Dr. Ida Cavaliere

The applicant sought statutory accident benefits following a motor vehicle accident, claiming catastrophic impairment under criteria 7 and 8, attendant care benefits, and physiotherapy services.

The Tribunal found the applicant was not catastrophically impaired, preferring the respondent's medical assessors and surveillance evidence which demonstrated the applicant maintained an active lifestyle and had significant pre-existing psychiatric conditions that were not properly accounted for by his own assessors.

The Tribunal also dismissed the claims for attendant care and physiotherapy, finding the applicant was capable of managing his daily activities independently and had reached maximum therapeutic benefit from prior treatments.

The applicant was injured in a motor vehicle accident and sought approval for a treatment plan for massage therapy, physiotherapy, and chiropractic services.

The insurer denied the plan, arguing the applicant's injuries were pre-existing and that he had reached maximum medical recovery.

The Tribunal applied the 'but for' test and found the accident was a necessary cause of the applicant's ongoing impairments.

Preferring the evidence of the applicant's treating chiropractor over the insurer's medical examiner, the Tribunal concluded the treatment plan was reasonable and necessary.

The applicant was awarded the treatment plan amount plus interest.

The applicant sought statutory accident benefits following a motor vehicle accident, including removal from the Minor Injury Guideline (MIG), income replacement benefits (IRBs), and approval of treatment plans.

The Licence Appeal Tribunal found that the applicant failed to prove his injuries, including alleged chronic pain and psychological impairments, warranted removal from the MIG.

As the $3,500 MIG limit was exhausted, the disputed treatment plans were not payable.

The Tribunal also dismissed the claim for IRBs, finding insufficient evidence that the applicant suffered a substantial inability to perform the essential tasks of his pre-accident employment as a warehouse worker.

Claims for interest and an award were consequently dismissed.

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

The respondent denied benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) and that he was barred from proceeding due to non-attendance at an insurer's examination.

The Tribunal found the applicant was not barred from proceeding, as the respondent failed to provide a requested interpreter for the examination.

However, the Tribunal concluded the applicant's injuries were predominantly minor, as he failed to establish chronic pain or a psychological impairment warranting removal from the MIG.

The Tribunal also dismissed the claim for non-earner benefits, finding the applicant returned to work shortly after the accident and did not suffer a complete inability to carry on a normal life.

The application was dismissed.

The applicant sought non-earner benefits following a September 2022 motor vehicle accident.

The respondent denied the claim, arguing the applicant's impairments stemmed from pre-existing depression and a prior accident in June 2022.

The Tribunal applied the 'but for' causation test and the Heath framework, finding the applicant failed to prove her impairments were caused by the September accident.

The Tribunal preferred the respondent's section 44 assessors, who properly compared the applicant's functioning before and after both accidents, over the applicant's section 25 assessors, who failed to review pre-accident records or account for the prior accident.

The application was dismissed.

The applicant sought payment for six treatment plans (OCF-18s) for chiropractic, massage, and physiotherapy following a 2018 motor vehicle accident.

The respondent insurer denied the benefits.

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

The Tribunal concluded the applicant's lower back pain was caused by age-related degenerative changes rather than the accident, and that the proposed treatments could not reasonably achieve the goal of pain reduction for his shoulder, neck, and head injuries.

Claims for interest and costs were also dismissed.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including a non-earner benefit and various treatment plans for chiropractic and psychological services.

The respondent denied the benefits.

The Licence Appeal Tribunal found that the applicant suffered a complete inability to carry on a normal life due to chronic pain and psychological impairments, entitling her to the non-earner benefit for the maximum 104-week period.

The Tribunal also partially approved several treatment plans for physical rehabilitation, acupuncture, and a psychological assessment, finding them reasonable and necessary.

Claims for an award under s. 10 of Reg. 664 were dismissed, but interest on overdue benefits was granted.

The applicant sought various statutory accident benefits following a motor vehicle accident, including multiple treatment plans for physiotherapy and psychological services, attendant care benefits, and the cost of an accounting report for income replacement benefits.

The Tribunal dismissed the application in its entirety.

The Tribunal found the applicant failed to prove the treatment plans were reasonable and necessary, noting inconsistencies in self-reported improvement and accepting medical evidence that the applicant required a multi-disciplinary chronic pain program rather than further facility-based physical therapy.

The Tribunal also denied the cost of the accounting report, finding the applicant's income calculation was straightforward and did not require an accountant's expertise.

Claims for attendant care benefits, interest, and a special award were similarly dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, including an income replacement benefit (IRB) and two treatment plans for chronic pain and attendant care assessments.

The Licence Appeal Tribunal dismissed the application.

The Tribunal found the applicant failed to prove entitlement to the IRB and that his application for the benefit was incomplete due to his failure to submit an Election of Income Replacement, Non-Earner or Caregiver Benefit form (OCF-10).

The Tribunal also found no compelling evidence that the proposed treatment plans were reasonable and necessary, relying on the unrefuted opinion of the respondent's physiatrist that the applicant's injuries were soft tissue in nature.

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

The respondent denied treatment plans for physiotherapy and a chronic pain assessment, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) and its $3,500 limit, which was exhausted.

The applicant argued she suffered from chronic pain and psychological impairments warranting removal from the MIG.

The adjudicator found the applicant sustained predominantly minor soft tissue injuries and failed to prove chronic pain with functional impairment or psychological impairment.

The adjudicator preferred the respondent's physiatry assessment over the applicant's medical evidence.

As the applicant remained within the MIG, the disputed treatment plans were denied, and no interest was payable.

The application was dismissed.

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

The respondent denied the benefits, arguing the injuries fell within the MIG.

The Tribunal found that the applicant failed to meet her evidentiary burden to prove her injuries warranted removal from the MIG.

The Tribunal preferred the respondent's medical evidence, which included in-person assessments, over the applicant's virtual assessments and uncorroborated claims.

The application was dismissed, and the disputed treatment plans, interest, and award were denied.