Dr. Moshiri

The applicant sought reconsideration of a Licence Appeal Tribunal decision that found her injuries fell within the Minor Injury Guideline (MIG).

The applicant argued that a psychological assessment report prepared by the respondent's expert, which diagnosed her with an adjustment disorder and specific phobia, constituted new evidence.

The respondent subsequently conceded that the applicant's injuries no longer fell within the MIG.

The Tribunal granted the reconsideration request, finding that the report was not reasonably available to the applicant prior to the close of the original hearing and would have affected the result.

The matter was remitted for a rehearing on the reasonableness and necessity of the disputed treatment plans.

The applicant's request for costs was denied.

The applicant sought statutory accident benefits following a motor vehicle accident, including medical benefits for physiotherapy and the cost of disability certificates (OCF-3s).

The insurer denied the claims on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and the treatments were not reasonable and necessary.

The adjudicator found that the applicant's injuries were predominantly minor and that she did not suffer from a pre-existing condition that would remove her from the MIG.

Relying on video surveillance that contradicted the applicant's reported limitations, the adjudicator concluded the treatment plans were not reasonable and necessary.

The claims for the OCF-3s were also dismissed as they were not requested by the insurer.

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

The respondent denied the claims, arguing the injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that while the applicant's physical injuries were minor, he sustained a psychological injury that exempted him from the MIG limits.

However, the Tribunal dismissed the claims for a psychological treatment plan and an orthopaedic assessment, finding them not reasonable and necessary.

The evidence, including the applicant's high level of post-accident occupational and social activity, contradicted the need for the proposed psychological treatment, and clinical records did not support ongoing physical impairments requiring further orthopaedic assessment.

The claim for an award for unreasonable delay was also dismissed.

The applicant sought the balance of a cost of examination for a psychological assessment following a motor vehicle accident.

The respondent had paid a portion of the claimed amount based on its own assessor's opinion of reasonable hours.

The Tribunal dismissed the application, finding the treatment plan vague and unparticularized, and noting the applicant failed to provide persuasive evidence justifying the full amount of time claimed.

The applicant, a pedestrian struck by a motor vehicle, sought income replacement benefits and funding for chronic pain and physiatry assessments from her insurer.

The Licence Appeal Tribunal found that the applicant failed to prove she suffered a substantial inability to perform the essential tasks of her pre-accident employment, relying on independent medical examinations that found no physical or psychological contraindications to her return to work.

The Tribunal also dismissed the claims for the assessments, finding them not reasonable and necessary given the lack of objective medical evidence supporting ongoing impairment and the applicant's self-reported improvements and return to work as a personal support worker.

The application was dismissed in its entirety.

The applicant sought payment for statutory accident benefits following a motor vehicle accident, including attendant care benefits, a non-earner benefit, and the cost of various assessments.

The Licence Appeal Tribunal found the applicant was not entitled to attendant care benefits or a non-earner benefit, as she failed to prove the expenses were reasonable and necessary or that she suffered a complete inability to carry on a normal life.

However, the Tribunal ordered the respondent to pay for a chronic pain assessment and two Assessments of Attendant Care Needs, finding them to be reasonable and necessary expenses, along with applicable interest.