Dr. I. Robertus

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

The respondent determined the applicant sustained a minor injury and was subject to the Minor Injury Guideline (MIG) limit of $3,500, denying several treatment plans.

The applicant argued his psychological impairments and chronic pain removed him from the MIG.

The Tribunal found the applicant's psychological evidence inconsistent and preferred the respondent's psychological assessment, which concluded the impairments were minor.

The Tribunal also found the applicant did not meet the criteria for chronic pain under the AMA Guides and had achieved full functional recovery.

As the applicant sustained a minor injury and had exhausted the MIG funding limit, the disputed treatment plans and interest were denied.

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

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

The Licence Appeal Tribunal found that the applicant sustained psychological injuries that removed her from the MIG.

The Tribunal ordered the insurer to pay for the disputed psychological, physiotherapy, and chronic pain assessments and treatments, finding them reasonable and necessary.

The applicant's claim for an award under Regulation 664 was dismissed because the insurer reasonably relied on its assessors' reports.

The applicant was injured in a motor vehicle accident and sought funding for a physiatry assessment.

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

Although the applicant was later removed from the MIG due to psychological injuries and chronic pain, the Tribunal found the physiatry assessment was not reasonable and necessary.

The assessment was proposed over two years before the chronic pain diagnosis, at a time when treating physicians only recommended physiotherapy.

Furthermore, the Tribunal found the proposed assessment would be duplicative of a chronic pain assessment already completed by the applicant's own medical expert.

The application was dismissed.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for caregiving, housekeeping, attendant care, and medical expenses, as well as a special award.

The arbitrator found that the applicant failed to establish on a balance of probabilities that she suffered a substantial inability to perform her pre-accident caregiving and housekeeping tasks, or that she required the claimed attendant care assistance.

The arbitrator noted inconsistencies in the applicant's evidence, her failure to disclose her ongoing receipt of ODSP benefits to medical assessors, and preferred the evidence of the insurer's occupational therapist who found the applicant could perform her activities of daily living with assistive devices.

All claims for benefits, interest, and a special award were dismissed.