Dr. Nikkhou

The applicant sought statutory accident benefits following a motor vehicle accident, arguing his injuries fell outside the Minor Injury Guideline (MIG) due to chronic pain syndrome and psychological impairment.

The Licence Appeal Tribunal found the applicant's evidence, including his family doctor's clinical notes, insufficient to support his claims, noting significant gaps in reporting pain or psychological issues.

The Tribunal preferred the respondent's insurer examination reports, which concluded the injuries were soft-tissue in nature and treatable within the MIG.

The application for disputed treatment plans and interest was dismissed.

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

The insurer denied several treatment plans, and the applicant applied to the Licence Appeal Tribunal.

The Tribunal found that the claims for an OT neurocognitive assessment, physiotherapy, and a chronic pain assessment were statute-barred, as the applicant failed to file the application within the two-year limitation period following clear and unequivocal denials by the insurer.

The Tribunal also dismissed the claim for psychological services, preferring the insurer's section 44 assessment which concluded the applicant did not suffer from an accident-related psychological impairment at the time the plan was submitted.

The application was dismissed in its entirety.

The applicant sought statutory accident benefits following a motor vehicle accident, including non-earner benefits (NEBs) and various treatment plans for physiotherapy, a psychological assessment, and a chronic pain assessment.

The Tribunal found that the applicant failed to establish a complete inability to carry on a normal life, noting that the applicant's evidence only showed some activities were more difficult, not that he was prevented from engaging in them.

The Tribunal also dismissed the claims for the treatment plans, finding the applicant failed to provide sufficient evidence or submissions to establish that the proposed treatments were reasonable and necessary.

The claim for incurred physiotherapy expenses was dismissed as the expenses were incurred prior to the submission of a treatment plan.

The application was dismissed in its entirety.

The applicant sought 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 the applicant sustained a concussion, removing her from the MIG, based on the contemporaneous diagnoses of her treating physicians.

However, the Tribunal denied the applicant's claim for a $2,845.64 physiotherapy treatment plan, finding insufficient evidence that it was reasonable and necessary.

The Tribunal also dismissed the respondent's claim for repayment of an income replacement benefit overpayment, as the respondent failed to provide evidence to quantify the amount owed.

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

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

The Tribunal found that the applicant sustained chronic pain and psychological impairments (including PTSD and driving phobia) that removed her from the MIG.

The Tribunal preferred the evidence of the applicant's treating practitioners and in-person assessors over the insurer's paper reviews and examinations.

The applicant was awarded all disputed medical and rehabilitation benefits, totaling over $10,000, plus interest on overdue payments.

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 that the applicant suffered from chronic pain with functional impairment, removing him from the MIG.

The Tribunal ordered the respondent to pay for massage, chiropractic, and physiotherapy treatment plans, as well as a psychological assessment, finding them reasonable and necessary.

The claim for an attendant care assessment was dismissed, as was the claim for an award under Regulation 664, because the respondent had not acted unreasonably given the late production of medical evidence.

The applicant sought a non-earner benefit following a motor vehicle accident.

The Tribunal found that the respondent insurer failed to comply with its procedural obligations under s. 36(4) of the Schedule by responding late to the application, and ordered payment of the benefit for the period of non-compliance.

However, for the remaining period, the Tribunal dismissed the claim, finding the applicant failed to prove a complete inability to carry on a normal life.

The applicant's evidence lacked objective support, and the respondent's independent examination assessors noted inconsistencies and symptom exaggeration.

The applicant sought a special award under section 10 of Regulation 664, alleging the respondent unreasonably withheld or delayed payment of income replacement benefits and a medical benefit for psychological treatment.

The adjudicator found that the applicant was responsible for delays by failing to provide medical documents in a timely manner and refusing to attend a functional abilities evaluation.

The respondent acted reasonably in scheduling independent examinations to assess the new medical information provided.

The claims for a special award and interest were dismissed.

The applicant requested a reconsideration of a decision finding that his injuries fell within the Minor Injury Guideline (MIG) and denying disputed treatment plans.

