove the physiotherapy and assessments were reasonable and necessary, noting a lack of clinical notes and preferring the respondent's medical assessments.

However, the Tribunal granted the outstanding balance for psychotherapy services, finding the proposed 1.5-hour sessions reasonable as recommended by the assessing psychologist.

Interest was awarded on the overdue psychotherapy benefits.

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

The applicant argued her pre-existing conditions, chronic pain syndrome, and psychological impairments warranted removal from the MIG.

The Tribunal found insufficient objective medical evidence to support removal from the MIG, noting the applicant's self-reports were inconsistent with medical records and she returned to work immediately after the accident.

The application was dismissed.

The applicant was involved in a motor vehicle accident and sought statutory accident benefits for psychological services, a chronic pain management program, and physical therapy.

The respondent partially denied the psychological services and fully denied the other treatment plans.

The Tribunal found that the psychological services, to be provided by a registered psychotherapist, were reasonable and necessary, and that the respondent unreasonably withheld payment by applying the unregulated professional rate.

The Tribunal awarded the disputed amount for psychological services, plus a 25% award under s. 10 of Reg. 664 and interest.

The claims for the chronic pain management program and physical therapy were dismissed, as the Tribunal preferred the respondent's medical evidence that the applicant had reached maximum medical recovery and did not meet the criteria for chronic pain.

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

The adjudicator found the applicant was entitled to the disputed amount for a psychological services treatment plan, noting that psychotherapy is a regulated profession and the respondent failed to provide sufficient explanations for its partial denial.

The adjudicator dismissed the claims for a chronic pain management program and a physical therapy treatment plan, preferring the respondent's medical experts who opined the applicant had reached maximum medical recovery.

An award of 25% under s. 10 of Reg. 664 was granted for the respondent's unreasonable handling of the psychological services claim, along with interest.

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 that pre-existing psychological conditions and chronic pain warranted removal from the MIG.

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

The Tribunal accepted the respondent's medical assessment that the injuries were predominantly minor.

The application for additional physiotherapy and interest was dismissed.

The applicant was involved in a motor vehicle accident and sought $2,170.28 for an occupational therapy treatment plan under the Statutory Accident Benefits Schedule.

The respondent denied the benefit, relying on insurer's examinations which concluded the applicant had reached maximum medical recovery and that further treatment was not reasonable or necessary.

The Tribunal found that the applicant failed to provide compelling medical evidence to establish the treatment plan was reasonable and necessary, noting that the applicant's chiropractor was not qualified to diagnose chronic pain syndrome.

The application was dismissed, and no interest was awarded.

The applicant sought statutory accident benefits following a motor vehicle accident, specifically claiming entitlement to a treatment plan for chiropractic, massage therapy, and acupuncture, as well as a psychological assessment.

The Licence Appeal Tribunal dismissed the application, finding that the physical treatment plan was not reasonable and necessary because the applicant had reached maximum medical improvement and had not reported physical complaints to her family physician for over a year.

The Tribunal also denied the psychological assessment, concluding it would be duplicative of an already completed and comprehensive driver rehabilitation evaluation that adequately addressed her primary psychological complaint of driving anxiety.

Claims for interest and an award for unreasonable delay were consequently dismissed.

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

The respondent 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 that pre-existing lateral epicondylitis and accident-related psychological injuries warranted removal from the MIG.

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

Furthermore, the Tribunal preferred the respondent's psychological assessment, which concluded the applicant did not suffer a psychological injury.

As the injuries were predominantly minor and the MIG limits were exhausted, the disputed treatment plans, interest, and an award were denied.

The applicant sought statutory accident benefits following a single-vehicle motorcycle accident.

The insurer denied the benefits, arguing the applicant sustained no injuries and provided inconsistent accounts of the accident.

The Tribunal found the applicant's contemporaneous reports to first responders, which indicated a low-speed departure into a field without physical injury, to be the most reliable.

Consequently, claims for attendant care, physiotherapy, and an attendant care assessment were dismissed.

However, the Tribunal approved psychological treatment by a psychotherapist at a rate of $146.91 per hour, finding the insurer could not unilaterally impose a lower rate for an unregulated provider under the Guidelines.

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.

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

The insurer denied a treatment plan on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant argued the insurer was precluded from relying on the MIG due to prior approvals, and alternatively, that her pre-existing obesity and alleged post-concussion syndrome removed her from the MIG.

The Tribunal held the insurer provided proper notice and was not precluded from applying the MIG.

The Tribunal further found the applicant failed to provide compelling evidence that her obesity was a documented pre-existing condition that prevented recovery within the MIG cap, or that she suffered a concussion caused by the accident.

The appeal was dismissed.

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

The respondent insurer denied the plans based on section 44 assessments.

The Licence Appeal Tribunal found the treatment plans reasonable and necessary, noting the applicant's pre-existing osteoarthritis and ongoing pain.

The Tribunal rejected the insurer's medical assessments because they failed to account for key medical evidence, including a diagnostic imaging report.

The applicant was awarded the disputed benefits and interest.

The applicant was struck by a motor vehicle as a pedestrian and sought statutory accident benefits, including income replacement benefits (IRBs), a functional abilities evaluation, and physiotherapy.

The insurer denied the claims.

The Licence Appeal Tribunal dismissed the appeal, finding the applicant was barred from claiming IRBs due to her failure to provide reasonably requested financial information under section 33 of the Schedule.

The Tribunal also found the applicant failed to prove the requested medical benefits and assessments were reasonable and necessary, preferring the insurer's medical evidence that the applicant had suffered uncomplicated soft tissue injuries that did not require further treatment.

The applicant sought non-earner benefits following a motor vehicle accident.

The respondent insurer denied the claim.

The Licence Appeal Tribunal found that the applicant failed to prove she suffered a complete inability to carry on a normal life.

The adjudicator preferred the respondent's multidisciplinary assessment reports, which found no objective physical or psychological impairment preventing the applicant from engaging in her pre-accident activities, and noted evidence of symptom exaggeration.

The applicant's failure to produce pre-accident disability records further undermined her claim.

The application was dismissed.