Dr. Marc Mandel

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 was struck by a vehicle as a pedestrian and sought statutory accident benefits for physical and psychological injuries.

The insurer limited her medical and rehabilitation benefits to $3,500, arguing her injuries fell within the Minor Injury Guideline.

The applicant claimed she suffered from chronic pain, a nerve impingement, and a psychological condition (PTSD) that removed her from the minor injury limit.

The Tribunal found that her physical soft tissue injuries had resolved and rejected her psychological expert's report because the expert had never actually met her.

The Tribunal concluded the applicant sustained predominantly minor injuries and dismissed her claims for further medical benefits and assessments.

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 motor vehicle accident and his claims for statutory accident benefits were dismissed in a prior arbitration decision.

In this subsequent decision on expenses, the insurer sought its costs of the proceeding.

The arbitrator found the insurer was entirely successful and therefore entitled to its expenses.

Applying a 2:1 ratio for preparation to hearing time, and allowing disbursements for expert witnesses while disallowing conduct money for uncalled witnesses and court reporter fees, the arbitrator ordered the applicant to pay the insurer's expenses fixed at $21,387.48.

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.

The applicant was injured in a motor vehicle accident while riding his bicycle.

He applied for accident benefits, initially electing a non-earner benefit, but later claimed entitlement to an income replacement benefit.

The arbitrator found that the applicant failed to prove he had a reasonable explanation for delaying his re-election.

Furthermore, the applicant did not meet the eligibility criteria for an income replacement benefit, as he was not employed for at least 26 weeks in the 52 weeks prior to the accident and was not receiving employment insurance benefits at the time of the accident.

The arbitrator also concluded that the applicant did not suffer a substantial inability to perform the essential tasks of his employment.

The claims for an income replacement benefit and a special award were dismissed.

The applicant, a pedestrian struck by a motor vehicle, sought statutory accident benefits including housekeeping, attendant care, and income replacement benefits.

The arbitrator dismissed the claim for housekeeping benefits as the insurer had already paid the amount claimed.

The arbitrator awarded attendant care benefits for the period before the applicant submitted the required Form 1, finding it was submitted within a reasonable time.

The claim for ongoing income replacement benefits was dismissed because the medical evidence, including reports from the applicant's own assessors, and the applicant's unreliable testimony failed to establish a substantial inability to perform the essential tasks of her pre-accident employment.