Dr. Rakesh Ratti

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

The insurer denied the claims on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and the $3,500 limit was exhausted.

The applicant argued for removal from the MIG based on left shoulder injuries, pre-existing spine conditions, chronic pain, and psychological impairments.

The Tribunal found that the shoulder injuries were minor, the pre-existing spine conditions did not preclude recovery within the MIG, and the claims of chronic pain and psychological impairment were uncorroborated and inconsistent with the evidence.

The application was dismissed.

The applicant, a pedestrian struck by a motor vehicle, sought accident benefits beyond the $3,500 Minor Injury Guideline (MIG) limit, claiming removal was warranted due to a pre-existing condition, psychological impairment, and chronic pain.

The Licence Appeal Tribunal found insufficient evidence that her pre-existing mechanical back pain prevented recovery within the MIG.

The Tribunal preferred the respondent's psychological assessment over the applicant's, finding no psychological impairment or chronic pain resulting from the accident.

As the applicant remained within the MIG, the disputed treatment plans were denied, and claims for a special award and interest were dismissed.

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

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

The applicant argued for removal from the MIG due to a pre-existing degenerative disc condition and accident-related psychological impairments.

The Tribunal found that the applicant failed to prove the pre-existing condition would prevent maximal recovery within the MIG, relying on the insurer's medical assessment.

The Tribunal also gave little weight to the psychological diagnoses provided by a chiropractor and preferred the insurer's psychological assessment.

The application was dismissed, and the applicant was found not entitled to the disputed treatment plans or interest.

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

The respondent denied the claims, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) and that she was barred from claiming a non-earner benefit (NEB) for failing to attend scheduled insurer's examinations.

The Tribunal found the applicant was barred from proceeding with the NEB claim due to her unexcused failure to attend the examinations, though she was awarded one day of NEBs because the respondent's denial notice was one day late.

The Tribunal also concluded the applicant failed to prove her physical or psychological injuries warranted removal from the MIG, as her psychological complaints were primarily related to life stressors rather than the accident.

Consequently, the claims for disputed treatment plans were dismissed.

The applicant sought various medical and rehabilitation benefits under the Statutory Accident Benefits Schedule following a motor vehicle accident.

The respondent insurer denied the treatment plans based on insurer examinations.

The Tribunal found that the applicant failed to meet his burden of proving the treatment plans were reasonable and necessary, placing greater weight on the contemporaneous insurer examination reports which concluded the applicant had reached maximum medical recovery and had no ongoing accident-related impairments.

The application was dismissed in its entirety.

The applicant sought various medical and rehabilitation benefits following a 2020 motor vehicle accident.

The adjudicator found the applicant was not subject to the Minor Injury Guideline, as the insurer had previously removed her from it.

The applicant was awarded a chronic pain assessment based on her family doctor's records, and the balance of a mental health assessment due to a non-compliant denial notice by the insurer.

Claims for psychological, physiatry, and neurological assessments were dismissed, as was the claim for a special award under s. 10 of Regulation 664.

The applicant sought statutory accident benefits following a motor vehicle accident, including attendant care benefits, chiropractic treatment, and psychological services.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to prove the proposed treatments and attendant care were reasonable and necessary.

The Tribunal also found no basis for an award for unreasonable delay or interest, as no benefits were overdue.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for massage therapy, botox injections, and acupuncture.

The respondent insurer denied the treatment plans.

The Tribunal found that the applicant established the massage therapy was reasonable and necessary to treat ongoing chronic neck and back pain, supported by clinical records.

However, the applicant failed to provide sufficient medical evidence or submissions demonstrating that the botox injections and acupuncture were reasonable and necessary.

The Tribunal ordered the respondent to pay for the massage therapy with interest, but dismissed the claims for botox and acupuncture.

The applicant sought entitlement to statutory accident benefits for psychological and physiotherapy treatment plans, a general practitioner's assessment, and a special award following a 2019 motor vehicle accident.

The Licence Appeal Tribunal found the applicant was partially entitled to one psychological treatment plan, preferring the treating psychiatrist's clinical notes over the respondent's section 44 assessor.

The remaining psychological and physiotherapy plans were denied as the applicant failed to prove they were reasonable and necessary, with the Tribunal finding the applicant had reached maximum medical improvement physically.

The claim for the general practitioner's assessment was barred by issue estoppel from a previous Tribunal decision.

No special award was granted as the insurer's conduct was not unreasonable.

The applicant sought statutory accident benefits following a motor vehicle accident, including a non-earner benefit and funding for various treatment plans.

The Licence Appeal Tribunal found that the applicant was not entitled to the non-earner benefit because he failed to prove a complete inability to carry on a normal life.

However, the Tribunal approved treatment plans for occupational therapy services, an occupational therapy assessment, and psychological assessments, finding them reasonable and necessary due to the applicant's accident-related psychological impairments.

A claim for physiotherapy services was denied as the applicant had reached maximum therapeutic benefit.

The Tribunal also awarded interest on the overdue payments but declined to order a special award under s. 10 of Reg. 664.

