Dr. Lital Grinberg

The respondent insurer requested a reconsideration of a Tribunal decision granting the applicant entitlement to a chronic pain assessment.

The insurer argued the Tribunal erred by finding that only psychologists and psychiatrists could provide expert opinion evidence on chronic pain, thereby improperly discounting the evidence of its general practitioner and orthopaedic surgeon.

The Vice-Chair granted the reconsideration, finding the Tribunal erred in its treatment of the medical experts.

Upon rehearing the issue, the Vice-Chair weighed the competing medical evidence and concluded that the applicant's ongoing reports of pain and diagnosis of somatic symptom disorder provided reasonable grounds to warrant a chronic pain assessment.

The treatment plan was deemed reasonable and necessary.

The applicant sought statutory accident benefits following a motor vehicle accident, which were denied by the respondent insurer.

The Licence Appeal Tribunal found that the applicant met her burden of proving that a neurological assessment, a chronic pain assessment, and chiropractic services were reasonable and necessary.

The Tribunal preferred the evidence of the applicant's treating practitioners and experts over the insurer's examiners, noting that the insurer's general practitioner was not qualified to opine on chronic pain and that the insurer's psychologist lacked specific findings to support claims of symptom exaggeration.

The application was granted, and the respondent was ordered to pay the disputed amounts with interest.

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

The respondent denied various treatment plans and assessments 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, preferring the respondent's medical evidence which aligned with the clinical notes of the treating family physician and ER records.

The Tribunal gave less weight to the applicant's assessors due to inconsistent self-reporting by the applicant.

As the applicant remained within the MIG, the disputed treatment plans and interest were denied.

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

The respondent denied several treatment plans and a non-earner benefit, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant suffered from chronic pain with functional impairment, removing him from the MIG.

The Tribunal approved treatment plans for physiotherapy, a psychological assessment, and a chronic pain assessment, but denied a treatment plan for psychological services.

The claim for a non-earner benefit was barred because the applicant failed to submit an Election of Benefits form (OCF-10).

A claim for an award under s. 10 of O. Reg. 664 was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to various treatment and assessment plans, including neuropsychological and neurological assessments, chiropractic services, massage therapy, acupuncture, and a functional ability assessment.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to prove on a balance of probabilities that the disputed plans were reasonable and necessary.

The Tribunal noted a lack of contemporaneous evidence from the applicant's treating family physician supporting the need for the requested interventions, and preferred the evidence of the respondent's section 44 assessor who found no objective evidence of residual musculoskeletal impairment.

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

The respondent denied the benefits.

The Licence Appeal Tribunal found that the applicant did not suffer a substantial inability to perform the essential tasks of his employment, relying on section 44 assessments.

The Tribunal also found that the applicant did not require attendant care services or the disputed medical benefits and assessments, as they were not supported by the medical evidence.

The application was dismissed in its entirety.

The applicant sought a non-earner benefit, a special award, and interest following a motor vehicle accident.

The Tribunal applied the test for a complete inability to carry on a normal life, comparing the applicant's pre- and post-accident activities.

Despite some reported pain and adjustments to her routine, the Tribunal found the applicant was still capable of performing most of her pre-accident activities, including working, studying, and personal care.

The Tribunal concluded the applicant did not suffer a complete inability to carry on a normal life and dismissed the application for the non-earner benefit, the special award, and interest.