Dr. Maistrelli

The applicant sought entitlement to statutory accident benefits following a motor vehicle accident, including costs for a catastrophic impairment assessment, chiropractic treatment plans, and a psychological assessment.

The Tribunal found that the applicant failed to prove the proposed treatments and assessments were reasonable and necessary, noting the minor nature of the physical injuries, the applicant's return to work and daily activities, and the unreliability of the applicant's medical reports.

The application was dismissed in its entirety, with no interest or special award payable.

The applicant sought payment for a multidisciplinary catastrophic impairment (CAT) assessment totaling $25,779.25 following a 2013 motor vehicle accident.

The Tribunal held that entitlement to a CAT assessment is a qualified right governed by section 15 of the Schedule, requiring each constituent assessment to be reasonable and necessary, rather than a substantive right under section 25.

Reviewing the medical evidence, the Tribunal found the applicant displayed normal range of motion, functioned independently, and had minimal ongoing treatment, which was inconsistent with the severity of impairment required for a CAT designation.

The application was dismissed, along with claims for interest and a special award.

The applicant was injured in a motorcycle accident and sought statutory accident benefits for physiotherapy, a neurological assessment, and a chronic pain assessment.

The Licence Appeal Tribunal found that the physiotherapy treatment was reasonable and necessary based on the physical findings of limited flexion and recommendations from treating neurologists, rejecting the insurer's orthopaedic assessment.

However, the Tribunal denied the requests for neurological and chronic pain assessments, finding insufficient evidence to support their necessity.

Claims for an award and costs were also dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, including a non-earner benefit and several medical and rehabilitation treatment plans.

The Licence Appeal Tribunal found that the applicant failed to meet the burden of proving a complete inability to carry on a normal life, noting a lack of detailed evidence regarding pre- and post-accident activities.

The Tribunal also dismissed the claims for medical benefits, preferring the respondent's orthopaedic assessment over the applicant's treating chiropractor, and finding the applicant's evidence insufficient to establish that the treatments were reasonable and necessary.

The application was dismissed in its entirety, and the applicant's request for costs was denied.

The applicant sought dispute resolution at the Licence Appeal Tribunal after the respondent insurer denied four treatment plans following a motor vehicle accident.

The adjudicator denied the request for an orthopaedic assessment, finding it was based solely on self-reported injuries without objective medical evidence.

Two chiropractic treatment plans were approved as reasonable and necessary because they included appropriate active and passive modalities consistent with the applicant's injuries.

A third chiropractic plan was denied due to a lack of substantive benefit and failure to address other barriers to recovery.

The applicant's claim for a special award under s. 10 of Regulation 664 was dismissed, but interest was awarded on the approved benefits.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits, claiming he suffered a catastrophic impairment due to psychological and chronic pain issues.

The insurer denied the benefits, relying on assessments that found only mild impairments and suggested symptom exaggeration.

The arbitrator preferred the evidence of the applicant's treating psychiatrist and found the applicant suffered a marked impairment in adaptation, qualifying as a catastrophic impairment.

The arbitrator awarded ongoing income replacement benefits, finding the applicant completely unable to engage in suitable employment, as well as attendant care, housekeeping benefits, and the cost of a chronic pain assessment.