The applicant argued the adjudicator violated procedural fairness by admitting the respondent's medical reports and excluding his affidavit, and made errors of law and fact regarding the MIG.

The Vice Chair dismissed the request, finding no jurisdictional error or procedural unfairness, as the affidavit was excluded based on a prior consent order.

The Vice Chair also found no error in the MIG analysis, noting the applicant failed to provide persuasive evidence of a psychological injury or chronic pain condition to warrant removal from the MIG.

The respondent's request for costs was denied.

The applicant was injured in a motor vehicle accident and sought an income replacement benefit (IRB) and various medical and rehabilitation benefits from the respondent insurer.

The insurer terminated the IRB and denied several treatment plans on the basis that the applicant no longer suffered a substantial inability to perform his pre-accident job tasks and that the treatments were not reasonable and necessary.

The Tribunal found that the applicant failed to prove a substantial inability to perform his employment tasks during the disputed period, relying on the insurer's expert assessments.

The Tribunal approved one chiropractic treatment plan as reasonable and necessary, noting the applicant's ongoing pain and the insurer's failure to conduct a timely examination, but denied the remaining plans for chiropractic, psychological, and occupational therapy services due to a lack of corroborating medical evidence.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for psychological assessments, psychological treatment, and physiotherapy.

The respondent insurer denied the benefits.

The Licence Appeal Tribunal found that the applicant failed to discharge the burden of proving that the proposed treatments and assessments were reasonable and necessary.

The Tribunal preferred the evidence of the respondent's experts, who found minimal psycho-emotional distress and no objective evidence of physical impairment, over the conflicting and inconsistent reports of the applicant's experts.

The application was dismissed.

The applicant was injured in a motor vehicle accident and sought medical benefits for exercise equipment, assistive devices, a chronic pain assessment, and chiropractic services under the Statutory Accident Benefits Schedule.

The respondent insurer denied the benefits.

The Licence Appeal Tribunal dismissed the application, finding that the applicant relied solely on self-reporting of pain without corroborating medical documentation.

The Tribunal preferred the evidence of the respondent's insurer examination assessors, who concluded that the requested treatments and assessments were not reasonable and necessary.

As no benefits were payable, the claims for interest and an award were also dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, including an income replacement benefit and various medical and rehabilitation benefits.

The respondent denied the benefits on the basis that the applicant's impairments fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant's physical injuries were predominantly minor and that he failed to establish a psychological impairment or chronic pain condition that would remove him from the MIG.

The Tribunal preferred the respondent's psychological assessment over the applicant's, noting the latter omitted a significant life event.

The Tribunal also found the applicant failed to prove he missed work as a result of the accident, dismissing the claim for an income replacement benefit.

The application was dismissed in its entirety.

The applicant sought reconsideration of a Licence Appeal Tribunal decision which found that his injuries from a motor vehicle accident fell within the Minor Injury Guideline (MIG), thereby capping his accident benefits at $3,500.

The applicant argued the Tribunal violated natural justice and erred in law by preferring the insurer's psychological report, refusing to take judicial notice of changes in the DSM regarding chronic pain, and failing to properly consider his physical functional limitations and pre-existing injuries.

The Executive Chair dismissed the request for reconsideration, finding no bias in the Tribunal's preference for the more recent psychological report and no error in requiring evidentiary proof rather than taking judicial notice of complex medical diagnoses.

The Chair also upheld the Tribunal's findings that the applicant failed to prove his physical limitations and pre-existing conditions exempted him from the MIG.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming her physical and psychological impairments removed her from the Minor Injury Guideline (MIG) and entitled her to an income replacement benefit (IRB).

The adjudicator found that the applicant failed to provide compelling evidence of a pre-existing condition, chronic pain, or severe psychological impairment that would take her injuries outside the MIG.

Furthermore, relying on the respondent's medical assessments, the adjudicator concluded that the applicant did not suffer a substantial inability to perform the essential tasks of her pre-accident employment.

The application for medical benefits beyond the MIG cap and for an IRB was dismissed.