Dr. Shahriar Moshiri

The applicant sought statutory accident benefits following a motor vehicle accident, including post-104 income replacement benefits (IRB), medical benefits, and a special award.

The Tribunal found the applicant did not meet the test for post-104 IRB, as she failed to prove a complete inability to engage in any employment for which she was reasonably suited.

The Tribunal preferred the evidence of the respondent's assessors, noting inconsistencies in the applicant's reporting and her failure to complete several assessments.

The claims for medical benefits, assessments, and a special award were also dismissed.

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

The Licence Appeal Tribunal found that the applicant failed to prove on a balance of probabilities that he sustained injuries falling outside the MIG.

The Tribunal preferred the respondent's expert medical evidence, which concluded the applicant suffered only minor injuries such as whiplash and a sprained shoulder.

Consequently, the applicant remained subject to the $3,500 MIG limit, and his claims for additional treatment plans, interest, and a special award were 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 applicant sought removal from the MIG on the basis of chronic pain and psychological impairments.

The Tribunal found that while there was evidence of accident-related chronic pain, the applicant failed to demonstrate a functional impairment.

Furthermore, the Tribunal preferred the respondent's psychological assessment over the applicant's, noting a lack of corroboration in the family doctor's clinical notes.

Consequently, the Tribunal held the applicant was subject to the MIG, dismissing the claims for treatment plans, interest, and a section 10 award.

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

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

The applicant argued she suffered from chronic pain and psychological injuries warranting removal from the MIG, and that the respondent's denial notices were non-compliant with section 38(8) of the Schedule.

The Tribunal found the applicant did not meet her evidentiary onus to prove her injuries warranted removal from the MIG, placing less weight on a social worker's report diagnosing a psychological impairment as it was out of scope.

The Tribunal also found the respondent's denial notices were compliant, as they clearly stated the medical reasons for denial.

The application was dismissed.

The applicant sought an income replacement benefit (IRB) following a motor vehicle accident.

The respondent denied the benefit, relying on insurer's examinations.

The Tribunal found the applicant met the test for an IRB, preferring the evidence of the applicant's treating physicians and the respondent's own kinesiologist, who found the applicant demonstrated functional limitations below the physical demands of his pre-accident job as a café supervisor.

The Tribunal rejected the respondent's other experts, noting inconsistencies in their reasoning.

The applicant was awarded the IRB with interest, but his claim for an award for unreasonable delay was dismissed due to lack of evidence.

The applicant sought a non-earner benefit following a motor vehicle accident.

The respondent denied the benefit and requested insurer examinations under section 44 of the Schedule.

The adjudicator found that the applicant failed to meet her evidentiary burden to prove a complete inability to carry on a normal life, as she provided no comparative evidence of her pre- and post-accident activities and relied solely on an OCF-3.

The adjudicator accepted the conclusions of the respondent's insurer examination assessors and dismissed the application, including claims for interest and an award.

The applicant sought entitlement to a $1,020 physiotherapy treatment plan, interest, and an award under s. 10 of Reg. 664 following a 2013 motor vehicle accident.

The applicant also brought a preliminary motion to exclude the respondent's insurer examination reports due to late production of the assessors' CVs.

The Tribunal denied the preliminary motion, finding no prejudice to the applicant.

On the substantive issues, the Tribunal found the applicant failed to prove the physiotherapy was reasonable and necessary, noting a lack of compelling contemporaneous medical evidence and relying on the respondent's s. 44 orthopedic assessment which concluded the applicant had reached maximum medical recovery.

The application was dismissed in its entirety.

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 applicant argued for removal from the MIG due to pre-existing osteoarthritis, chronic pain, and psychological impairments.

The Tribunal found that the applicant failed to prove her pre-existing condition prevented maximal recovery within the MIG.

Furthermore, the Tribunal gave little weight to the applicant's medical evidence regarding chronic pain, noting she had failed to disclose five prior and subsequent workplace injuries to her assessors.

The Tribunal concluded the injuries were predominantly minor, dismissed the claims for the treatment plans, and found the respondent's denial notices compliant with the Schedule.

The applicant sought statutory accident benefits following a motor vehicle accident, including an income replacement benefit (IRB) and two treatment plans for chronic pain and attendant care assessments.

The Licence Appeal Tribunal dismissed the application.

The Tribunal found the applicant failed to prove entitlement to the IRB and that his application for the benefit was incomplete due to his failure to submit an Election of Income Replacement, Non-Earner or Caregiver Benefit form (OCF-10).

The Tribunal also found no compelling evidence that the proposed treatment plans were reasonable and necessary, relying on the unrefuted opinion of the respondent's physiatrist that the applicant's injuries were soft tissue in nature.

The applicant was involved in a motor vehicle accident and received an Income Replacement Benefit (IRB).

The respondent insurer sought repayment of $101,571.44, alleging the applicant willfully misrepresented his functional abilities and receipt of collateral disability benefits.

