Dr. Mehdiratta

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that denied seven of eight disputed treatment plans following a motor vehicle accident.

The applicant argued the adjudicator erred in weighing medical evidence, particularly by focusing on inconsistencies in her self-reporting, and failed to properly apply s. 38(8) of the Schedule regarding the insurer's denial letters.

The Tribunal dismissed the request, finding that the applicant was attempting to re-litigate arguments and re-weigh evidence already considered at the initial hearing.

The Tribunal concluded that the adjudicator made no error of law or fact, nor any breach of procedural fairness, that would warrant reconsideration.

The applicant, a pedestrian struck by a vehicle, sought payment for three physiotherapy treatment plans under the Statutory Accident Benefits Schedule.

The respondent denied the benefits, relying on section 44 assessments indicating no further physical rehabilitation was necessary.

The Tribunal found the applicant's medical evidence unpersuasive, as the reports were either based on phone consultations, lacked physical examinations, or contradicted hospital records.

The Tribunal preferred the respondent's assessments and dismissed the application, finding the treatment plans were not reasonable or necessary.

The applicant was involved in a motor vehicle accident and sought a determination of catastrophic impairment due to a mild traumatic brain injury and psychological impairments.

The Licence Appeal Tribunal found that the applicant did not meet the criteria for catastrophic impairment under Criterion 6 (Glasgow Outcome Scale) because she maintained some independence and employment.

However, the Tribunal concluded that the applicant sustained a marked impairment in adaptation under Criterion 8 due to her somatic symptom disorder and cognitive challenges.

The Tribunal awarded attendant care benefits of $1,561.89 per month, various treatment plans, and interest, but denied the claim for 24/7 attendant care and a special award under Regulation 664.

The applicant, a pedestrian struck by a vehicle, sought various statutory accident benefits including attendant care, physiotherapy, psychological services, and a neuropsychological assessment.

The insurer denied the benefits.

The Licence Appeal Tribunal found that the applicant suffered a fractured ankle and a mild concussion but returned to work quickly and demonstrated high functional independence.

Claims for attendant care, occupational therapy, and psychological services were dismissed as not reasonable and necessary.

Physiotherapy claims were denied for failure to exhaust collateral benefits.

The Tribunal granted the request for a neuropsychological assessment and minor medication expenses.

A claim for a special award for unreasonable withholding of benefits was dismissed.

The applicant was involved in a motor vehicle accident and sought statutory accident benefits, including Income Replacement Benefits (IRBs) and chiropractic treatment, which the respondent insurer denied.

The Licence Appeal Tribunal found that the applicant suffered a concussion and was substantially unable to perform the essential tasks of his employment, entitling him to IRBs for the first 104 weeks post-accident.

However, the applicant failed to prove a complete inability to engage in any suitable employment, precluding IRB entitlement beyond 104 weeks.

The Tribunal also held that the chiropractic treatment plan was not reasonable and necessary.

Notably, the Tribunal determined that the Canada Emergency Response Benefit (CERB) received by the applicant is tantamount to "other remuneration from employment" under the Schedule and is therefore deductible from the IRB entitlement.

The claim for an award was dismissed as the insurer's denial was not unreasonable.

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

The insurer denied medical benefits beyond the $3,500 Minor Injury Guideline limit and denied a non-earner benefit.

The Licence Appeal Tribunal found that the applicant failed to prove her injuries extended beyond predominantly minor soft tissue injuries, rejecting her claims of chronic pain and psychological impairment due to insufficient objective medical evidence.

The Tribunal also dismissed the claim for a non-earner benefit, finding no evidence that the applicant suffered a complete inability to carry on a normal life.

All claims, including a request for an award for unreasonable delay, were dismissed.

The applicant sought entitlement to various medical and rehabilitation benefits, including assistive devices, chiropractic treatment, physiotherapy, Botox treatment, a diagnostic nuclear imaging assessment, and pilates expenses, following a motor vehicle accident.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to prove on a balance of probabilities that the disputed treatment plans and expenses were reasonable and necessary.

The Tribunal preferred the evidence of the respondent's assessors, who opined that the applicant did not require assistive devices, had reached maximum medical recovery, and did not require further facility-based treatment.

The applicant sought post-104-week income replacement benefits following a motor vehicle accident.

The insurer denied the benefits based on insurer's examinations concluding the applicant did not suffer a complete inability to engage in suitable employment.

The Licence Appeal Tribunal dismissed the application, finding the applicant failed to provide sufficient recent medical evidence to rebut the insurer's expert reports and prove a complete inability to work.

Claims for interest and a special award were also dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, specifically claiming for a chiropractic treatment plan and a hospital emergency room visit.

The respondent insurer denied the claims.

The Licence Appeal Tribunal found the chiropractic treatment plan to be reasonable and necessary, as it helped reduce pain and increase range of motion, despite the insurer's medical reports suggesting otherwise.

However, the Tribunal denied the claim for the hospital visit, finding the applicant failed to prove it was directly related to the accident.

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

The insurer denied payment, arguing the injuries were predominantly minor and subject to the $3,500 treatment limit under the Minor Injury Guideline, or alternatively, that the injuries were caused by a subsequent accident.

The Licence Appeal Tribunal found that the applicant suffered from a concussion with post-concussive symptoms caused by the first accident, which is not a predominantly minor injury.

The Tribunal ordered the insurer to pay for a driving rehabilitation assessment and an occupational therapy assessment, finding them reasonable and necessary.

The applicant was awarded interest on overdue payments but denied an award for unreasonable denial, as the insurer's belief regarding the cause of the injuries was reasonable.

The applicant sought payment for a neurocognitive assessment, a psychological assessment, and various other expenses following a motor vehicle accident.

The Licence Appeal Tribunal found that the neurocognitive assessment was reasonable as it was intended to help the applicant decide whether to bring a claim for catastrophic impairment, but capped the payable amount at $2,000 plus tax.

The claims for the psychological assessment and other expenses were dismissed, as the applicant failed to prove they were reasonable and necessary, and the medical evidence provided by the applicant was found to be inconsistent and lacking credibility.