Dr. Raphael Chow

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

The Licence Appeal Tribunal dismissed claims for amounts exceeding approved treatment plans and for services not covered by the Professional Service Guideline.

Claims for occupational therapy oversight of a fitness trainer and ongoing massage therapy were also dismissed as redundant or unnecessary, given the applicant had reached maximum medical improvement.

However, the Tribunal allowed the claim for a situational occupational therapy catastrophic impairment assessment, finding it distinct from an in-home assessment and necessary for a complete evaluation.

The applicant sought statutory accident benefits for rehabilitation and care services following a 1993 motor vehicle accident.

The insurer denied the claims, arguing the applicant's pervasive physical, cognitive, and psychological conditions were not caused by the accident.

The arbitrator dismissed the applicant's claims, finding she failed to prove on a balance of probabilities that the accident materially contributed to her impairments.

The arbitrator noted a complete absence of pre-accident medical records, relying solely on the applicant's unreliable self-reporting, and drew an adverse inference from her failure to call pre-accident treating physicians or lay witnesses to corroborate her pre-accident health and functional abilities.

The applicant was injured in a motor vehicle accident and received income replacement benefits until the insurer terminated them after 104 weeks.

The applicant sought arbitration, claiming a complete inability to engage in any employment for which she was reasonably suited.

The arbitrator reviewed the applicant's education, training, and work history, noting she primarily worked part-time.

Relying on the consensus of the applicant's own medical experts that she could return to part-time sedentary work, the arbitrator found she did not meet the test for complete inability to work.

The application for income replacement benefits and a special award was dismissed.

The applicant sought the cost of a Vigano couch or a chair as a supplementary medical and rehabilitation benefit following a motor vehicle accident.

The insurer denied the claim and sought repayment of funds previously advanced for an orthopaedic mattress, alleging fraud.

The arbitrator dismissed the applicant's claim, finding the specific couch ordered was not firm as prescribed by his doctor.

The arbitrator ordered the applicant to repay $388.48 to the insurer, as he had fraudulently pocketed the difference between the funds advanced for a queen-sized mattress and the cheaper twin beds he actually purchased.

The applicant was denied his expenses for the arbitration.