Dr. Goodfield

The applicant sought statutory accident benefits following a motor vehicle accident, including treatment plans for psychological services, a neurological assessment, and physiotherapy.

The Tribunal found the applicant partially entitled to the psychological services treatment plan for counselling sessions, but denied the in-car driving reintegration therapy, preferring the respondent's psychological assessment that the applicant did not suffer from a severe driving phobia.

The claims for a neurological assessment and physiotherapy were dismissed due to a lack of supporting medical evidence.

The applicant's request for an award under s. 10 of Regulation 664 was denied, but interest was awarded on the overdue psychological counselling benefits.

The applicant sought statutory accident benefits following a motor vehicle accident, including non-earner benefits, attendant care benefits, and funding for various treatment plans.

The respondent denied the claims.

The Tribunal found that the applicant failed to establish a complete inability to carry on a normal life, as medical evidence showed little difference between his pre- and post-accident activities.

The Tribunal also found that attendant care benefits were not reasonable and necessary, preferring the multidisciplinary assessments of the respondent's examiners over the applicant's single nursing assessment.

The treatment plans for physiotherapy and psychological services were denied as the applicant had reached maximal medical recovery and the respondent had properly approved the maximum permitted fees under the Professional Services Guideline.

The application was dismissed in its entirety.

The applicant sought statutory accident benefits following a motor vehicle accident, specifically claiming the cost of an OCF-3 disability certificate and a chronic pain treatment program.

The respondent denied the benefits, arguing the OCF-3 was not requested and the chronic pain program was not reasonable and necessary.

The Tribunal found the OCF-3 was payable as it provided material medical evidence that led to the reinstatement of the applicant's non-earner benefit.

The Tribunal also approved the chronic pain treatment plan, preferring the evidence of the applicant's chronic pain specialist over the respondent's general practitioner, and finding the applicant met the criteria for chronic pain syndrome.

Interest was awarded on the overdue benefits.

The applicant sought payment for two psychological treatment plans, a special award, and interest following a motor vehicle accident.

The Licence Appeal Tribunal found that the applicant failed to prove the treatment plans were reasonable and necessary, noting that the treating psychologist's reports were boilerplate and did not reflect the applicant's reported improvements or lack of functional difficulties.

The Tribunal preferred the respondent's section 44 assessor's report, which recommended a ramp down in treatment.

The application was dismissed, and no interest or award was payable.

The applicant sought ongoing Income Replacement Benefits (IRBs) and a psychological assessment following a motor vehicle accident.

The insurer terminated IRBs after 104 weeks, arguing the applicant no longer met the test for entitlement.

The Tribunal found that while the applicant suffered from accident-related physical and psychological impairments, he failed to prove a substantial or complete inability to work as a real estate agent.

The applicant's credibility was significantly undermined by a forensic accounting report revealing he misrepresented his pre- and post-accident income to all assessors, and that he actually earned more in the year following the accident.

Consequently, the claim for ongoing IRBs was dismissed.

However, the Tribunal granted the $2,000 psychological assessment, finding it reasonable and necessary to address the applicant's ongoing psychological impairment.

The applicant sought income replacement benefits (IRBs) following a motor vehicle accident, claiming a substantial inability to perform his pre-accident employment as a hazardous material worker due to exacerbated chronic back pain and psychological symptoms.

The respondent denied the IRBs after December 1, 2019.

The Licence Appeal Tribunal dismissed the application, preferring the evidence of the respondent's medical assessors over the applicant's family physician.

The Tribunal found no objective findings to support the subjective complaints and concluded the applicant did not suffer a substantial inability to perform the essential tasks of his employment.

Claims for a special award and interest were also dismissed.

The applicant sought medical benefits for chiropractic services and a psychological assessment following a motor vehicle accident.

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

The Tribunal found that the medical evidence, including the applicant's own treatment records and the insurer's examinations, confirmed the physical injuries were predominantly minor.

The Tribunal also found insufficient evidence of a psychological impairment that would warrant removal from the MIG.

As the MIG limit was exhausted, the treatment plans were deemed not reasonable and necessary.

The applicant sought attendant care benefits, chiropractic treatment, and a psychological assessment following a motor vehicle accident.

The adjudicator found the applicant was not entitled to attendant care benefits beyond the 104-week mark as she had not been deemed catastrophically impaired.

The chiropractic treatments and psychological assessment were deemed not reasonable and necessary based on section 44 assessments and the applicant's pre-existing conditions.

The application was dismissed.

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

The respondent insurer removed the applicant from the Minor Injury Guideline (MIG) due to psychological impairments but denied several treatment plans.

The Tribunal found that the physical treatment plans were not reasonable and necessary as the physical injuries were predominantly minor.

However, the Tribunal approved the psychological treatment and assessments at reduced rates in accordance with the Professional Fee Guideline, and approved a chronic pain assessment to investigate the connection between the applicant's subjective pain and psychological diagnoses.

The applicant sought statutory accident benefits for chiropractic treatment, hospital expenses, and a psychological assessment 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 adjudicator found that the applicant failed to prove on a balance of probabilities that he suffered from chronic pain or a psychological impairment that would take him out of the MIG.

As the applicant had already exhausted the $3,500 MIG limit, the disputed benefits were not payable.

The respondent's request for costs was also denied.

The applicant sought a medical and rehabilitation benefit of $12,001.80 for a chronic pain treatment program following a motor vehicle accident.

The insurer denied the claim.

The Tribunal found that the applicant did not meet the AMA criteria for chronic pain, noting that he had returned to full-time work, completed a university degree, and maintained social and self-care activities.

The Tribunal concluded the treatment was not reasonable and necessary, dismissing the appeal and the claims for interest and a special award.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that denied his claim for income replacement benefits following a motor vehicle accident.

The applicant argued the Tribunal erred by relying on the respondent's surveillance evidence and an assessment by Dr. Goodfield, while failing to properly weigh his own medical evidence.

The Executive Chair dismissed the request, finding that the Tribunal was entitled to weigh the evidence as it saw fit and properly concluded that the applicant's self-reporting to his medical practitioners lacked credibility when contrasted with the surveillance footage.