Dr. Mehdi Lotfalizadeh

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

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

The applicant argued for removal from the MIG based on a pre-existing chronic back condition and a psychological impairment.

The Tribunal found that the applicant failed to provide compelling medical evidence that his pre-existing back condition would prevent maximal recovery under the MIG.

Furthermore, the psychological evidence was insufficient to establish an impairment warranting removal.

As the applicant remained subject to the MIG, the disputed treatment plans and claim for interest were dismissed.

The applicant sought $3,697.14 for a psychological services treatment plan involving virtual drive counselling following a motor vehicle accident.

The insurer denied the plan and requested additional information under section 33 of the Schedule, which the applicant failed to provide.

The Tribunal found the applicant did not meet her burden to prove the treatment was reasonable and necessary, preferring the insurer's section 44 psychological assessment over the applicant's evidence.

Claims for interest and an award for unreasonable delay were also dismissed.

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

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

The Tribunal found the applicant suffered from a psychological impairment and chronic pain, removing her from the MIG.

The Tribunal approved treatment plans for an attendant care assessment, psychological services, physiotherapy, and a lumbar back brace, finding them reasonable and necessary.

A psychological assessment was denied as redundant.

The Tribunal also awarded interest on overdue benefits but dismissed the applicant's claim for a special award, finding the respondent relied on expert opinions and did not unreasonably withhold payments.

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

The applicant claimed entitlement to psychological and physiotherapy treatment plans, arguing that psychological impairments and pre-existing conditions warranted removal from the MIG.

The Tribunal excluded late-filed medical evidence from the applicant due to non-compliance with production deadlines.

Relying on the respondent's psychological assessment, the Tribunal found the applicant failed to prove on a balance of probabilities that she suffered from a psychological impairment or pre-existing condition that would remove her from the MIG.

As the MIG limits were exhausted, the treatment plans, interest, and a claim for a special award were dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to treatment plans for chiropractic and psychological services beyond the $3,500 Minor Injury Guideline (MIG) limit.

The applicant argued for removal from the MIG on the basis of chronic pain and psychological impairments.

The Tribunal found the applicant failed to establish chronic pain with functional impairment, noting a lack of contemporaneous medical evidence and his return to full-time work.

The Tribunal also preferred the respondent's psychological assessment, which flagged symptom exaggeration, over the applicant's expert report.

The application was dismissed, and the applicant was not entitled to the disputed treatment plans or interest.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to psychological and physical rehabilitation treatment plans outside the $3,500 Minor Injury Guideline (MIG) limit.

The applicant argued that chronic pain and psychological impairments warranted removal from the MIG.

The Tribunal found that the applicant's self-reports to his psychological assessor were inaccurate and unsupported by corroborating clinical notes and records from his treating physicians.

Furthermore, the applicant failed to meet the AMA Guides criteria for chronic pain.

The Tribunal concluded the injuries were predominantly minor, and because the MIG limit was exhausted, the disputed treatment plans and interest were not payable.

The application was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, specifically claiming entitlement to a physiotherapy treatment plan and an attendant care assessment.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to prove the treatments were reasonable and necessary.

The Tribunal relied on the respondent's insurer examination reports, which concluded the applicant sustained only minor injuries and did not require further assessment or physiotherapy.

Claims for interest and a special award were consequently dismissed.

The applicant sought accident benefits following a motor vehicle accident, claiming removal from the Minor Injury Guideline (MIG) on the basis of chronic pain and psychological impairment.

The respondent denied the benefits, arguing that the applicant's ongoing complaints were not caused by the subject accident, as she had been involved in multiple subsequent incidents, including a bus accident, a slip and fall, and being crushed by subway doors.

The Tribunal applied the 'but for' test for causation and found that the applicant failed to prove her chronic pain and psychological impairments were caused by the subject accident.

The Tribunal concluded the applicant's injuries were predominantly minor and dismissed the claims for treatment plans, interest, and an award.

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

The Licence Appeal Tribunal considered claims for psychological services, dental services, and a chronic pain management program.

The Tribunal awarded the psychological services, finding the hourly rate for psychotherapy reasonable.

