Dr. Marc Mandel

The applicant sought statutory accident benefits following a motor vehicle accident, disputing the respondent's determination that his injuries fell within the Minor Injury Guideline (MIG).

The applicant failed to provide written submissions or comply with Tribunal deadlines.

Relying on the respondent's multidisciplinary assessments, the Tribunal found the applicant's injuries were predominantly minor and did not warrant removal from the MIG.

The application for treatment plans and interest was dismissed.

Due to the applicant's unreasonable behaviour and bad faith in the proceeding, the Tribunal ordered costs of $1,000 against the applicant.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming her injuries warranted treatment outside the Minor Injury Guideline (MIG) due to chronic pain, psychological issues, and exacerbation of a pre-existing condition.

The insurer denied the disputed treatment plans, arguing the injuries were predominantly minor.

The Tribunal found the applicant failed to meet her burden of proving her injuries fell outside the MIG, preferring the insurer's medical examination reports over the applicant's unsupported treatment plans.

As the $3,500 MIG limit had been exhausted, the application for the disputed treatment plans and interest was dismissed.

The applicant was involved in a motor vehicle accident and sought statutory accident benefits, including income replacement benefits (IRB) and various treatment plans.

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

The Tribunal found that the applicant's physical injuries, including a claimed pars defect, and psychological impairments did not warrant removal from the MIG.

The Tribunal preferred the respondent's medical evidence, noting the applicant's diagnostic imaging showed no fractures and the psychological assessment relied heavily on self-reporting.

The Tribunal also found that the respondent had already paid the claimed IRB.

The application was dismissed.

The applicant sought non-earner benefits, medical benefits for physiotherapy, and the cost of examinations for mental health and chronic pain assessments following a motor vehicle accident.

The Tribunal dismissed the application, finding the applicant failed to establish a complete inability to carry on a normal life.

The Tribunal gave little weight to the applicant's expert reports due to their reliance on self-reporting without a Somali interpreter and failure to include signed expert duty acknowledgments.

The respondent's section 44 assessments, which utilized an interpreter and found symptom magnification and minor injuries, were preferred.

The applicant sought statutory accident benefits following a motor vehicle accident, arguing his injuries fell outside the Minor Injury Guideline (MIG) due to pre-existing rheumatoid arthritis, psychological impairments, and chronic pain.

The Tribunal found the applicant's rheumatoid arthritis was in remission and did not prevent maximal recovery.

The Tribunal preferred the respondent's expert evidence, concluding the applicant did not suffer from a psychological impairment or chronic pain syndrome that would warrant removal from the MIG.

The applicant's physical injuries were deemed predominantly minor.

The disputed treatment plans were deemed reasonable and necessary only up to the remaining MIG limits.

The applicant's claim for a special award was dismissed for failing to provide particulars.

The applicant sought $2,818.14 for psychotherapy services following a motor vehicle accident.

The Licence Appeal Tribunal found that the applicant failed to prove the treatment plan was reasonable and necessary, noting that the applicant had already received 51 sessions and the supporting psychological report lacked specifics on the necessity, frequency, and duration of further treatment.

Claims for an award under Regulation 664 and interest were consequently dismissed.

The respondent's request for costs was also denied as the applicant's conduct was not unreasonable, frivolous, vexatious, or in bad faith.

The applicant sought medical and rehabilitation benefits following a motor vehicle accident.

The respondent insurer denied the claims on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant's physical injuries were predominantly minor, relying on medical reports attributing his back pain to a subsequent work-related injury.

However, the Tribunal held that the respondent failed to comply with the notice requirements under s. 38(9) of the Schedule when denying the psychological assessment and treatment plans, as it did not explicitly state that the MIG applied.

Consequently, under s. 38(11), the respondent was prohibited from taking the position that the MIG applied to the psychological claims and was ordered to pay those benefits.

The applicant was injured in a rear-end motor vehicle accident and sought income replacement benefits, various treatment plans, and a chronic pain assessment from her insurer.

The Licence Appeal Tribunal found that the applicant did not suffer a substantial inability to perform the essential tasks of her pre-accident employment, relying on surveillance evidence that contradicted her self-reported limitations.

The Tribunal approved treatment plans for physiotherapy and massage therapy as reasonable and necessary, but denied plans for drive counselling, a treadmill, and a chronic pain assessment due to insufficient medical evidence and inconsistencies in the applicant's presentation.

Claims for an award for unreasonably delayed payments were also dismissed.

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

The respondent insurer denied the claims, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) and were subject to the $3,500 limit.

The Licence Appeal Tribunal found that the applicant failed to prove her injuries were more than soft tissue in nature or that she had a pre-existing condition warranting removal from the MIG.

The Tribunal preferred the respondent's psychological assessment, which found no psychological impairment, over the applicant's evidence.

The application for benefits was dismissed.

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

The insurer denied funding for additional chiropractic treatments and assessments beyond the $3,500 Minor Injury Guideline (MIG) limit.

The Licence Appeal Tribunal found that the applicant's physical and psychological injuries fell within the MIG.

The Tribunal preferred the evidence of the insurer's medical experts, who provided extensive reports based on testing, over the applicant's practitioners, who failed to provide details of testing or lacked appropriate accreditation.

As the applicant had already exhausted the MIG funding limit, the claims for additional medical benefits and interest were dismissed.

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

The respondent denied several treatment plans on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant's physical injuries were predominantly minor and that he failed to provide compelling evidence of a pre-existing condition that would preclude maximal recovery within the MIG limits.

The Tribunal also preferred the evidence of the respondent's psychological expert, finding that the applicant did not suffer from a psychological impairment that would remove him from the MIG.

As the applicant's injuries were confined to the MIG, the disputed benefits exceeding the $3,500 cap were denied.

The applicant sought ongoing income replacement benefits following a motor vehicle accident.

The respondent had paid benefits until November 2014 but denied further entitlement.

The Tribunal found that the applicant's ongoing back pain was related to pre-existing mild degenerative changes and obesity, not the accident.

Medical evidence also suggested symptom embellishment.

The Tribunal concluded the applicant failed to prove a substantial inability to perform his pre-accident employment or a complete inability to engage in any suitable employment.

The application for ongoing benefits was dismissed.

The respondent's request for repayment of an overpayment was also dismissed as it was not properly raised at the case conference.

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

The respondent denied several treatment plans for physiotherapy and a psychological assessment, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the medical evidence, including the applicant's own orthopaedic assessment, established that the injuries were predominantly minor soft tissue injuries.

The applicant failed to provide compelling evidence of a pre-existing medical condition or psychological impairment that would remove him from the MIG.

Consequently, the disputed treatment plans were deemed not reasonable and necessary, and the application was dismissed.

The applicant, a pedestrian struck by a vehicle, sought Income Replacement Benefits (IRBs) and funding for psychological and chronic pain assessments.

The insurer terminated IRBs after six months and denied the assessments, arguing the applicant's injuries fell within the Minor Injury Guidelines (MIG).

The Tribunal found the applicant did not suffer a substantial inability to perform his essential tasks for the first 104 weeks, nor a complete inability to engage in employment thereafter, relying on surveillance evidence showing him working and medical reports indicating symptom magnification.

The Tribunal also concluded the applicant's injuries were minor, dismissing the claims for the assessments.