Dr. Gilbert Yu Ming Yee

The applicant sought statutory accident benefits following a 2017 motor vehicle accident, claiming catastrophic impairment, income replacement benefits (IRB), and various medical and rehabilitation benefits.

The Licence Appeal Tribunal found the applicant was not catastrophically impaired, as she did not demonstrate Marked or Class 4 impairments in three of four functional domains, relying partly on surveillance evidence showing her ability to socialize and complete tasks.

Consequently, her claim for attendant care benefits was dismissed.

However, the Tribunal granted her claim for a post-104-week IRB, finding her severe chronic pain and heavy medication use rendered her completely unable to engage in suitable employment.

Several treatment plans, including for medical marijuana and lidocaine injections, were approved as reasonable and necessary for pain relief, while others were denied.

The claim for an award for unreasonably withheld benefits was dismissed.

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

The insurer denied claims for physiotherapy and assessments, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant argued for removal from the MIG based on chronic pain, psychological impairment, and a pre-existing condition.

The Tribunal found the applicant failed to prove on a balance of probabilities that his chronic pain adversely affected his well-being, applying the AMA Guides criteria.

The Tribunal also gave little weight to the applicant's psychological evidence and found no documented pre-existing condition preventing maximal recovery.

As the MIG limits were exhausted, the application was dismissed.

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

He subsequently had a slip and fall and a second motor vehicle accident.

The Tribunal found that the applicant's psychological impairments were caused by the first accident, but he failed to prove that his physical impairments were caused by the first accident, as they were likely caused by the subsequent slip and fall or second accident.

The Tribunal dismissed the claims for physical treatment plans due to lack of causation.

The claims for psychological treatment and assessments were also dismissed because the applicant failed to prove they were reasonable and necessary, or failed to comply with the signature requirements under s. 38(3) of the Schedule.

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

The respondent insurer suspended the IRBs after the applicant failed to attend a scheduled orthopaedic insurer's examination (IE).

The applicant argued the IE was not reasonably necessary and sought payment of the withheld IRBs, an award, and interest.

The Tribunal found that the requested orthopaedic IE was reasonably necessary given new medical evidence (an MRI showing an annular tear) and that the applicant failed to provide a reasonable explanation for his non-attendance.

Consequently, the insurer was not required to pay IRBs for the period of non-compliance.

However, the Tribunal awarded the applicant $250 in costs due to the insurer's unreasonable and bad faith conduct in evading service of a summons for its adjuster.

The insurer's request for costs was denied.