Dr. Randy Silverman

The applicant sought statutory accident benefits following a motor vehicle accident, claiming removal from the Minor Injury Guideline (MIG) due to psychological impairments.

The Licence Appeal Tribunal found the applicant's psychological evidence unpersuasive, noting a lack of corroboration in clinical records and preferring the respondent's psychological assessment which found no substantive psychological impairment.

The Tribunal concluded the applicant failed to prove his injuries fell outside the MIG, dismissing the claims for psychological treatment, assessment, and interest.

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

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

The Tribunal found that the applicant failed to prove a psychological impairment warranting removal from the MIG, preferring the respondent's psychological assessment over the applicant's pre-screening report.

The Tribunal also dismissed the claim for an income replacement benefit because the applicant failed to identify the essential tasks of his employment.

As the MIG limits were exhausted, the claims for treatment plans and expenses were dismissed.

The applicant sought statutory accident benefits following a 2018 motor vehicle accident.

The Licence Appeal Tribunal considered whether the applicant was entitled to treatment plans for psychological services, an MRI, and a chronic pain program, as well as an award under s. 10 of Regulation 664.

The Tribunal found the psychological services reasonable and necessary, relying on expert evidence that the accident exacerbated the applicant's pre-existing psychological issues.

However, the Tribunal denied the MRI request because the applicant failed to demonstrate why it could not be obtained through OHIP.

The chronic pain treatment was also denied, as the Tribunal found the supporting medical reports relied heavily on self-reporting and failed to account for the applicant's significant pre-accident impairments.

The claim for an award was dismissed, but interest was granted on the overdue psychological benefits.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits from the respondent insurer.

The Licence Appeal Tribunal considered whether the applicant was entitled to pre-104 week and post-104 week income replacement benefits (IRBs), various treatment plans, interest, and a special award.

The Tribunal found that the applicant, a self-employed massage therapist, suffered a substantial inability to perform the essential tasks of her employment and was entitled to pre-104 week IRBs.

However, the Tribunal rejected the applicant's claim that her self-employment income was $30,000, finding the supporting documentation unreliable, and instead calculated the IRBs at $169.00 per week based on her originally declared income.

The applicant failed to establish entitlement to post-104 week IRBs.

The Tribunal approved several treatment plans, including occupational therapy, rehabilitation support worker sessions, psychotherapy, an attendant care assessment, and a rollator walker, finding them reasonable and necessary based on the medical evidence, including supportive reports from the respondent's own occupational therapy assessor.

Other treatment plans were denied for lack of evidence.

The Tribunal awarded interest on overdue payments but denied the request for a special award, concluding the insurer's reliance on its own medical reports was not unreasonable.

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 applicant argued for removal from the MIG due to a concussion, psychological impairments, and pre-existing conditions.

The Tribunal found insufficient evidence of a concussion or accident-related psychological impairment, preferring the respondent's psychological assessment.

The Tribunal also found that the applicant failed to prove her pre-existing conditions would prevent maximal recovery within the MIG limits.

The application was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, disputing the insurer's determination that her injuries fell within the Minor Injury Guideline (MIG).

The applicant argued for removal from the MIG based on chronic pain and psychological impairments, and sought income replacement benefits (IRBs) and various treatment plans.

The Tribunal found that the applicant failed to establish functional impairment from chronic pain or a diagnosable psychological disorder, keeping her within the MIG.

As the $3,500 MIG limit was exhausted, the treatment plans were not payable.

The Tribunal also dismissed the claim for IRBs, finding insufficient evidence of a substantial inability to perform the essential tasks of her pre-accident employment.

Claims for an award and costs were both dismissed.

The applicant sought payment for chiropractic, occupational therapy, and social work treatment plans following a motor vehicle accident.

The respondent insurer denied the plans based on insurer's examinations concluding the applicant had no accident-related impairments.

The Tribunal found that the applicant failed to meet his onus to prove the treatments were reasonable and necessary, noting a lack of contemporaneous medical evidence and failure to disclose medical records.

The application for accident benefits was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, disputing the respondent's determination that his injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found the applicant failed to prove his injuries were non-minor or that he suffered from chronic pain, relying on the respondent's psychological and physiatry assessments.

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

The Tribunal also dismissed the respondent's request for repayment of an income replacement benefit, finding the respondent failed to provide timely notice and did not establish wilful misrepresentation by the applicant.