The Tribunal also awarded the chronic pain management program, accepting the applicant's expert evidence that treatment was necessary despite the respondent's argument that the applicant did not meet the criteria for chronic pain syndrome.

The claim for dental services was dismissed due to insufficient evidence linking the injuries to the accident.

Interest was awarded on the overdue payments.

The applicant sought statutory accident benefits, including income replacement benefits (IRBs) and funding for seven physiotherapy treatment plans, following a motor vehicle accident.

The Licence Appeal Tribunal dismissed the application in its entirety.

The adjudicator found the applicant's self-reporting to medical assessors unreliable due to symptom magnification and surveillance evidence showing the applicant working long hours at a restaurant.

Consequently, the applicant failed to prove a substantial inability to perform the essential tasks of his employment for pre-104 week IRBs, or a complete inability to engage in any employment for post-104 week IRBs.

The physiotherapy plans were deemed not reasonable and necessary, as the applicant contemporaneously reported to his family doctor that the treatments were ineffective.

The applicant sought entitlement to statutory accident benefits for an occupational therapy assessment, social worker counselling, and chiropractic services following a motor vehicle accident.

The applicant argued the respondent's denial notices were procedurally defective under s. 38(8) of the Schedule.

The Tribunal found that while one denial was late, the applicant failed to prove the expenses were incurred during the period of non-compliance.

The Tribunal concluded the respondent's notices provided clear medical reasons for the denials, relying on insurer's examinations.

As the applicant made no submissions on the substantive reasonableness and necessity of the treatment plans, the application was dismissed.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for a chronic pain assessment in the amount of $2,460.00.

The respondent insurer denied the treatment plan based on an insurer's examination report which concluded the applicant suffered only minor soft tissue injuries.

The Licence Appeal Tribunal found the insurer's medical report failed to adequately consider the clinical notes and records of the applicant's family physicians, which included a chronic pain diagnosis.

Relying on the applicant's psychological assessments and the AMA Guides criteria for chronic pain, the Tribunal concluded the chronic pain assessment was reasonable and necessary.

The Tribunal ordered the respondent to pay for the assessment and interest on the overdue payment, but dismissed the applicant's claim for a special award under section 10 of O. Reg. 664, finding the insurer's conduct did not meet the threshold of being excessive or imprudent.

The applicant sought statutory accident benefits for psychological services following a 2016 motor vehicle accident.

The insurer denied the treatment plan based on an insurer's examination which concluded the applicant suffered no accident-related psychiatric impairment.

The Tribunal found that the applicant failed to prove the treatment was reasonable and necessary, noting that the applicant's expert reports related to a previous 2012 accident, there was a lack of psychological complaints to his family doctor, and the applicant successfully completed a realtor program despite alleged concentration issues.

The application was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, including income replacement benefits (IRBs) and two treatment plans.

The respondent insurer denied the benefits, arguing the applicant did not meet the test for IRBs and failed to attend scheduled independent medical examinations (IEs).

The Tribunal found the applicant's credibility lacking due to her failure to produce documents explaining her non-attendance at the IEs and drew an adverse inference.

However, relying on the applicant's psychological expert, the Tribunal concluded she suffered severe psychological impairments rendering her substantially unable to perform the essential tasks of her pre-accident employment as a personal support worker.

The Tribunal awarded ongoing IRBs, excluding the period of non-attendance at the IEs, but denied the disputed treatment plans as duplicative or unproven.

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

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

The Tribunal found that the applicant sustained predominately minor injuries and failed to provide compelling evidence of a pre-existing condition or psychological impairment that would prevent maximal recovery within the MIG.

The application for benefits was dismissed, and the respondent's request for costs was also denied.

The applicant was injured in a motor vehicle accident and sought payment for a psychological assessment and physiotherapy services.

The respondent insurer denied the treatment plans on the basis that the applicant's injuries were predominantly minor and subject to the $3,500 cap under the Minor Injury Guideline (MIG).

The Tribunal found that the applicant failed to provide sufficient medical evidence to prove her chronic pain, fibromyalgia, and psychological impairments were caused by the accident or removed her from the MIG.

The application was dismissed, and the applicant was denied the claimed benefits, interest, and costs.