Dr. Vincenzo Santo Basile

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

The respondent denied several treatment plans and assessments, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant established a chronic pain condition with functional impairment, relying on the AMA Guides criteria and expert medical evidence, thereby warranting removal from the MIG.

The Tribunal ordered the respondent to pay for the disputed chiropractic treatment plans, a neurological assessment, and a chronic pain assessment, finding them reasonable and necessary.

The applicant was also awarded interest on overdue benefits, but her claim for a special award under s. 10 of O. Reg. 664 was dismissed.

The applicant sought statutory accident benefits for physical therapy services following a 2016 motor vehicle accident.

The respondent denied the treatment plan and brought a preliminary motion to exclude late-filed medical evidence and an affidavit from the applicant, while also seeking costs.

The Tribunal admitted the medical evidence, finding no prejudice to the respondent, and partially admitted the affidavit.

On the substantive issue, the Tribunal applied the 'but for' test for causation and found the applicant suffered from accident-related chronic pain syndrome.

The Tribunal concluded the proposed physical therapy plan was reasonable and necessary, ordering the respondent to pay $4,620.73 plus interest.

The respondent's request for costs was denied.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming catastrophic impairment under Criteria 7 and 8 of the Schedule due to vascular dementia and other impairments.

The respondent denied the benefits, noting the applicant had already reached the non-catastrophic funding limit.

The Licence Appeal Tribunal found that the applicant failed to meet the burden of proving catastrophic impairment, as the medical evidence did not establish a 55% whole person impairment under Criterion 7 or a marked impairment in three domains under Criterion 8.

Consequently, the claims for additional medical benefits, interest, and a section 10 award were dismissed.

The applicant sought a determination of catastrophic impairment and entitlement to attendant care benefits and assistive devices following a 2019 motor vehicle accident.

The adjudicator found the applicant was not catastrophically impaired, rejecting the orthopaedic expert's 24% whole person impairment rating because it failed to account for the applicant's significant pre-accident history of right shoulder issues.

Without the orthopaedic rating, the applicant could not meet the 55% threshold.

The claims for assistive devices and attendant care benefits were also dismissed as the applicant failed to provide the necessary evidentiary support, including a Form-1 for attendant care.

The applicant sought statutory accident benefits following a motor vehicle accident, disputing the insurer's denial of treatment plans for chiropractic services, an occupational therapy assessment, and neurological assessments.

The insurer argued the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found the applicant suffered a concussion and ongoing impairments, removing her from the MIG.

The Tribunal granted the chiropractic treatment plans and one neurological assessment, finding them reasonable and necessary, but denied the occupational therapy assessment and a second neurological assessment due to lack of evidence or duplication.

Interest was awarded on the overdue benefits.

The applicant sought various statutory accident benefits following a 2018 motor vehicle accident, including attendant care benefits, post-104 income replacement benefits, and several treatment plans.

The Tribunal dismissed the claims for attendant care and income replacement benefits, finding the applicant was independent with personal care and did not suffer a complete inability to engage in suitable employment.

The Tribunal granted the treatment plans for a SPECT scan and occupational therapy, finding them reasonable and necessary to address the applicant's traumatic brain injury and ongoing impairments.

Claims for other assessments, physiotherapy, speech-language therapy, and a special award were dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, disputing the insurer's denial of several treatment plans.

The Licence Appeal Tribunal found the applicant was not entitled to a chronic pain assessment, as it would duplicate extensive assessments already completed by an orthopaedic surgeon and a neurologist.

However, the Tribunal granted the claims for physiotherapy and occupational therapy for driving anxiety, relying on medical evidence that the applicant had not reached maximal medical improvement.

The claim for assistive devices was largely denied due to a lack of supporting evidence, though a documentation fee was approved.

The Tribunal awarded interest on the overdue benefits but declined to order a special award, finding the insurer's denials were not unreasonable.

The applicant sought various statutory accident benefits following a motor vehicle accident, including income replacement benefits (IRBs), attendant care benefits (ACBs), transportation costs, and a chronic pain assessment.

The Licence Appeal Tribunal dismissed the application in its entirety.

The Tribunal found the applicant failed to prove a substantial or complete inability to work to qualify for IRBs, noting she had returned to work and later received CERB due to pandemic-related job loss.

Claims for ACBs, transportation costs, and the chronic pain assessment were also dismissed for lack of supporting evidence and failure to meet the respective legal thresholds.

Consequently, claims for interest and a Regulation 664 award were denied.

The applicant was struck by a minivan while crossing the street and sought statutory accident benefits, including non-earner benefits, attendant care, housekeeping, and medical benefits for assistive devices.

The Tribunal dismissed the claims for non-earner and attendant care benefits, finding the applicant failed to provide sufficient evidence of her pre- and post-accident activities or that attendant care expenses were incurred.

The claim for a mattress topper was statute-barred as it was purchased before a treatment plan was submitted.

However, the Tribunal found the anti-fatigue mat was reasonable and necessary, and ordered the respondent to pay for it.