Dr. El-Hage

The applicant sought accident benefits following a 2019 motor vehicle accident, claiming catastrophic impairment due to psychological issues.

The adjudicator first held that the applicant was barred from disputing attendant care benefits because he failed to attend scheduled insurer's examinations without a valid reason.

On the catastrophic impairment issue, the adjudicator preferred the respondent's psychiatric assessment, finding that the applicant's marked psychological impairments were attributable to extensive pre-existing conditions, including bereavement following his mother's death, rather than the subject accident.

As the applicant did not meet the catastrophic impairment threshold and his non-catastrophic limits were exhausted, the claims for disputed treatment plans were dismissed.

The applicant sought income replacement benefits (IRBs) following a motor vehicle accident.

The Tribunal found that while the applicant met the medical test for pre-104 week IRBs due to chronic pain and adjustment disorder, they failed to provide the necessary financial documents, such as tax returns, to determine the quantum of the benefit.

The Tribunal also found that the applicant did not meet the more stringent post-104 week test of a complete inability to engage in suitable employment.

As no quantum could be determined, the application for IRBs and interest was dismissed.

The applicant sought various medical and rehabilitation benefits following a motor vehicle accident.

The Licence Appeal Tribunal found that the applicant was entitled to funding for physiotherapy, Botox injections, a mental health driving assessment, a virtual social work assessment, a sleep study, an oculo-visual assessment, and prescription medication, as these were reasonable and necessary to treat his accident-related impairments, including a mild traumatic brain injury.

However, claims for a functional cognitive assessment, an attendant care assessment, and occupational therapy were denied because the applicant demonstrated an ability to engage in pre-accident activities and perform necessary tasks independently.

The Tribunal also denied the applicant's request for a special award, finding that the insurer reasonably relied on its assessors' opinions.

The applicant sought statutory accident benefits for chiropractic services and a social work assessment following a motor vehicle accident.

The Tribunal found the chiropractic treatment plans reasonable and necessary, preferring the evidence of the applicant's specialists over the respondent's general physicians.

The claim for a social work assessment was dismissed due to a lack of supporting evidence.

The Tribunal also granted an award of 5% under s. 10 of Regulation 664, finding that the respondent unreasonably delayed the approval and payment of benefits despite receiving corroborative medical evidence.

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.