Dr. Melissa Hershberg

The applicant sought payment for three physiotherapy treatment plans following a motor vehicle accident.

The adjudicator found that the applicant failed to prove the treatments were reasonable and necessary, noting that the applicant's own family physician recorded that physiotherapy was not helping, and neither the applicant's nor the respondent's medical assessors recommended ongoing physiotherapy.

The applicant also argued entitlement based on the insurer's failure to provide timely notice under section 38(8) of the Schedule.

The adjudicator agreed the insurer was non-compliant but dismissed the claim because the applicant provided no evidence that the expenses were actually incurred during the period of non-compliance.

The application was dismissed.

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

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

The Tribunal found that the applicant sustained a psychological impairment, specifically driving anxiety and nightmares, removing him from the MIG.

The Tribunal approved a psychological assessment and partially approved a physiotherapy treatment plan for a TENS unit and heating pad, but denied facility-based treatment.

The Tribunal also found the respondent's initial denial notice non-compliant with s. 38(8) of the Schedule, but held that s. 38(11) only required payment for items incurred during the non-compliance period.

The claim for an award for unreasonable delay was dismissed, but interest on overdue benefits was granted.

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

The Licence Appeal Tribunal found that the applicant's injuries were predominantly minor soft-tissue injuries.

The Tribunal preferred the respondent's insurer's examination reports, which found no accident-related psychological condition or functional impairment, over the applicant's unsupported claims.

As the MIG limits were exhausted, the applicant was not entitled to the disputed treatment plans, an award, or interest.

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

The respondent denied various treatment plans 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 failed to provide compelling evidence of a pre-existing psychological condition or chronic pain syndrome that would prevent maximal medical recovery within the MIG.

Relying on clinical notes, prescription records, and independent medical examinations, the Tribunal concluded the injuries were minor.

As the MIG limits were exhausted, the disputed treatment plans and interest were denied.

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

The respondent denied various 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 prove any pre-existing condition, psychological impairment, or chronic pain with functional impairment that would warrant removal from the MIG.

As the MIG funding limit was exhausted, the disputed treatment plans were not payable.

The application was dismissed.

The applicant sought statutory 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 her shoulder injury, psychological impairments, and chronic pain warranted removal from the MIG.

The Tribunal found that the shoulder injury was likely a pre-existing condition related to her employment as a personal support worker and was not caused by the accident.

Furthermore, the applicant failed to provide compelling medical evidence of an accident-related psychological impairment or functional limitations due to chronic pain.

The Tribunal concluded the applicant's injuries were subject to the MIG and dismissed the claims for additional medical benefits, examination expenses, interest, and an award.

The applicant was injured in a motor vehicle accident and sought income replacement benefits from her insurer.

The insurer denied the benefits, arguing her injuries fell within the Minor Injury Guideline.

The arbitrator found the applicant credible and accepted medical evidence that she suffered from Chronic Pain Syndrome as a result of the accident.

The arbitrator concluded the applicant suffered a substantial inability to perform the essential tasks of her employment for the first 104 weeks, and a complete inability to engage in any suitable employment thereafter.

The applicant was awarded ongoing income replacement benefits and interest on overdue payments.