Dr. Edwin Urovitz

The applicant sought various medical and rehabilitation benefits following a motor vehicle accident, including psychological services, a chronic pain assessment, an attendant care assessment, an orthopaedic assessment, and physical therapy.

The Licence Appeal Tribunal found that the applicant was entitled to the chronic pain assessment, as medical evidence supported ongoing pain symptoms.

However, the Tribunal denied the higher psychologist rate for services provided by a psychotherapist.

The Tribunal also denied the attendant care and orthopaedic assessments, as well as further physical therapy, finding them not reasonable and necessary given the applicant's return to work and studies, and the lack of objective orthopaedic impairment.

The claim for an award under s. 10 of Reg. 664 was dismissed due to procedural non-compliance.

The applicant sought entitlement to statutory accident benefits for chiropractic and psychological services following a motor vehicle accident.

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

The Tribunal relied on an insurer's orthopaedic assessment to deny the chiropractic plan and found the applicant did not justify paying a psychotherapist at a psychologist's hourly rate for the psychological services.

Claims for interest and a special award were also dismissed.

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 she should be removed from the MIG due to psychological impairments and chronic pain with functional impairment.

The Tribunal found that the applicant failed to provide sufficient medical evidence linking her psychological complaints or ongoing pain to a functional impairment caused by the accident.

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

The Tribunal also found the insurer complied with the notice requirements under s. 38(8) of the Schedule and dismissed the claims for an award and interest.

The applicant sought statutory accident benefits following a motor vehicle accident, specifically claiming attendant care benefits and the cost of an orthopaedic mattress.

The Licence Appeal Tribunal dismissed the application, finding no evidence that the attendant care expenses were incurred and concluding that the orthopaedic mattress was not proven to be reasonable and necessary.

The Tribunal preferred the evidence of the respondent's orthopaedic surgeon over the applicant's occupational therapist regarding the necessity of the mattress.

The applicant sought statutory accident benefits following a motor vehicle accident, specifically claiming entitlement to chiropractic treatments, an in-home assessment, and in-home treatments.

The Licence Appeal Tribunal dismissed the application, finding that the applicant had achieved maximal recovery and functional range of motion.

The Tribunal preferred the respondent's insurer's examinations, noting the applicant had returned to full-time employment as a nurse and was able to participate in activities such as hiking, cycling, and yoga.

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

The applicant sought statutory accident benefits following a motor vehicle accident, claiming his injuries warranted removal from the Minor Injury Guideline (MIG) due to a pre-existing condition of Chronic Facet syndrome.

The adjudicator found the applicant failed to provide compelling medical evidence that the pre-existing condition would prevent maximal recovery within the MIG limits, preferring the evidence of the respondent's section 44 orthopaedic assessor over the applicant's chiropractor.

As the applicant remained subject to the MIG, the disputed treatment plans and claims for an award and interest were dismissed.

The applicant, a law student who was struck by a vehicle while riding a bicycle, sought a determination of catastrophic impairment under Criterion 8 (mental and behavioural disorders) and entitlement to various treatment plans.

The Tribunal found that the applicant did not meet the threshold for catastrophic impairment, as he did not demonstrate a marked impairment in three of four functional domains.

Despite accident-related challenges, the applicant successfully completed law school, passed the bar, and maintained employment as a lawyer.

The Tribunal also dismissed the claims for the disputed treatment plans, finding that the applicant failed to prove they were reasonable and necessary.

The applicant sought medical treatment benefits for physiotherapy following a motor vehicle accident.

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 her burden of proof, as she did not produce any objective, contemporaneous medical evidence to support the treatment plans and failed to comply with medical record production requirements.

The Tribunal accepted the evidence of the respondent's orthopedic examiner, who concluded the applicant had reached maximum medical recovery and did not require further formal treatment.

The application was dismissed.

The applicant sought a medical benefit of $1,812.52 for physiotherapy treatment following a 2014 motor vehicle accident.

The respondent denied the benefit, arguing the treatment was not reasonable and necessary.

The Tribunal found that the applicant failed to meet his burden of proving the treatment plan was reasonable and necessary, noting a lack of evidence that previous physiotherapy had been beneficial and that the applicant had reached maximum medical improvement.

The application was dismissed.

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

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

The adjudicator found that the applicant's psychological symptoms, documented by her family physician shortly after the accident, warranted removal from the MIG.

The adjudicator approved the disputed psychological assessment and chiropractic treatment plans, finding them reasonable and necessary based on contemporaneous medical records.

The adjudicator also rejected the respondent's argument that one of the treatment plans was time-barred, noting that the limitation period was suspended by COVID-19 regulations.

The applicant was awarded the disputed benefits with interest.

The applicant sought medical benefits for two physiotherapy treatment plans and the cost of an attendant care assessment following a motor vehicle accident.

