Dr. L. Weisleder

The applicant was struck by a vehicle as a pedestrian and sought statutory accident benefits, including non-earner benefits and various medical and rehabilitation treatment plans.

The Licence Appeal Tribunal dismissed the claim for non-earner benefits, finding that the applicant's functionality had improved and he did not suffer a complete inability to carry on a normal life, as evidenced by his return to post-secondary education and independence with self-care.

The Tribunal approved treatment plans for a chronic pain assessment and a functional abilities evaluation, finding them reasonable and necessary to investigate ongoing impairments.

The remaining claims for treatment plans and an award for unreasonable delay were dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, including an income replacement benefit and medical benefits for physiotherapy and chiropractic services.

The respondent denied the benefits on the basis that the applicant did not suffer a substantial inability to perform the essential tasks of her pre-accident employment and that the proposed treatments were not reasonable and necessary.

The Tribunal dismissed the application, preferring the evidence of the respondent's assessors that the applicant's psychological and physical impairments did not meet the substantial inability test, and finding that the applicant had already received adequate treatment for her accident-related injuries.

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

The respondent insurer determined the injuries fell within the Minor Injury Guideline (MIG) and denied several treatment plans.

The Tribunal found that the applicant suffered from chronic pain with functional impairment as a result of the accident, removing him from the MIG and its $3,500 funding limit.

The Tribunal approved five treatment plans for chiropractic and physical therapy services as reasonable and necessary, but denied two assessment plans for lack of supporting medical evidence.

The applicant sought medical benefits for chiropractic services and a chronic pain assessment following a motor vehicle accident.

The respondent insurer denied the claims.

The Tribunal found that the applicant sustained uncomplicated soft tissue injuries and that ongoing physical therapy beyond May 2019 was not reasonable and necessary, relying on the opinions of the respondent's medical assessors.

The Tribunal awarded the first two treatment plans for chiropractic care totaling $5,006.42 plus interest, but denied the remaining plans and the chronic pain assessment as duplicative and unnecessary.

The applicant sought statutory accident benefits, including a non-earner benefit and medical benefits for physiotherapy, following a minor rear-end motor vehicle accident.

The adjudicator found that the applicant failed to establish a complete inability to carry on a normal life, relying on the applicant's own statements to independent medical examiners regarding his post-accident activities.

The adjudicator also found no medical evidence of an ongoing physical impairment necessitating the claimed physiotherapy.

The application was dismissed in its entirety.

The applicant sought statutory accident benefits following a motor vehicle accident, specifically claiming entitlement to attendant care benefits and the costs of chronic pain and orthopaedic assessments.

The Tribunal found that the applicant was not entitled to further attendant care benefits beyond what the respondent had already paid, as the services were no longer reasonable or necessary after January 15, 2015.

The Tribunal approved the chronic pain assessment, finding it reasonable and necessary given the applicant's ongoing pain and psychological injuries.

However, the orthopaedic assessment was denied as unnecessary, since the applicant's physical injuries were already well-documented and the chronic pain assessment would sufficiently address the ongoing issues.

The applicant was injured in a rear-end motor vehicle collision and sought statutory accident benefits for chiropractic treatment and a physiatry assessment.

The respondent insurer denied the claims on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and the $3,500 funding limit had been exhausted.

The Tribunal found that the applicant's physical injuries, including a partial rotator cuff tear, were minor injuries under the Schedule.

The Tribunal preferred the evidence of the respondent's experts over the applicant's physiatrist, finding no compelling evidence of a pre-existing condition or psychological injury that would preclude recovery within the MIG.

The application was dismissed.

The insurer appealed arbitration decisions that dismissed its motions to compel the insured to attend insurer examinations and ordered it to pay a special award for unreasonably delaying benefits.

The insured cross-appealed the denial of a special award for other periods of delay.

The Director's Delegate dismissed both appeals.

The Delegate found that the arbitrators did not err in law in refusing the insurer examinations, as the insurer had delayed its requests until after the arbitration process was well underway.

Furthermore, the insurer's concession of entitlement during the hearing precluded a finding that it was denied a fair hearing.

The Delegate upheld the special award, finding no basis to interfere with the arbitrator's assessment of the insurer's unreasonable conduct, and agreed that the insurer's delay while seeking a stay of an interim order was not unreasonable.

The applicant was injured in a motor vehicle accident and received income replacement benefits until the insurer terminated them based on an occupational medicine examination.

The applicant was subsequently involved in a second motor vehicle accident but only sought benefits related to the first.

The arbitrator found that the applicant's evidence was inconsistent and that multiple medical specialists noted exaggerated pain behaviour and illness behaviour.

The arbitrator concluded that the applicant did not suffer a physiological or anatomical impairment from the first accident that disabled her from working, and that her psychological impairment did not prevent her from performing the essential tasks of her employment.

The application for arbitration was dismissed.