Dr. Rhonda Nemeth

The applicant sought entitlement to statutory accident benefits for physiotherapy, massage, and kinesiology treatment plans following a motor vehicle accident.

The respondent insurer denied the plans based on independent medical examinations suggesting the applicant's ongoing complaints were subjective or related to pre-existing trauma.

The Tribunal found the treatment plans reasonable and necessary, preferring the corroborative evidence of the applicant's treating family physician and s. 25 assessors over the respondent's experts.

The applicant was awarded both treatment plans and interest on overdue benefits.

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

The respondent insurer denied a $2,460 treatment plan for an orthopedic assessment, arguing the applicant's injuries were predominantly minor and subject to the $3,500 limit under the Minor Injury Guideline (MIG).

The Tribunal found that the applicant had developed chronic pain syndrome, satisfying four of the six criteria under the AMA Guides, which warranted removal from the MIG.

The Tribunal concluded the proposed orthopedic assessment was reasonable and necessary, ordering the respondent to pay the treatment plan amount plus interest.

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

The applicant argued for removal from the MIG based on a pre-existing back injury, chronic pain, and psychological impairments, and also claimed entitlement to Non-Earner Benefits (NEBs).

The Tribunal found that the applicant failed to provide compelling medical evidence to support removal from the MIG, preferring the respondent's insurer's examinations which found no chronic pain or psychological condition requiring treatment beyond the MIG.

The Tribunal also dismissed the claim for NEBs, finding the applicant did not suffer a complete inability to carry on a normal life.

The application was dismissed.

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

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

The applicant applied to the Licence Appeal Tribunal.

The Tribunal found that the applicant suffered from psychological impairments, including PTSD and major depressive disorder, which warranted removal from the MIG.

The Tribunal ordered the respondent to pay for the disputed psychological services and assessment, along with interest.

The applicant's claim for a special award for unreasonable delay was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming his psychological impairments and chronic pain warranted removal from the Minor Injury Guideline (MIG).

The respondent denied the benefits, arguing the injuries were predominantly minor soft tissue injuries.

The Licence Appeal Tribunal found that the applicant failed to prove on a balance of probabilities that he suffered from a psychological impairment or chronic pain with functional impairment that would remove him from the MIG.

The Tribunal preferred the respondent's medical assessments, noting the applicant had returned to full-time work and had not reported psychological symptoms to his treating physicians.

The application was dismissed, and the disputed treatment plans were found not payable as they exceeded the $3,500 MIG limit.

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).

As a preliminary issue, the Tribunal found the applicant was not statute-barred from disputing a treatment plan, as the limitation period was extended by 183 days due to the COVID-19 pandemic under O. Reg. 73/20.

On the substantive issues, the Tribunal held that the applicant failed to establish chronic pain or psychological impairments warranting removal from the MIG.

Because the $3,500 MIG limit was already exhausted, the disputed treatment plans were not payable, and the application was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, disputing the insurer's denial of treatment plans for psychological services and a psychological assessment.

The Tribunal found the psychological services reasonable and necessary to assist with pain management and driving anxiety.

The Tribunal also approved the cost of the psychological assessment, rejecting the insurer's argument that the fee was unreasonable for lacking an hourly breakdown, as it fell within the Schedule limit.

The Tribunal awarded interest on the overdue benefits, noting inconsistencies in the insurer's medical examinations, but denied the applicant's request for a special award under O. Reg. 664, finding no evidence that the insurer unreasonably withheld or delayed payments.

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

The respondent denied the claims, arguing the injuries fell within the Minor Injury Guideline (MIG) and its $3,500 limit.

The Tribunal found that the applicant's pre-existing psychological issues were exacerbated by the accident, resulting in diagnoses of depression and anxiety that removed her from the MIG.

The Tribunal preferred the evidence of the applicant's psychologist over the respondent's insurer examination psychologist.

Consequently, the Tribunal ordered the respondent to pay for the disputed physical treatment, psychological assessment, and psychological treatment, finding them all to be reasonable and necessary, along with interest on overdue payments.

The insurer requested a reconsideration of a Licence Appeal Tribunal decision that awarded the insured $1,160.50 for a Treatment and Assessment Plan.

The insurer argued that the insured filed hearing materials late in breach of Rule 9.2, and that the Tribunal erred in its assessment of the evidence regarding the insured's physical limitations, work capacity, and causation.

The Executive Chair denied the reconsideration request, finding that the insured complied with the disclosure timeline set in a case conference order, rendering the Rule 9.2 argument moot.

Furthermore, the Chair held that the Tribunal's factual findings regarding the insured's limitations and need for the recommended assistive devices were reasonably supported by the evidentiary record, including reports from the insurer's own examiners.

The insured's request for costs was also denied, as the insurer's conduct was not unreasonable, frivolous, or in bad faith.

The applicant was injured in a rear-end motor vehicle collision and claimed income replacement benefits for fibromyalgia and psychological impairments.

The insurer terminated benefits after June 24, 2003.

The arbitrator found that the applicant's physical complaints were not objectively verifiable and preferred the insurer's psychological assessment, which concluded she was not substantially disabled from performing the essential tasks of her employment as a computer sales representative.

The application for arbitration was dismissed.