The Tribunal found no willful misrepresentation regarding functional abilities or CPP disability benefits, but found the applicant willfully misrepresented his receipt of $43,400 in disability income from RBC Insurance.

The Tribunal ordered the applicant to repay $27,000 of the IRB, representing the overlapping period, plus interest.

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

The Tribunal found the applicant's injuries were predominantly minor soft-tissue injuries, relying on hospital records and insurer examinations that showed normal range of motion and insignificant psychological symptoms.

As the applicant failed to establish chronic pain with functional impairment or a psychological condition warranting removal from the MIG, and the $3,500 limit was already exhausted, the disputed treatment plans and interest were denied.

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's injuries were predominantly minor and that he failed to provide compelling medical evidence of a pre-existing condition, psychological impairment, or chronic pain syndrome that would warrant removal from the MIG.

As the remaining MIG limit was insufficient to cover the proposed chronic pain assessment, and the assessment was not reasonable and necessary, the claim was dismissed.

No interest was awarded as no benefits were overdue.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for physiotherapy services and a driving reintegration assessment.

The respondent insurer denied the treatment plans, relying on independent medical examinations and arguing the expenses were not incurred within 260 weeks of the accident.

The Licence Appeal Tribunal found the treatment plans to be reasonable and necessary, preferring the evidence of the applicant's assessors over the insurer's examiners.

The Tribunal also rejected the insurer's argument regarding the 260-week limitation, noting that requiring an insured to pre-pay for treatment would disadvantage the impecunious.

The applicant was awarded the costs of both treatment plans plus interest.

The applicant was injured in a 2018 motor vehicle accident and sought ongoing income replacement benefits (IRBs) beyond the 104-week mark, along with medical benefits, an award, and costs.

The respondent denied the IRBs, arguing the applicant could work part-time in alternative roles.

The Tribunal found that the applicant met the post-104 week test for IRBs because the alternative employment proposed by the respondent offered significantly less income and status than her pre-accident work, and her psychological impairments limited her to working only 6 to 10 hours per week.

However, the Tribunal dismissed the claims for metabolic testing, neuromonitoring, and physiotherapy due to insufficient evidence regarding their necessity and reasonable costs.

The claims for a special award and costs were also dismissed.

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 that psychological sequelae and physical injuries warranted removal from the MIG.

The Tribunal found the applicant's psychological evidence lacked objective support and failed to disclose pre-existing conditions, preferring the respondent's psychological and physical assessments.

The Tribunal concluded the applicant's injuries were predominantly minor, and because the MIG limit was exhausted, the disputed treatment plans and interest were not payable.

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

The insurer limited the applicant to the Minor Injury Guideline (MIG).

The Tribunal found that the applicant demonstrated psychological sequelae, specifically an adjustment disorder with mixed anxiety and depressed mood, warranting removal from the MIG.

However, the Tribunal denied the applicant's claim for a $2,180.00 psychological assessment because the expense was incurred before the treatment plan was submitted to the insurer, contrary to section 38(2) of the Schedule.

Claims for an award and interest were also dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, including psychological services, a driving evaluation, and physiotherapy.

The respondent denied the treatment plans.

The Licence Appeal Tribunal found that the applicant failed to prove the treatment plans were reasonable and necessary.

The psychological services were not supported as the applicant did not recall previous sessions being helpful.

The driving evaluation was unnecessary as the applicant did not drive.

The physiotherapy was related to a significant pre-existing condition rather than the accident.

The application was dismissed.

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

The respondent insurer denied a treatment plan for a psychological assessment, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant argued for removal from the MIG based on pre-existing back and hip issues and a post-accident psychological injury.

The Tribunal found no compelling medical evidence that the pre-existing conditions would preclude maximal medical recovery under the MIG.

Furthermore, the Tribunal preferred the respondent's psychological assessment, finding the applicant's self-reporting did not support a psychological impairment.

The application was dismissed, and the applicant's injuries were deemed subject to the MIG limit.

The applicant sought statutory accident benefits following a motor vehicle accident, specifically claiming costs for a psychological assessment, a chronic pain assessment, and a chronic pain program.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to prove on a balance of probabilities that the proposed treatment plans were reasonable and necessary.

The Tribunal preferred the evidence of the insurer's experts, noting a lack of corroborative evidence for chronic pain syndrome and failure to demonstrate functional impairment under the AMA Guides.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to income replacement benefits (IRBs), psychological treatment, and assessment costs.

The adjudicator found that the applicant suffered soft tissue injuries, fractured ribs, and psychological injuries, but failed to prove a substantial inability to perform the essential tasks of his pre-accident employment after January 21, 2020.

The claims for psychological treatment were dismissed because the treatment plans did not comply with the Schedule, as they listed a psychological associate as the provider while the services were actually provided by an unsupervised psychotherapist.

The adjudicator also found the requested 1.5-hour sessions were not reasonable or necessary compared to the 1-hour sessions recommended by the respondent's assessor.

The applicant was awarded $50.39 for the cost of preparing one treatment plan due to an improper denial, with interest.