Dr. Vitelli

The applicant sought statutory accident benefits following a motor vehicle accident, disputing the respondent's denial of treatment plans for physiotherapy, assistive devices, an attendant care assessment, and a driver evaluation.

The Licence Appeal Tribunal found that the applicant failed to provide objective medical evidence to establish that the physiotherapy, assistive devices, and attendant care assessment were reasonable and necessary, noting the respondent's unchallenged orthopaedic assessment.

However, the Tribunal granted the treatment plan for a driver evaluation, as it was specifically recommended by the applicant's psychological assessors and uncontradicted by the respondent.

The applicant was also awarded interest on the overdue payment.

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) and the $3,500 funding limit had been exhausted.

The applicant argued her pre-existing conditions, chronic pain syndrome, and psychological impairments warranted removal from the MIG.

The Tribunal found insufficient objective medical evidence to support removal from the MIG, noting the applicant's self-reports were inconsistent with medical records and she returned to work immediately after the accident.

The application was dismissed.

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

The respondent denied a treatment plan for a chronic pain assessment on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant failed to prove on a balance of probabilities that his injuries warranted removal from the MIG based on a pre-existing condition, psychological impairment, or chronic pain.

The medical evidence, including insurer's examinations, demonstrated that the applicant had functional abilities to complete most activities of daily living.

The application was dismissed.

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 Tribunal found that the applicant's physical injuries were predominantly minor and did not warrant removal from the MIG, dismissing claims for physiotherapy, chiropractic services, and orthopaedic/neurological assessments.

However, the Tribunal preferred the applicant's psychological evidence over the respondent's section 44 assessor, finding that the applicant suffered from severe depression and anxiety directly resulting from the accident.

Consequently, the applicant was removed from the MIG on psychological grounds, and the treatment plans for a psychological assessment and psychological treatment were deemed reasonable and necessary, with interest payable.

The applicant was injured in a motor vehicle accident and sought various medical and rehabilitation benefits, which the respondent insurer denied on the basis that her injuries fell within the Minor Injury Guideline (MIG).

The applicant argued that pre-existing conditions, chronic pain, and psychological impairments warranted removal from the MIG.

The Tribunal found that the applicant's physical injuries were uncomplicated soft-tissue injuries and that she failed to provide compelling evidence that any pre-existing condition prevented her recovery within the MIG.

Furthermore, the Tribunal preferred the respondent's medical evidence regarding the lack of a psychological impairment, noting inconsistencies in the applicant's expert reports.

The application was dismissed, and the disputed treatment plans were found not to be reasonable and necessary.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to psychological treatment, physiotherapy treatment, a chronic pain assessment, and a driving reintegration assessment.

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

The Tribunal gave little to no weight to the applicant's expert reports, noting they were completed years after the accident and were inconsistent with the clinical notes and records of the applicant's family physicians, which showed minimal complaints and primarily degenerative changes.

The applicant sought payment of $11,533.24 for the unapproved balance of a treatment plan (OCF-18) for multi-disciplinary catastrophic impairment assessments.

The insurer had partially approved the plan for $12,000.

The Tribunal found that the unapproved assessment items were needless bifurcations or duplications of assessments already conducted by the insurer, and the applicant failed to prove they were reasonable and necessary.

The Tribunal awarded $400 for the cost of completing the OCF-18 and OCF-19 forms, but denied the remainder of the claim.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for assistive devices and psychological treatment.

The insurer denied the treatment plans.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to provide medical evidence proving the assistive devices were reasonable and necessary, and failed to submit the psychological treatment plan into evidence to justify the disputed balance.

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

The applicant was injured in a motor vehicle accident and sought a medical benefit for psychological services, arguing her pre-existing depression and anxiety warranted removal from the Minor Injury Guideline (MIG).

The respondent denied the benefit, relying on a section 44 psychological assessment.

The Tribunal found that the applicant sustained predominantly minor injuries and failed to prove her pre-existing conditions were exacerbated by the accident or prevented maximal medical recovery within the MIG.

The Tribunal preferred the respondent's expert evidence and concluded the proposed treatment plan was not reasonable and necessary.

The application was dismissed.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including non-earner benefits, medical/rehabilitation treatments, and various assessments.

The insurer denied many of the benefits based on reports from its assessors.

The Licence Appeal Tribunal found that the applicant met the test for a complete inability to carry on a normal life and awarded non-earner benefits for the 104-week post-accident period.

The Tribunal also approved the disputed treatment plans and assessments, subject to the $2,000 statutory cap per assessment.

Furthermore, the Tribunal ordered the insurer to pay interest on overdue benefits and a special award of 33% under O. Reg. 664, finding that the insurer unreasonably delayed approving treatments that its own experts had recommended.

