Dr. Grigory Karmy

The applicant sought statutory accident benefits following a rear-end motor vehicle accident.

The respondent insurer denied treatment plans for physiotherapy, a chronic pain assessment, and a psychological assessment 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 Licence Appeal Tribunal found that the applicant failed to prove her injuries warranted treatment outside the MIG, noting that the medical evidence from her family doctor did not support the diagnoses of concussion, psychological impairment, or chronic pain syndrome advanced by her assessing experts.

The application was dismissed, along with claims for a special award and costs.

The applicant sought statutory accident benefits following a rear-end motor vehicle accident.

The respondent denied various treatment plans on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) limit of $3,500, which had been exhausted.

The Tribunal found that the applicant failed to meet his onus to prove his physical or psychological injuries warranted removal from the MIG.

The adjudicator preferred the respondent's insurer examination reports over the applicant's assessors, noting significant inconsistencies in the applicant's evidence, particularly his failure to report any accident-related complaints to his family doctor for over two years.

The application was dismissed.

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

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

The Tribunal found the applicant failed to prove that pre-existing conditions, chronic pain, or psychological impairments warranted removal from the MIG, noting inconsistencies and omissions in her self-reports to medical experts.

The Tribunal also dismissed the claim for non-earner benefits, finding the applicant's evidence regarding her post-accident education and activities unreliable and insufficient to establish a complete inability to carry on a normal life.

The application was dismissed in its entirety.

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

The insurer denied claims for physiotherapy and assessments, 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 a pre-existing condition.

The Tribunal found the applicant failed to prove on a balance of probabilities that his chronic pain adversely affected his well-being, applying the AMA Guides criteria.

The Tribunal also gave little weight to the applicant's psychological evidence and found no documented pre-existing condition preventing maximal recovery.

As the MIG limits were exhausted, the application was dismissed.

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

The respondent insurer determined her injuries fell within the Minor Injury Guideline (MIG) and denied a treatment plan for a chronic pain assessment.

The applicant argued she should be removed from the MIG due to chronic pain.

The Licence Appeal Tribunal applied the AMA Guides criteria and found the applicant failed to prove her pain adversely affected her well-being, noting she had returned to full-time work, resumed regular exercise, and did not use prescription pain medication.

The Tribunal concluded the injuries remained within the MIG and the proposed chronic pain assessment was not reasonable and necessary.

The application was dismissed.

The applicant sought various statutory accident benefits following a motor vehicle accident, including attendant care benefits and multiple treatment plans for psychological and physical injuries.

The Licence Appeal Tribunal denied the claim for attendant care benefits because the applicant failed to prove the expenses were incurred.

However, the Tribunal ordered the insurer to pay for several treatment plans, including a psychological assessment and physical therapy, because the insurer failed to provide proper medical reasons for its denials as required by section 38(8) of the Schedule.

The Tribunal also approved a chronic pain assessment and shockwave therapy based on medical evidence of ongoing pain, but denied other treatment plans for lack of evidence of reasonableness and necessity.

The claim for a special award was 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 insurer denied the benefits on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and the claimed benefits exceeded the $3,500 limit.

The applicant argued he should be removed from the MIG due to a pre-existing condition, psychological injuries, and chronic pain.

The Tribunal found the applicant's evidence, including expert reports, to be contradictory and unsupported by the objective medical records.

The Tribunal concluded the injuries were minor and dismissed the application, including claims for an award under Regulation 664.

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).

The Tribunal found that the applicant's injuries were predominantly minor and did not meet the threshold for chronic pain that would remove him from the MIG.

However, because the respondent failed to provide proper notice under s. 38(8) of the Schedule for a chiropractic treatment plan, it was ordered to pay any incurred expenses for that plan.

The respondent also conceded payment for a chronic pain assessment due to late notice.

The applicant's claim for a special award under O. Reg. 664 was dismissed.

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 applicant was injured in a motor vehicle accident and sought medical, rehabilitation, and non-earner benefits.

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

The applicant argued that chronic pain and psychological impairments took him outside the MIG.

The Tribunal found that the applicant did not meet the AMA Guides criteria for chronic pain and failed to prove a psychological impairment, giving little weight to the applicant's medical experts due to inconsistencies.

The Tribunal concluded the injuries were predominantly minor, dismissed the claim for non-earner benefits as the applicant returned to work and most pre-accident activities, and denied claims for a special award, interest, and costs.

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

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

The Licence Appeal Tribunal found that the medical evidence, including clinical notes from treating physicians and diagnostic imaging, supported a finding of minor soft tissue injuries.

The Tribunal afforded little weight to the applicant's chronic pain specialist's report, noting it lacked objective testing and was contradicted by other medical records.

The application was dismissed as the injuries were subject to the MIG.

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 cap.

The applicant argued she should be removed from the MIG due to a pre-existing condition and chronic pain.

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

Furthermore, the Tribunal preferred the respondent's expert evidence and surveillance footage over the applicant's chronic pain assessment, concluding the applicant did not suffer from chronic pain.

The application was dismissed, and the applicant's injuries were deemed minor.

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

The Tribunal found that the Minor Injury Guideline did not apply due to the insurer's failure to provide proper notice under subsection 38(8) of the Schedule.

However, the applicant's claims for attendant care benefits, physiotherapy, and chronic pain treatments were dismissed as the expenses were either not incurred or not reasonable and necessary.

The Tribunal ordered the insurer to pay for assistive devices and an attendant care assessment due to procedural breaches, and granted a 50% special award under O. Reg. 664 for unreasonably withholding payments.

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

The respondent denied funding for attendant care benefits and various treatment plans, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant's injuries, particularly chronic pain, removed him from the MIG.

The Tribunal partially approved the treatment plans for physical therapy and assistive devices, and approved the cost of a chronic pain assessment.

However, claims for attendant care benefits, psychological treatment, psychological assessment, and a special award were dismissed.

Interest was awarded on overdue payments.

The applicant sought statutory accident benefits following a motor vehicle accident, including income replacement benefits, attendant care benefits, and various medical benefits.

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 establish entitlement to income replacement benefits, as he returned to work full-time and his business suffered no economic loss.

Furthermore, the Tribunal concluded that the applicant's physical injuries were predominantly minor and that he failed to prove on a balance of probabilities that he suffered from psychological impairments, chronic pain syndrome, or post-concussion syndrome that would remove him from the MIG.

Consequently, the application for benefits was denied.

The applicant, a pedestrian struck by a vehicle, sought Income Replacement Benefits (IRBs) and funding for psychological and chronic pain assessments.

The insurer terminated IRBs after six months and denied the assessments, arguing the applicant's injuries fell within the Minor Injury Guidelines (MIG).

The Tribunal found the applicant did not suffer a substantial inability to perform his essential tasks for the first 104 weeks, nor a complete inability to engage in employment thereafter, relying on surveillance evidence showing him working and medical reports indicating symptom magnification.

The Tribunal also concluded the applicant's injuries were minor, dismissing the claims for the assessments.