Dr. M. Goldstein

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to non-earner benefits and various medical and assessment plans outside the Minor Injury Guideline (MIG).

The adjudicator found that the applicant's injuries were predominantly minor, noting a lack of persuasive evidence for accident-related psychological, neurological, or chronic pain impairments.

The adjudicator preferred the insurer's medical reports and highlighted inconsistencies in the applicant's self-reporting, including a subsequent cycling accident and surveillance showing her working.

The application was dismissed, with no entitlement to the disputed benefits, interest, or an award.

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

The respondent initially placed her in the Minor Injury Guideline (MIG) but later removed her, approving some treatment plans.

At issue was the reasonableness and necessity of several chiropractic treatment plans, a chronic pain assessment, a functional ability evaluation, and a work site assessment.

The Tribunal found the chiropractic treatments and chronic pain assessment to be reasonable and necessary, preferring the evidence of the applicant's treating practitioners and chronic pain assessor over the respondent's orthopedic IE assessor.

However, the functional ability evaluation and work site assessment were denied as the applicant failed to provide submissions or establish their goals.

Interest was awarded on the approved plans.

The applicant was injured in a rear-end motor vehicle accident and sought statutory accident benefits for a treatment plan that included massage therapy.

The respondent partially approved the plan but denied funding for massage therapy.

The Tribunal found that massage therapy was not reasonable and necessary, as the applicant's family physician and the insurer's examination physician both recommended only active therapy such as physiotherapy and home exercises.

A late-filed chiropractic report recommending massage therapy was admitted but given less weight due to its timing.

The application for benefits, interest, and costs was dismissed.

The applicant sought income replacement benefits, medical and rehabilitation benefits for chiropractic treatment, and the cost of a psychological assessment following a motor vehicle accident.

The respondent denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) and she did not suffer a substantial or complete inability to work.

The adjudicator dismissed the application, finding no medical evidence supported the applicant's inability to work.

Insurer examination reports consistently showed no physical or psychological impairments preventing a return to employment.

The adjudicator also found the applicant failed to prove the proposed chiropractic treatments and psychological assessment were reasonable and necessary.

The insurer requested a reconsideration of a Tribunal order finding the claimant entitled to medical benefits for physical rehabilitation and acupuncture.

The insurer argued that the hearing adjudicator made significant errors of law and fact by finding the expenses were incurred and reasonable and necessary, and by allegedly reversing the burden of proof.

The Tribunal dismissed the request, finding that the hearing adjudicator properly weighed the evidence, did not reverse the burden of proof, and made findings of fact that were within his discretion.

The Tribunal noted that a reconsideration is not an opportunity to re-litigate the matter.

The applicant was injured in a motor vehicle accident and sought medical benefits for physical rehabilitation and acupuncture services, which the respondent insurer denied.

The Licence Appeal Tribunal found that the applicant's physical and psychological impairments were caused by the accident.

The Tribunal placed limited weight on the insurer's medical examination reports due to methodological flaws and incomplete record reviews.

The Tribunal concluded that the proposed treatment plans were reasonable and necessary to address the applicant's persistent pain and psychological distress.

The applicant was awarded the claimed medical benefits and interest, while the respondent's request for costs was denied.

The applicant sought interim payment of dental and chiropractic accounts under the 'pay pending dispute' provisions of the Statutory Accident Benefits Schedule following a 1993 motor vehicle accident.

The insurer moved to dismiss the arbitration as duplicitous with the applicant's civil action and sought to introduce defence medical reports obtained in that action.

The arbitrator admitted the medical reports, finding the interests of justice outweighed the deemed undertaking rule, but refused to dismiss the arbitration, holding the claims were distinct.

The arbitrator ordered the insurer to pay the medical accounts on an interim basis, finding the applicant had established the requisite de minimis connection between the accident and the treatment.