The applicant was involved in a motor vehicle accident and sought income replacement benefits (IRBs) and medical benefits beyond the Minor Injury Guideline (MIG) limit.

The Tribunal found that the applicant's injuries, including strains and sprains, did not fall outside the MIG, rejecting claims of psychological and chronic pain disorders due to inconsistencies with surveillance and medical records.

As the $3,500 MIG limit was exhausted, the treatment plans were denied.

However, the Tribunal awarded IRBs for a limited period, finding the applicant suffered a substantial inability to perform his heavy physical employment tasks during his initial recovery.

The applicant was injured in a motor vehicle accident and sought medical benefits and the cost of examinations under the Statutory Accident Benefits Schedule.

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

The Licence Appeal Tribunal found that the applicant's physical injuries, including sprains and strains, met the definition of minor injuries.

The Tribunal preferred the respondent's psychological assessment over the applicant's, concluding that the applicant did not suffer from a psychological impairment that would remove her from the MIG.

Furthermore, the applicant failed to provide compelling evidence that any pre-existing conditions would prevent her maximal recovery within the MIG limit.

The application was dismissed.

The applicant was injured in a rear-end motor vehicle collision and sought medical benefits beyond the $3,500 Minor Injury Guideline (MIG) limit, claiming a psychological injury and a partial muscle tear.

The Licence Appeal Tribunal found that the applicant's physical injuries, including the partial tear, were expressly included within the MIG.

The Tribunal also rejected the psychological injury claim, noting that the applicant's evidence predated the accident and the respondent's psychological assessment found only temporary, resolved symptoms.

The application for additional benefits was dismissed, though the applicant was permitted to use the remaining $129.81 of the MIG limit.

The applicant sought non-earner benefits and a chronic pain assessment following a motor vehicle accident.

The Licence Appeal Tribunal found that the applicant did not suffer a complete inability to carry on a normal life, as his pain did not practically prevent him from engaging in his daily activities and there were significant pre-existing conditions from a prior workplace accident.

However, the Tribunal found the chronic pain assessment to be reasonable and necessary given the applicant's consistent reports of pain.

The applicant was awarded the cost of the assessment and applicable interest, but denied non-earner benefits.

The applicant was struck by a vehicle while riding his electric bike, sustaining two fractured ribs.

He sought income replacement benefits (IRBs), medical benefits, and the cost of various assessments from his insurer.

The Licence Appeal Tribunal found that the applicant was not entitled to IRBs because he was not employed, self-employed, or receiving Employment Insurance at the time of the accident, nor had he worked 26 of the 52 weeks prior.

The Tribunal also dismissed the claims for medical benefits and assessments, finding that the applicant's accident-related injuries had substantially resolved by July 2017 and the proposed treatments and assessments were not reasonable and necessary.

Claims for an award under O. Reg. 664 and interest were consequently dismissed.

The Applicant sought a determination that he suffered a catastrophic impairment following a motor vehicle accident.

In a previous decision, the arbitrator found the Applicant's Whole Person Impairment (WPI) was 50%, falling short of the 55% threshold.

On appeal, the Director's Delegate remitted the matter back to arbitration to determine the impairment rating under Chapter 4, Table 3 of the AMA Guides and to assign a rating for medication use.

Upon reassessment, the arbitrator assigned a 15% WPI for the nervous system impairment (after applying a 2% discount for double counting) and a 2% WPI for medication use.

Combining these with the previously confirmed ratings resulted in a 54% WPI, which rounds to 55%.

Consequently, the arbitrator concluded the Applicant sustained a catastrophic impairment.

The applicant sought statutory accident benefits, including caregiver benefits, attendant care benefits, and the cost of a psychological assessment, following a motor vehicle accident.

The arbitrator dismissed all claims, finding the applicant lacked credibility due to pervasive inconsistencies in his evidence regarding his employment status, living arrangements, and caregiving responsibilities.

The arbitrator concluded the applicant's self-reports to assessors were unreliable, undermining the medical reports supporting his claims.

The defendant pleaded guilty to possessing child pornography between April 6 and 7, 2010.

Police discovered 3,610 images and 191 movie clips of child pornography on the defendant's computer.

The Crown sought 9 months incarceration and 3 years probation, while the defence sought 90 days intermittent imprisonment and 1 year probation.

The court imposed a 90-day intermittent sentence with 1 year probation, finding that denunciation and general deterrence could be adequately addressed through this sentence.

The court considered the defendant's age, lack of criminal record, genuine remorse, extensive counselling, low risk of reoffending, and significant caregiving responsibilities for his brother as mitigating factors.