Dr. Rozen

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

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

The Tribunal found the applicant suffered from chronic pain with functional impairments, warranting removal from the MIG.

The Tribunal approved treatment plans for physiotherapy, a chronic pain assessment, and a psychological assessment, finding them reasonable and necessary based on medical evidence and contemporaneous reporting.

A treatment plan for an orthopaedic assessment was denied as the applicant failed to establish it was warranted.

The applicant was also awarded interest on overdue benefits.

The applicant was injured in a motor vehicle accident and received income replacement benefits (IRBs) for approximately 13 years before the respondent insurer terminated them.

The applicant sought post-104 week IRBs, arguing that his chronic pain, reliance on opioids, and resulting cognitive issues prevented him from working.

The respondent relied on independent medical examinations and video surveillance to argue the applicant could perform light duties.

The Tribunal found that the applicant's pain and medication use severely limited his functionality, rendering him unable to sustain competitive employment.

The Tribunal held that the applicant met the test for post-104 week IRBs and awarded the benefits with interest.

The respondent's request for costs was denied.

The applicant sought statutory accident benefits for a chronic pain assessment and a chronic pain program following a motor vehicle accident.

The respondent insurer denied the treatment plans, arguing a lack of medical evidence.

The Licence Appeal Tribunal found that the applicant failed to meet her burden of proving the treatment plans were reasonable and necessary, as she did not provide post-accident clinical notes and records from her treating physicians.

The expert reports relied upon by the applicant were based solely on self-reporting and pre-accident records.

The application was dismissed in its entirety.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that denied entitlement to chiropractic treatment plans and a chronic pain assessment following a motor vehicle accident.

The applicant argued the Tribunal made significant errors of fact and law regarding the medical evidence of causation, the severity of a subsequent accident, and the refusal to extend a limitation period for a denied treatment plan.

The Vice-Chair dismissed the request, finding no significant errors of law or fact that would have likely resulted in a different decision.