The applicant sought statutory accident benefits following a 2018 motor vehicle accident, claiming catastrophic impairment due to psychological disorders.

The Tribunal found the applicant was not catastrophically impaired, as she sustained only moderate impairments in concentration, persistence, and pace, and social functioning.

However, applying the Sabadash causation test, the Tribunal found the applicant's impairments were caused by the 2018 accident, despite being aggravated by a subsequent 2020 accident involving the death of her son.

The Tribunal awarded attendant care benefits of $2,327.87 per month, along with specific treatment plans for occupational therapy and a rehabilitation support worker.

Claims for housekeeping benefits, a second occupational therapy plan, and a special award were dismissed.

The applicant was injured in a rear-end motor vehicle accident and sought medical and rehabilitation benefits beyond the $3,500 Minor Injury Guideline (MIG) limit, arguing that a pre-existing clavicle fracture was exacerbated, leading to chronic pain and psychological impairments.

The adjudicator found that the applicant failed to provide compelling evidence of functional impairment or disability resulting from chronic pain, noting that he continued to work and travel, and did not meet the criteria under the AMA Guides.

The adjudicator concluded that the applicant's injuries were predominantly minor and subject to the MIG limit.

As the MIG limit had been exhausted, the disputed treatment plans were denied and the application was dismissed.

The applicant was injured in a motor vehicle accident and deemed catastrophically impaired.

He sought ongoing statutory accident benefits for housekeeping and home maintenance, as well as a rent differential to move to a larger apartment.

The Licence Appeal Tribunal found that while the applicant suffered a substantial inability to perform his pre-accident housekeeping tasks, he failed to prove that the claimed housekeeping expenses were actually incurred.

The Tribunal also dismissed the claim for a rent differential, finding insufficient evidence that moving to a larger apartment was a reasonable and necessary medical or rehabilitation expense.

Claims for interest and an award for unreasonable delay were consequently dismissed.

The applicant sought dispute resolution after the respondent insurer denied treatment plans for psychological, chiropractic, and massage services following a motor vehicle accident.

The insurer argued the applicant's injuries fell within the Minor Injury Guideline (MIG).

The adjudicator found that the applicant's ongoing pain complaints, supported by medical evidence, established a chronic pain condition that removed him from the MIG.

However, the adjudicator concluded that the applicant failed to prove the disputed treatment plans were reasonable and necessary, as there was insufficient objective medical evidence supporting the need for psychological or chiropractic intervention.

The claims for the treatment plans, a special award, and interest were dismissed.

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

The respondent denied the claims on the basis that the applicant's injuries were predominantly minor and the $3,500 limit under the Minor Injury Guideline (MIG) had been exhausted.

The applicant argued that he sustained psychological injuries that removed him from the MIG.

The Tribunal found that the applicant's evidence of psychological impairment was insufficient, noting that he had expressly denied psychological issues to the respondent's assessor and in other documentation.

The Tribunal concluded that the applicant's injuries fell within the MIG, dismissing his claims for medical benefits, interest, and an award.

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

The respondent denied the treatment plans, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) and its $3,500 limit.

The Licence Appeal Tribunal found that while the applicant did not establish a psychological impairment, his physical injuries fell outside the MIG due to chronic pain and nerve injuries.

The Tribunal concluded that the two physiotherapy treatment plans were reasonable and necessary, and ordered the respondent to pay the benefits with interest.

The applicant was injured in a rear-end motor vehicle accident and sought statutory accident benefits from the insurer.

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

The arbitrator found that the applicant's ongoing chronic pain and worsening psychological condition, which interfered with her functioning, removed her from the MIG.

The arbitrator approved treatment plans for physical therapy, psychological assessment and treatment, and chronic pain assessment, but denied several other assessments as premature or unnecessary.

The applicant was also awarded interest on overdue benefits.

The applicant was injured in a motor vehicle accident and sought payment for two treatment plans under the Statutory Accident Benefits Schedule: $3,558.72 for psychological services and $2,772.32 for assistive devices.

The Licence Appeal Tribunal dismissed both claims.

The Tribunal found the applicant failed to prove the psychological services were reasonable and necessary, preferring the respondent's independent examination report.

The claim for assistive devices was also dismissed as the applicant failed to prove the disputed amount was reasonable and necessary beyond the modified amount already paid by the respondent.