Dr. Lance Majl

The applicant sought statutory accident benefits following a motor vehicle accident, including a non-earner benefit (NEB), a functional abilities assessment, and a chronic pain assessment.

The Tribunal found the respondent failed to comply with a production order regarding the NEB denial letter and drew an adverse inference, concluding the respondent failed to provide proper notice under s. 36(4) of the Schedule.

Consequently, the NEB was payable under s. 36(6).

The Tribunal denied the functional abilities assessment, finding the applicant's physical condition did not limit his daily tasks or employment.

However, the Tribunal approved the chronic pain assessment based on consistent reports of ongoing pain.

Claims for an award and costs were dismissed.

The respondent insurer requested a reconsideration of a Tribunal decision that found the applicant catastrophically impaired based on a 55% whole person impairment rating.

The respondent argued the Tribunal provided insufficient reasons, reversed the burden of proof regarding psychiatric impairments, and erred in its assessment of musculoskeletal and headache impairments.

The Vice-Chair dismissed the request, finding that the original panel provided comprehensive, logical reasons for preferring the applicant's medical experts and correctly applied the AMA Guides.

No errors of law, fact, or procedural fairness were established.

The applicant sought non-earner benefits, interest, and an award under the Statutory Accident Benefits Schedule following a motor vehicle accident.

The respondent denied benefits, arguing the applicant's impairments stemmed from a pre-existing condition.

The Tribunal found that the applicant sustained serious psychological and physical impairments as a result of the accident, which continuously prevented her from engaging in substantially all of her pre-accident activities.

The Tribunal ordered the respondent to pay non-earner benefits for the eligible 104-week period and interest, but denied the claim for an award as the respondent's reliance on its assessments was not unreasonable.

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

The insurer denied treatment plans for neurological and chronic pain assessments, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant filed her appeal beyond the two-year limitation period, but the Tribunal granted an extension under s. 7 of the LAT Act.

While the Tribunal found the applicant's injuries did not warrant removal from the MIG, it held that the insurer's denial notices failed to provide sufficient medical reasons as required by s. 38(8) of the Schedule.

Consequently, under s. 38(11), the insurer was ordered to pay for the disputed assessments with interest.

The applicant sought statutory accident benefits following a motor vehicle accident, disputing the respondent's denial of treatment plans for a neurological assessment, psychotherapy services, transportation costs for an orthopaedic assessment, and physiotherapy services.

The Licence Appeal Tribunal found that the neurological assessment and physiotherapy services were not reasonable and necessary, relying on insurer examination reports and the lack of objective improvement from past treatments.

The Tribunal also held that the applicant failed to justify a higher hourly rate for a psychotherapist and did not provide evidence of incurred transportation expenses.

The application was dismissed in its entirety.

The applicant sought entitlement to various statutory accident benefits following a motor vehicle accident, including treatment plans for psychological, physiotherapy, and chiropractic services, as well as catastrophic assessments and medical expenses.

The Licence Appeal Tribunal found the psychological and physiotherapy treatment plans to be reasonable and necessary, supported by extensive medical evidence, and noted the insurer's failure to provide proper notice of denial for one plan.

However, the Tribunal denied the chiropractic plan as there was no proof it was submitted, denied the catastrophic assessments as the unapproved file reviews were not standalone assessments, and denied the medical expenses incurred in China as they were submitted late and not proven reasonable and necessary.

The applicant was injured in a motor vehicle accident and received income replacement benefits (IRBs) for 104 weeks.

The respondent terminated IRBs on the basis that the applicant did not meet the post-104 week test of a complete inability to engage in any suitable employment.

The applicant applied to the Licence Appeal Tribunal for dispute resolution.

The Tribunal found the applicant's evidence regarding his pain levels to be unreliable, noting evidence of symptom exaggeration and malingering from the respondent's expert assessors.

The Tribunal concluded the applicant failed to prove he suffered a complete inability to engage in suitable employment and dismissed the claims for IRBs, interest, and a special award.

The applicant sought statutory accident benefits following two motor vehicle accidents in 2007.

The arbitrator found the applicant's evidence to be unreliable due to poor recall and contradictions with documentary evidence, including Ontario Works records showing he had returned to work.

Relying on the medical evidence, particularly the applicant's orthopaedic surgeon, the arbitrator concluded the applicant suffered a complete inability to engage in suitable employment for a limited period.

The applicant was awarded income replacement benefits from July 7, 2009, to August 1, 2010, but his claims for various assessment costs and a special award were dismissed.

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

The arbitrator found that the applicant did not qualify for an income replacement benefit as he was not employed at the time of the accident.

Applying the test for NEBs, the arbitrator concluded that the applicant did not suffer a complete inability to carry on a normal life, as he remained independent in self-care and was not completely unable to engage in housekeeping and home maintenance.

The application for NEBs, a special award, and interest was dismissed.