Dr. Yong-Kyong Michael Ko

The applicant sought a non-earner benefit, various chiropractic treatment plans, an orthopaedic assessment, interest, and an award under the Statutory Accident Benefits Schedule following a motor vehicle accident.

The Licence Appeal Tribunal dismissed the application, finding the applicant failed to demonstrate a complete inability to carry on a normal life, as medical evidence indicated she continued to substantially engage in her pre-accident activities.

The Tribunal also found the applicant did not meet her burden to prove the disputed treatment plans were reasonable and necessary.

Claims for interest and an award were consequently dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, specifically claiming entitlement to Platelet-Rich Plasma (PRP) injections and the outstanding balance of a chronic pain program.

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

The Tribunal accepted the respondent's medical evidence that the applicant sustained only soft tissue injuries and that PRP injections lacked sufficient clinical evidence for such injuries.

As no benefits were payable, claims for interest and a special award were also dismissed.

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, including funding for hyperbaric oxygen therapy and two catastrophic impairment assessments.

The respondent denied the treatment plans.

The Tribunal found that the applicant failed to prove the hyperbaric oxygen therapy was reasonable and necessary, noting a lack of medical evidence supporting its effectiveness for her injuries and deeming it experimental.

The Tribunal also denied the catastrophic impairment assessments, finding the applicant failed to justify the need for multiple assessments in single disciplines and the duplication of services across the two treatment plans.

The application was dismissed, and claims for interest and an award were denied.

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 statutory accident benefits following a motor vehicle accident, including an income replacement benefit (IRB), physiotherapy, and various assessments.

The Tribunal found the applicant was entitled to an IRB for the period between her early retirement and her planned retirement date, as accident-related pain substantially prevented her from performing the essential tasks of her employment.

The Tribunal also approved the treatment plans for physiotherapy, a psychological assessment, and a chronic pain assessment, finding them reasonable and necessary.

The neurological assessment was approved because the insurer's denial failed to comply with the medical reasons requirement under s. 38(8) of the Schedule.

The claim for a special award was dismissed as the insurer's conduct was not unreasonable.

The applicant sought entitlement to a $4,008.42 physiotherapy treatment plan following a motor vehicle accident.

The Licence Appeal Tribunal dismissed the application, finding the applicant failed to provide contemporaneous medical evidence from a qualified physical rehabilitation specialist to support the plan.

The Tribunal preferred the evidence of the respondent's physiatrist, who concluded the applicant had full range of motion and the treatment was not reasonable and necessary.

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

The applicant sought statutory accident benefits following a motor vehicle accident, arguing her injuries warranted removal from the Minor Injury Guideline (MIG) due to a pre-existing back condition and chronic pain syndrome.

The adjudicator found the applicant failed to provide compelling medical evidence that her pre-existing condition precluded recovery within the MIG, preferring the respondent's section 44 assessors over the applicant's pain specialist.

The adjudicator also found insufficient evidence of functional impairment to support a chronic pain diagnosis.

As the applicant remained within the MIG, her claims for treatment plans exceeding the limit, an award, and interest were dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to treatment beyond the Minor Injury Guideline (MIG) and a non-earner benefit.

The Licence Appeal Tribunal found that the applicant failed to demonstrate that his chronic pain, psychological impairments, or pre-existing conditions warranted removal from the MIG.

As the MIG limits were exhausted, the disputed treatment plan for physiotherapy was not payable.

The Tribunal also dismissed the claim for a non-earner benefit, finding insufficient evidence to establish that the applicant suffered a complete inability to carry on a normal life.

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

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to prove she suffered a complete inability to carry on a normal life.

The adjudicator noted that the applicant had returned to her pre-accident employment as a practical nurse, increased her hours to full-time, and failed to provide sufficient particulars regarding her pre-accident activities and how her pain practically prevented her from engaging in them.

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

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

The respondent denied the benefits, arguing the applicant's injuries were predominantly minor and subject to the $3,500 limit under the Minor Injury Guideline (MIG).

The applicant applied to the Licence Appeal Tribunal, claiming his injuries had progressed to chronic pain with functional impairment, warranting removal from the MIG.

The Tribunal found that the medical evidence supported a diagnosis of soft tissue injuries falling within the MIG definition.

The Tribunal concluded the applicant failed to demonstrate chronic pain with severe functional impairment or any psychological injury.

As the MIG limit was exhausted, the claims for additional treatment plans and the cost of clinical records were dismissed.

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

The respondent denied four physiotherapy treatment plans on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and the $3,500 limit had been exhausted.

The applicant argued for removal from the MIG due to pre-existing psychological conditions and accident-related chronic pain.

