Elana Korman

The applicant, who sustained a catastrophic impairment in a motor vehicle accident, sought payment for outstanding balances on six treatment plans for psychological services and $400 for housekeeping benefits.

The Licence Appeal Tribunal dismissed the application.

The Tribunal found the applicant failed to justify billing a psychotherapist's services at the higher hourly rate of a psychologist.

The claim for housekeeping benefits was denied because the applicant provided no evidence that the expenses were actually incurred or reasonable and necessary.

The applicant sought statutory accident benefits following a motor vehicle accident, including a non-earner benefit (NEB) and medical benefits for chiropractic and psychological services.

The respondent denied the benefits, citing the applicant's failure to comply with requests for medical records under s. 33 of the Schedule and relying on insurer examinations (IEs) that concluded the applicant did not suffer a complete inability to carry on a normal life.

The Tribunal dismissed the application, finding the applicant failed to provide medical evidence to refute the IE findings or establish that the treatment plans were reasonable and necessary.

Claims for an award and interest were also dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to a non-earner benefit (NEB), chiropractic services, an occupational therapy assessment, and a special award for unreasonable delay.

The Tribunal found that the applicant's accident-related chronic pain and exacerbation of pre-existing Post Polio Syndrome continuously prevented him from engaging in substantially all of his pre-accident activities, entitling him to an NEB for 104 weeks.

The Tribunal also approved the treatment plans for chiropractic services and an occupational therapy assessment, preferring the evidence of the applicant's experts who considered the functional limitations caused by his pain.

The claim for a special award was dismissed as the insurer's reliance on its independent medical examinations was not unreasonable.

The applicant sought statutory accident benefits following a 2017 motor vehicle accident.

She applied for a catastrophic impairment determination based on psychological and neurological impairments.

The Tribunal found the applicant was not catastrophically impaired, as her mental and behavioural disorders resulted in only mild impairments in social functioning and concentration, persistence, and pace, and there was insufficient evidence of a mild traumatic brain injury to meet the 55% whole person impairment threshold.

The Tribunal allowed the applicant to change her election from a non-earner benefit to an income replacement benefit, finding the initial election invalid because the insurer failed to provide a proper explanation of benefits.

The insurer was granted a repayment of the non-earner benefit due to deductible collateral benefits.

The Tribunal approved one occupational therapy treatment plan and awarded a 10% special award under s. 10 of O. Reg. 664, finding the insurer unreasonably maintained its denial despite acknowledging the plan should have been reassessed.

Claims for a massage chair, attendant care benefits, and other assessments were dismissed.