Dr. Rod Day

The applicant sought entitlement to various chiropractic and psychological treatment plans following a motor vehicle accident, as well as an award for unreasonable delay.

The Tribunal found all disputed treatment plans to be reasonable and necessary, noting consistent medical reporting and rejecting the insurer's credibility concerns.

The Tribunal also granted an award under s. 10 of Regulation 664, finding the insurer unreasonably withheld benefits, particularly by denying psychological services despite agreement between its own assessor and the applicant's assessor.

The award was set at 10% for psychological services and 5% for chiropractic services.

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

The Licence Appeal Tribunal considered entitlement to multiple treatment plans for psychological, optometric, dietary, and physical rehabilitation services.

The Tribunal granted the plans for optometric services and a dietary assessment, finding them reasonable and necessary based on the medical evidence and the applicant's positive response to vision therapy.

The Tribunal denied the remaining plans, including psychological and physical therapy, finding that the applicant either failed to prove they were reasonable and necessary, failed to exhaust collateral benefits, or incurred expenses prior to submitting a plan.

The claim for a special award was dismissed, but interest was awarded on overdue benefits.

The applicant sought statutory accident benefits following a motor vehicle accident, including transportation services, chiropractic services, and psychological assessments and services.

The respondent denied or partially approved the treatment plans.

The Tribunal found that the applicant failed to prove on a balance of probabilities that the disputed treatment plans were reasonable and necessary.

The applicant did not provide sufficient medical evidence to support the need for transportation expenses, facility-based chiropractic treatment outside the Minor Injury Guideline, or extended psychological sessions.

The application was dismissed, and claims for interest and an award for unreasonable delay were also dismissed.

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

The respondent denied the benefits and argued the applicant was statute-barred for missing insurer's examinations.

The Tribunal found the applicant was not statute-barred as she attended rescheduled examinations.

However, the Tribunal dismissed the substantive claims, finding the applicant failed to prove a substantial or complete inability to perform the essential tasks of her employment as an Uber driver, relying on the respondent's psychological assessments.

The claims for medication expenses, interest, and a section 10 award were also dismissed.

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

The applicant also claimed entitlement to an income replacement benefit (IRB) and various treatment plans.

The Tribunal found that the applicant failed to provide medical evidence warranting removal from the MIG, relying on insurer examination reports confirming only soft tissue injuries.

The IRB claim was dismissed as the applicant had returned to modified work and continued receiving sick pay, failing to prove a substantial inability to perform essential tasks or provide updated income documentation.

The Tribunal also upheld the respondent's denials of the treatment plans as procedurally valid under s. 38(8) of the Schedule.

The application was dismissed in its entirety.

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 the applicant suffered from chronic pain with functional impairment, meeting the criteria under the AMA Guides, and removed him from the MIG.

However, the applicant failed to provide the treatment plans or sufficient submissions to prove they were reasonable and necessary.

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

The applicant sought entitlement to statutory accident benefits for an orthopaedic assessment and physiotherapy services following a motor vehicle accident.

The adjudicator found that the applicant failed to meet her burden of proving the treatment plans were reasonable and necessary, noting that she did not submit the plans into evidence or provide specific submissions on their goals.

Relying on insurer examination reports which indicated the applicant had uncomplicated soft tissue injuries and was working 13 hours a day without restrictions, the adjudicator dismissed the claims for treatment, interest, and a special award.

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

The Licence Appeal Tribunal dismissed the application in its entirety.

The adjudicator found that the applicant failed to prove a substantial inability to perform the essential tasks of his pre-accident employment, relying on the respondent's medical assessments which found no residual physical or neurological impairments preventing his return to work.

The adjudicator also denied all disputed treatment plans, finding that several were not entered into evidence, while others included unpayable expenses such as personal protective equipment (PPE) and unauthorized transportation costs.

As no benefits were payable, the claim for interest was also dismissed.

The applicant, a pedestrian struck by a vehicle, sought various statutory accident benefits including attendant care, multiple treatment plans, and assessments.

The respondent denied the benefits, arguing many of the claimed needs arose from a subsequent accident rather than the subject accident.

The Licence Appeal Tribunal found the applicant was not entitled to attendant care or most of the treatment plans, as she failed to differentiate her injuries between the two accidents and lacked corroborating recommendations from treating physicians.

However, the Tribunal granted entitlement to a chronic pain assessment and an MRI, preferring the evidence of the applicant's specialized medical assessor over the respondent's family physician.

Interest was awarded on the overdue benefits.

The applicant sought entitlement to statutory accident benefits following a motor vehicle accident, specifically claiming costs for physiotherapy, psychological services, and a multi-disciplinary catastrophic impairment assessment.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to provide sufficient medical evidence or submissions to prove the treatment plans were reasonable and necessary.