The respondent insurer denied the claims on the basis that they were not reasonable and necessary, relying on independent medical examinations which concluded the applicant had reached maximum medical recovery from soft tissue injuries.

The adjudicator dismissed the application, preferring the evidence of the insurer's assessors who conducted physical examinations over the applicant's occupational therapy paper review report.

The adjudicator found the applicant had returned to full-time work, was independent in personal care, and did not require further treatment.

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

The insurer denied income replacement benefits, a medical benefit, and the cost of a psychological assessment, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Licence Appeal Tribunal found that the applicant's injuries were not minor, as he suffered from a psychological impairment and chronic pain syndrome that could not be treated within the $3,500 MIG limit.

The Tribunal awarded income replacement benefits up to the 104-week mark, finding the applicant suffered a substantial inability to perform the essential tasks of his pre-accident employment.

The Tribunal also awarded the cost of a psychological assessment but denied the remaining balance for a physiotherapy treatment plan because the massage therapy rate exceeded the FSCO guideline limit.

The applicant sought income replacement benefits (IRBs) and attendant care benefits (ACBs) following a motor vehicle accident.

The Tribunal found the applicant lacked credibility, having concealed her return to work and regular gym attendance from assessors.

Relying on objective medical imaging and the respondent's experts, the Tribunal concluded the applicant did not suffer a substantial inability to perform the essential tasks of her pre-accident employment as a dental assistant.

The claim for ACBs was dismissed because the expenses were not incurred as defined in the Schedule.

The respondent was awarded repayment of $2,984.59 for IRBs paid while the applicant was working.

Both parties' requests for costs were denied.

The applicant sought medical and rehabilitation benefits, including chiropractic and physiotherapy treatment plans, following a motor vehicle accident.

The adjudicator found that the applicant failed to prove the treatment plans were reasonable and necessary, relying on the respondent's orthopaedic assessments which found no objective evidence of accident-related impairment.

The applicant's claim for a psychological assessment was also dismissed as a duplication of service.

Furthermore, the adjudicator ordered the applicant to repay $8,583.12 in income replacement benefits that were overpaid due to an insurer error, as the applicant failed to establish any exception to the repayment obligation under section 52 of the Schedule.

Claims for a section 10 award and costs were dismissed.

The applicant was injured in a rear-end motor vehicle collision and sought statutory accident benefits from his insurer.

The insurer terminated income replacement, attendant care, and housekeeping benefits, arguing the applicant was no longer disabled and had not sustained a catastrophic impairment.

The arbitrator found that while the applicant's physical injuries were largely resolved or pre-existing, the accident triggered a mental disorder (Adjustment Disorder/Major Depressive Disorder) that caused a marked impairment in the sphere of adaptation.

Consequently, the applicant was deemed catastrophically impaired.

The arbitrator ordered the insurer to pay ongoing income replacement benefits, finding the applicant met both the eligibility and disability tests.

The arbitrator also awarded ongoing housekeeping benefits at $90 per week and specific attendant care benefits, but dismissed the claims for assessment costs and a special award.

The applicant sought statutory accident benefits following two motor vehicle accidents in 2007.

The arbitrator found the applicant's evidence to be unreliable due to poor recall and contradictions with documentary evidence, including Ontario Works records showing he had returned to work.

Relying on the medical evidence, particularly the applicant's orthopaedic surgeon, the arbitrator concluded the applicant suffered a complete inability to engage in suitable employment for a limited period.

The applicant was awarded income replacement benefits from July 7, 2009, to August 1, 2010, but his claims for various assessment costs and a special award were dismissed.

The applicant was injured in a motor vehicle accident and received statutory accident benefits.

He later developed intense lower back pain and was diagnosed with herniated discs, which he claimed were caused by the accident.

He also sought to include an unpaid $30,000 management fee in his pre-accident income calculation.

The arbitrator found that the medical evidence did not support a causal link between the accident and the back injuries, preferring the opinions of the insurer's and court-appointed experts.

The arbitrator also accepted the insurer's accounting expert's evidence that the unpaid management fee should not be included in the applicant's income.

The applicant's claims for further benefits were dismissed, though he was awarded his arbitration expenses.

The applicant was injured in a motor vehicle accident in February 1993, his fourth accident in two years.

He applied for statutory accident benefits, and the insurer terminated his weekly income benefits in July 1993.

The arbitrator found that the accident materially contributed to the applicant's disability but concluded that the effects of the accident had resolved by October 13, 1993.

The arbitrator determined the correct quantum of weekly benefits by averaging the applicant's pre-accident income over 52 weeks, rather than just the weeks worked.

The applicant was ordered to repay collateral benefits received from a disability policy, but was not required to repay the insurer's overpayment of weekly benefits because the error was the insurer's.

The applicant was awarded his expenses of the arbitration.