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, warranting removal from the MIG.

The Tribunal approved treatment plans for physiotherapy, chiropractic services, and a chronic pain assessment, finding them reasonable and necessary.

However, a proposed psychological assessment was denied due to insufficient evidence of an accident-related psychological condition.

The Tribunal also awarded interest on overdue benefits but declined to order a special award, finding the respondent's conduct was not unreasonable.

The applicant sought entitlement to statutory accident benefits for physiotherapy, massage therapy, a psychological assessment, and a chronic pain assessment following a November 2020 motor vehicle accident.

The Licence Appeal Tribunal dismissed all claims, finding that the applicant failed to provide corroborating medical evidence to establish that the treatment plans were reasonable and necessary.

The Tribunal preferred the evidence of the insurer's medical examiners, who found no objective evidence of ongoing physical or psychological impairment related to the accident.

Claims for an award under s. 10 of Regulation 664 and interest were also dismissed.

The applicant sought statutory accident benefits following a 2016 motor vehicle accident.

The Tribunal found that the applicant's lower extremity neurological symptoms were related to a pre-existing condition and not caused by the accident.

However, the Tribunal concluded that the applicant's accident-related psychological impairments and pain in his head, neck, and shoulders resulted in a complete inability to carry on a normal life, entitling him to non-earner benefits.

Claims for attendant care benefits and various treatment plans were dismissed due to insufficient evidence that the expenses were incurred or reasonable and necessary.

The applicant sought entitlement to statutory accident benefits following a motor vehicle accident, specifically claiming unapproved balances for a psychological assessment and psychological services, as well as a treatment plan for chiropractic and massage therapy.

The Licence Appeal Tribunal dismissed the application, finding the applicant failed to prove the claimed costs for the psychological assessment were reasonable.

The Tribunal also held the applicant failed to justify paying a psychotherapist at a psychologist's hourly rate, and lacked sufficient medical evidence to establish that the chiropractic and massage therapy treatments were reasonable and necessary.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to a non-earner benefit, a chiropractic treatment plan, and removal from the Minor Injury Guideline (MIG) due to chronic pain and psychological impairments.

The adjudicator found that the applicant's physical injuries, including neck, back, and heel pain, were minor in nature and did not meet the criteria for chronic pain.

Furthermore, the adjudicator accepted the respondent's psychological assessment that the applicant did not meet the criteria for any mental health diagnosis.

The adjudicator also dismissed the claim for a non-earner benefit, finding insufficient evidence comparing the applicant's pre- and post-accident activities to establish a complete inability to carry on a normal life.

The application was dismissed.

The applicant sought statutory accident benefits following a 2019 motor vehicle accident, specifically a $19,097.00 treatment plan for a catastrophic impairment (CAT) assessment and an award for unreasonable delay.

The Tribunal found the applicant was entitled to $9,266.00 for the CAT assessment, approving the physiatry, psychiatry, and occupational therapy components, but denying duplicative or premature elements like the intake assessment and OCF-19 completion.

The Tribunal admitted several late or disputed medical reports, finding them relevant and not prejudicial.

The claim for a special award was dismissed as the insurer's denial was not unreasonable, though interest was awarded on the overdue assessment costs.

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

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

The Tribunal found the applicant sustained a psychological impairment, removing him from the MIG.

However, the applicant failed to prove entitlement to a non-earner benefit, as he returned to most pre-accident activities.

Most treatment plans were denied as not reasonable and necessary, or because the respondent cured initially deficient notices before the plans were incurred.

One psychological assessment was deemed payable under s. 38(11) because it was incurred before the respondent provided proper medical reasons for denial.

The claim for an award for unreasonable delay was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, including an income replacement benefit (IRB) and numerous treatment plans.

The Tribunal held that the 'complete inability' test for IRBs applies 104 weeks after the accident, not after 104 weeks of cumulative disability, and found the applicant did not meet this standard as she transitioned between similar factory jobs.

The Tribunal approved several treatment plans for chiropractic and occupational therapy services based on ongoing physical pain, as well as a later social work plan, but denied others lacking evidentiary support.

Claims for a section 10 award and costs were dismissed.

The applicant sought entitlement to various treatment plans for occupational therapy, physiotherapy, and psychological services following a motor vehicle accident.

The respondent denied the benefits, arguing they were not reasonable and necessary and that the claims were barred by the 260-week limitation period under s. 20(1) of the Schedule.

The Tribunal found that while the claims were not time-barred, the applicant failed to provide sufficient evidence to prove the treatment plans were reasonable and necessary.

The application was dismissed.

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

The parties settled the claims for income replacement and medical benefits, leaving only the issue of whether the applicant was entitled to a Special Award under s. 282(10) of the Insurance Act for the insurer's initial denial of benefits.

The arbitrator found that the insurer acted reasonably at all relevant times based on the medical information available, which supported a theory that the applicant's impairments were due to pre-existing degenerative disc disease rather than the accident.

The claim for a Special Award was dismissed.