The Tribunal found insufficient medical evidence that the pre-existing conditions prevented maximal medical recovery within the MIG.

Relying on the respondent's physiatry assessment, the Tribunal concluded the injuries were predominantly minor.

The application was dismissed.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for physiotherapy, optometric services, and prescription expenses.

The respondent denied the treatment plans on the basis that they were not reasonable and necessary.

The Tribunal found that the applicant failed to meet the burden of proving the treatments were reasonable and necessary, preferring the evidence of the respondent's insurer's examination assessors over the applicant's treatment plans and reports, which lacked sufficient documentation and relied on unsupported assumptions of a concussion.

The application was dismissed.

The applicant sought accident benefits following a motor vehicle accident, claiming his injuries warranted removal from the Minor Injury Guideline (MIG) due to chronic pain, psychological, and neurological impairments.

The Licence Appeal Tribunal found the applicant failed to meet his burden of proof, preferring the evidence of the respondent's independent medical examiners and the applicant's own family physician over the applicant's chiropractor and nurse.

The Tribunal held the applicant remained within the MIG and was therefore not entitled to an attendant care benefit.

While one of the respondent's denial letters breached s. 38(8) of the Schedule, no payment was ordered as there was no evidence the services were incurred.

Claims for treatment plans, an award, and interest were dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, arguing his injuries should be excluded from the Minor Injury Guideline (MIG) due to pre-existing conditions, psychological impairments, and chronic pain.

The Tribunal found the applicant failed to provide compelling medical evidence that his pre-existing neck issues or depression prevented him from reaching maximal recovery within the MIG limits.

The Tribunal preferred the respondent's psychological assessment, which was supported by the family doctor's records showing the applicant was weaning off psychiatric medication.

The Tribunal also found insufficient objective medical evidence to support a diagnosis of chronic pain.

As the injuries fell within the MIG and the funding limits were exhausted, the claims for disputed treatment plans, interest, and costs were dismissed.

The applicant sought a non-earner benefit following a motor vehicle accident, claiming a complete inability to carry on a normal life due to physical and psychological impairments.

The respondent denied the benefit, arguing the applicant's psychological issues were pre-existing and that she failed to meet the rigid test for a complete inability.

The Tribunal found that the applicant's psychological assessments lacked objective baseline information regarding her pre-accident activities and afforded them less weight.

Relying on pre-accident medical records showing significant pre-existing limitations, the Tribunal concluded the applicant failed to prove her impairments were caused by the accident or that she suffered a complete inability.

The application was dismissed.

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

The respondent insurer took the position that the applicant's injuries fell within the Minor Injury Guideline (MIG) and denied several treatment plans.

The applicant argued she should be removed from the MIG due to pre-existing conditions and chronic pain.

The Tribunal found the applicant failed to prove that her pre-existing conditions prevented maximal recovery within the MIG or that her chronic pain adversely affected her well-being and function under the AMA Guides criteria.

However, the Tribunal ordered the respondent to pay for a physiatry assessment because the respondent failed to provide proper medical reasons for its denial, triggering the consequences of s. 38(11) of the Schedule.

The remaining treatment plans were dismissed as they proposed treatment outside the MIG limits.

The respondent insurer requested a reconsideration of a Tribunal decision which found that the applicant's injuries fell outside the Minor Injury Guideline (MIG) and awarded medical benefits.

The insurer argued the Tribunal erred in fact by accepting unsubstantiated opinion evidence regarding chronic pain and erred in law by misapplying the MIG test.

The adjudicator dismissed the request, finding no significant errors of fact or law that would have changed the outcome, as the Tribunal properly weighed the totality of the medical evidence.

The applicant's request for costs was also denied.

The applicant was injured in a motor vehicle accident and sought medical benefits for physiotherapy.

The respondent denied the treatment plans, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) and its $3,500 limit.

The Licence Appeal Tribunal found that while the applicant did not establish a psychological impairment, his physical injuries fell outside the MIG due to chronic pain and nerve injuries.

The Tribunal concluded that the two physiotherapy treatment plans were reasonable and necessary, and ordered the respondent to pay the benefits with interest.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits from the insurer.

The central issues were whether the applicant's injuries fell within the Minor Injury Guideline (MIG) and whether the insurer's payment of over $3,500 in treatment costs constituted a waiver of the MIG limit.

The arbitrator found that the applicant's injuries were minor and that the insurer did not waive the MIG limit simply by overpaying.

The arbitrator rejected the applicant's experts' diagnoses of chronic pain and WAD III, preferring the insurer's experts who concluded the applicant suffered only soft tissue injuries.

All claims for additional rehabilitation benefits and examination costs were dismissed.