Dr. Hashmat Khan

The applicant sought statutory accident benefits following a motor vehicle accident, specifically claiming entitlement to treatment plans for chiropractic services and a functional abilities evaluation (FAE).

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to prove the proposed treatments were reasonable and necessary.

The adjudicator gave little weight to the applicant's chronic pain diagnosis, noting it did not meet the AMA Guides criteria and was contradicted by surveillance evidence showing the applicant engaging in full-time studies and physical activities without visible pain.

The Tribunal also dismissed the applicant's procedural motions to exclude the respondent's surveillance and insurer's examination reports.

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

The adjudicator found that the applicant failed to provide sufficient objective medical evidence of a functional limitation or a pre-existing condition that would preclude recovery within the MIG.

Relying on the respondent's independent medical examination, the adjudicator concluded the injuries were predominantly minor.

Consequently, the claims for physiotherapy treatment plans, interest, and an award for unreasonable delay were dismissed.

The Applicant sought entitlement to statutory accident benefits for chiropractic services and a psychological assessment following a motor vehicle accident.

The Licence Appeal Tribunal dismissed the application, finding that the Applicant failed to meet the onus of establishing that the proposed treatment plans were reasonable and necessary.

The Tribunal noted that the Applicant relied solely on the OCF-18 forms and self-reporting without providing sufficient medical evidence or explaining how the treatment goals would be met.

Claims for an award and interest were also dismissed.

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

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

The applicant argued that he suffered from chronic pain and should be removed from the MIG.

The Tribunal found that the applicant failed to establish that his pain met the threshold for chronic pain or that it resulted in a functional impairment.

Consequently, the applicant's injuries were deemed predominantly minor and subject to the $3,500 MIG limit.

The claims for chiropractic treatment plans and interest were dismissed.

The applicant sought statutory accident benefits, including an income replacement benefit (IRB) and medication expenses, following a motor vehicle accident.

The respondent denied the benefits and argued the applicant was statute-barred for missing insurer's examinations.

The Tribunal found the applicant was not statute-barred as she attended rescheduled examinations.

However, the Tribunal dismissed the substantive claims, finding the applicant failed to prove a substantial or complete inability to perform the essential tasks of her employment as an Uber driver, relying on the respondent's psychological assessments.

The claims for medication expenses, interest, and a section 10 award were also dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, specifically claiming entitlement to several treatment plans for psychological services and an orthopaedic assessment.

The respondent had partially approved the psychological services at the rate of a psychotherapist ($99.75/hour) rather than the requested rate of a psychologist ($149.61/hour).

The Tribunal found that the applicant failed to provide evidence, such as the treating psychotherapists' credentials, to justify payment at the higher psychologist rate.

The Tribunal also denied the orthopaedic assessment, noting the applicant failed to submit the treatment plan into evidence and giving significant weight to the respondent's s. 44 assessor who found the assessment unnecessary.

Claims for interest and a special award were consequently dismissed.

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

The respondent denied a treatment plan 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 she should be removed from the MIG due to chronic pain and psychological injuries.

The Tribunal found that the applicant's injuries were predominantly minor, preferring the in-person assessments of the respondent's experts and the clinical notes of the applicant's family physician over the virtual assessment of the applicant's expert.

The Tribunal concluded the applicant failed to demonstrate chronic pain with functional impairment or a psychological injury, and dismissed the application.

The applicant sought accident benefits following a motor vehicle accident, which the respondent insurer denied on the basis that the injuries fell within the Minor Injury Guideline (MIG).

The applicant argued for removal from the MIG due to chronic pain, but the Tribunal found insufficient evidence of functional limitations or psychological impairment to warrant removal.

The Tribunal also dismissed the applicant's claim for a non-earner benefit, noting a lack of evidence demonstrating a complete inability to carry on a normal life.

Finally, the Tribunal found the respondent provided sufficient medical reasons for denying the disputed treatment plans within the required timelines.

The application was dismissed in its entirety.

The applicant sought statutory accident benefits for various treatment plans and assessments following a motor vehicle accident.

The respondent denied the benefits.

The Tribunal dismissed the application, finding that the applicant failed to meet her burden of proving the treatment plans were reasonable and necessary.

Crucially, the applicant failed to submit the actual treatment plans (OCF-18s) into evidence, making it impossible for the Tribunal to assess them.

Furthermore, the Tribunal preferred the respondent's medical evidence, including multiple insurer examinations, which concluded the applicant had reached maximum medical improvement and did not require the disputed treatments.

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

The respondent denied claims for chiropractic services and income replacement benefits, asserting the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Licence Appeal Tribunal found that the applicant failed to prove his injuries warranted removal from the MIG based on pre-existing conditions, chronic pain, or psychological impairment.

As the $3,500 MIG limit was exhausted, the claims for chiropractic services were dismissed.

The claim for income replacement benefits was also dismissed due to a lack of evidence.

Consequently, claims for an award and interest were denied.

The applicant sought statutory accident benefits following a motor vehicle accident, arguing her injuries fell outside the Minor Injury Guideline (MIG) due to a pre-existing psychological condition and accident-related driving anxiety.

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

The Tribunal preferred the respondent's psychological assessment, which concluded the applicant's injuries were minor and not a barrier to recovery.

The application for additional medical benefits and interest was dismissed.

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

The respondent denied claims for a psychological assessment and physiotherapy services on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant sustained predominantly minor injuries and failed to prove that pre-existing conditions, chronic pain, or psychological impairments removed her from the MIG.

As the applicant had already been approved for the $3,500 funding limit, she was not entitled to the disputed treatment plans, interest, or an award.

The applicant sought payment for a psychological assessment and a chronic pain assessment following a motor vehicle accident.

The Tribunal denied the psychological assessment because the applicant incurred the cost before the treatment plan was properly submitted to the respondent, violating s. 38(2) of the Schedule.

However, the Tribunal granted the chronic pain assessment, finding it reasonable and necessary given the applicant's exacerbation of pre-existing pain and functional limitations.

The claim for an award under s. 10 of O. Reg. 664 was dismissed as the insurer's denials were not unreasonable.

The applicant was injured in a motor vehicle accident and sought a medical benefit of $10,600 for a chronic pain treatment program, which the respondent insurer denied.

The Licence Appeal Tribunal found that the applicant proved on a balance of probabilities that the treatment plan was reasonable and necessary, preferring the evidence of the applicant's experts who diagnosed chronic pain over the respondent's assessors who did not specifically evaluate for chronic pain.

The Tribunal ordered the respondent to pay for the treatment plan and interest on overdue amounts, but denied the applicant's request for a special award under Ontario Regulation 664, finding no evidence that the insurer unreasonably withheld or delayed payment.

The applicant sought statutory accident benefits following a motor vehicle accident, disputing the insurer's denial of psychological services, chiropractic treatments, a chronic pain assessment, and a chronic pain program.

The Licence Appeal Tribunal found the psychological, chiropractic, and chronic pain program treatments to be reasonable and necessary, preferring the evidence of the applicant's treating practitioners over the insurer's assessors.

The claim for a chronic pain assessment was denied as redundant.

The applicant was awarded interest on overdue payments, but claims for a special award and costs were dismissed.