The Tribunal preferred the respondent's psychological assessment, which concluded the applicant had reached maximum recovery, over the applicant's evidence.

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

The applicant sought statutory accident benefits following a 2013 motor vehicle accident, including a home modifications assessment, yoga therapy, medical cannabis, and various physical therapies.

The respondent insurer denied the treatment plans.

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

The Tribunal noted the home modification assessment exceeded statutory limits and lacked safety justification, the yoga therapy duplicated approved attendant care, the applicant derived no benefit from medical cannabis, and physical therapies were ineffective for her resolved physical injuries.

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 applicant argued for removal from the MIG based on a pre-existing injury, chronic pain, and psychological impairments.

The Tribunal found the applicant failed to demonstrate that her injuries warranted removal from the MIG, preferring the respondent's medical evidence that the injuries were uncomplicated soft tissue injuries and that there was no accident-related psychological injury.

The application for benefits and interest was dismissed.

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 establish that she suffered from chronic pain, neurological/cognitive deficits, or psychological impairments caused by the accident that would warrant removal from the MIG.

As the $3,500 MIG limit had already been exhausted, the Tribunal dismissed the claims for additional psychological and physiotherapy treatment plans, as well as the claim for interest.

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

The Licence Appeal Tribunal found that the applicant's injuries were predominantly minor soft-tissue injuries.

The Tribunal preferred the respondent's insurer's examination reports, which found no accident-related psychological condition or functional impairment, over the applicant's unsupported claims.

As the MIG limits were exhausted, the applicant was not entitled to the disputed treatment plans, an award, or interest.

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

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

The Licence Appeal Tribunal found that the applicant failed to prove his injuries warranted removal from the MIG, preferring the respondent's insurer examination reports over the applicant's limited medical evidence.

As the MIG limit was exhausted, the treatment plans were denied.

Claims for a section 10 award, interest, and costs were also dismissed.

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

The Licence Appeal Tribunal found that the proposed cognitive training was reasonable and necessary based on a functional cognitive assessment.

However, the Tribunal dismissed the claims for a driver reintegration assessment, psychological services, and chiropractic treatment, preferring the respondent's medical evidence that the applicant's psychological and soft tissue injuries had resolved.

The Tribunal awarded interest on the overdue cognitive training benefit but declined to make a special award, finding no egregious conduct by the insurer.

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

The insurer denied several treatment plans for physiotherapy, psychological services, and various assessments.

The Tribunal first determined that the applicant was not barred from disputing a treatment plan denied more than two years prior, applying the COVID-19 limitation period suspension under O. Reg. 73/20 and granting an extension under s. 7 of the LAT Act.

On the merits, the Tribunal denied the physiotherapy and chronic pain assessment plans, finding the applicant's physical injuries were predominantly soft-tissue and had resolved.

However, the Tribunal approved the psychological, cognitive, biopsychosocial, and driving therapy plans, preferring the evidence of the applicant's assessors and certain insurer examinations that confirmed the applicant suffered from accident-related depression and anxiety.

Claims for an award and costs were dismissed due to lack of supporting submissions.

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

The respondent determined the applicant's injuries fell within the Minor Injury Guideline (MIG) and denied several treatment plans as the $3,500 limit was exhausted.

The applicant argued for removal from the MIG based on chronic pain and psychological impairment.

The Tribunal found insufficient medical evidence to support chronic pain or a psychological impairment, noting the applicant's physical injuries were predominantly soft-tissue and had largely resolved.

The Tribunal concluded the applicant remained within the MIG, dismissing the claims for treatment plans, interest, and an award.

The respondent's request for costs due to late submissions was also denied.

The applicant was injured in a motor vehicle accident in December 2005 and received income replacement benefits (IRBs) until August 2008.

She sought IRBs beyond the 104-week mark, requiring her to prove a complete inability to engage in any employment for which she was reasonably suited, caused by the accident.

The applicant advanced several theories of causation, including spinal injuries, exacerbation of pre-existing fibromyalgia, and a psychological disorder.

The arbitrator rejected all theories, finding that the applicant likely only sustained minor soft tissue injuries in the accident, that the cause of fibromyalgia is unknown making exacerbation unprovable, and that the psychological diagnoses lacked adequate foundation.

The application for ongoing IRBs and a special award was dismissed.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including income replacement, medical, and housekeeping benefits, which the insurer denied.

The arbitrator found that the applicant suffered from accident-related depression that substantially disabled her from performing the essential tasks of her employment and housekeeping for a limited period.

The applicant was awarded income replacement and housekeeping benefits for the period from March to June 2005, along with interest.

Claims for ongoing income replacement, further medical benefits, examination expenses, and a special award were dismissed.