Dr. Howard Jacobs

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

The respondent denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant argued for removal from the MIG based on chronic pain and psychological impairments.

The Tribunal found insufficient medical evidence of functional impairment arising from chronic pain or psychological injuries, preferring the respondent's insurer's examinations over the applicant's medical reports.

The application was dismissed, and the applicant was found not entitled to the disputed treatment plans, interest, or an award.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming his injuries, including chronic pain, warranted treatment outside the Minor Injury Guideline (MIG).

The respondent denied the treatment plans, arguing the injuries were minor.

The Licence Appeal Tribunal found that the applicant failed to prove he suffered from non-minor injuries or chronic pain with functional impairment.

The Tribunal preferred the comprehensive insurer's examination report over the applicant's medical evidence.

As the applicant remained within the MIG and its $3,500 limit was exhausted, the claims for treatment plans, an award, and interest were dismissed.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including income replacement benefits (IRBs), medical benefits, and cost of examinations.

The respondent denied the benefits, arguing the applicant had returned to work and suffered only minor injuries.

The Tribunal found the applicant was entitled to IRBs up to June 2018, but made no order for payment as the applicant failed to provide post-accident income information.

The Tribunal also found the applicant was entitled to various medical benefits, including physiotherapy, psychological services, shockwave therapy, and a chronic pain program, as the evidence demonstrated she suffered from chronic pain caused by the accident.

The claims for cost of examinations and a Regulation 664 award were dismissed.

The respondent insurer requested a reconsideration of a Tribunal decision which found that the applicant's injuries fell outside the Minor Injury Guideline (MIG) and awarded medical benefits.

The insurer argued the Tribunal erred in fact by accepting unsubstantiated opinion evidence regarding chronic pain and erred in law by misapplying the MIG test.

The adjudicator dismissed the request, finding no significant errors of fact or law that would have changed the outcome, as the Tribunal properly weighed the totality of the medical evidence.

The applicant's request for costs was also denied.

The applicant sought statutory accident benefits following a motor vehicle accident, including a non-earner benefit and funding for chiropractic services and a chronic pain assessment.

The Licence Appeal Tribunal dismissed the claim for a non-earner benefit, finding that surveillance evidence and inconsistencies in the applicant's self-reporting undermined her claim of a complete inability to carry on a normal life.

However, the Tribunal granted the medical benefits, concluding that the applicant suffered from an accident-related pain condition and that the proposed treatments were reasonable and necessary to address her physical and psychological impairments.

The respondent's request for costs was denied.

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

The Licence Appeal Tribunal found that the insurer failed to provide adequate medical reasons in its notices denying certain treatment plans under s. 38(8) of the Schedule, entitling the applicant to incurred costs until proper notice is given.

The Tribunal also found three chiropractic treatment plans and one psychological treatment plan to be reasonable and necessary.

However, a second psychological treatment plan, a chronic pain assessment, and a cognitive assessment were deemed not reasonable and necessary.

The applicant's claim for an award under Regulation 664 was dismissed.

The applicant was injured in a motor vehicle accident and sought medical benefits for physiotherapy.

The respondent denied the treatment plans, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) and its $3,500 limit.

The Licence Appeal Tribunal found that while the applicant did not establish a psychological impairment, his physical injuries fell outside the MIG due to chronic pain and nerve injuries.

The Tribunal concluded that the two physiotherapy treatment plans were reasonable and necessary, and ordered the respondent to pay the benefits with interest.

The applicant was injured in a rear-end motor vehicle accident and sought income replacement benefits, various treatment plans, and a chronic pain assessment from her insurer.

The Licence Appeal Tribunal found that the applicant did not suffer a substantial inability to perform the essential tasks of her pre-accident employment, relying on surveillance evidence that contradicted her self-reported limitations.

The Tribunal approved treatment plans for physiotherapy and massage therapy as reasonable and necessary, but denied plans for drive counselling, a treadmill, and a chronic pain assessment due to insufficient medical evidence and inconsistencies in the applicant's presentation.

Claims for an award for unreasonably delayed payments were also dismissed.

The Applicant was catastrophically injured in a motor vehicle accident, sustaining a traumatic brain injury and chronic pain.

He applied for statutory accident benefits, including non-earner, attendant care, and housekeeping benefits, which the Insurer denied or underpaid.

The Arbitrator found that the Applicant suffered a complete inability to lead a normal life and awarded non-earner benefits.

The Arbitrator also deemed past attendant care and housekeeping expenses to have been incurred under s. 3(8) of the Schedule, finding that the Insurer unreasonably withheld benefits by failing to advise the impecunious and functionally illiterate Applicant that it would pay for professional services.

However, the Arbitrator declined to order a special award, finding the Insurer's conduct was not sufficiently egregious.

The applicant sought a non-earner benefit following a 2014 motor vehicle accident, having previously been involved in three other accidents.

The Tribunal found that the applicant failed to meet her onus of proving a complete inability to carry on a normal life, noting a lack of evidence regarding her pre-accident activities and credibility issues with her self-reporting.

The Tribunal placed limited weight on the psychological assessments because the assessors lacked critical information about the applicant's prior accidents and academic history.

The application for benefits, interest, and costs was dismissed.

The plaintiff sought damages for injuries from a motor vehicle accident.

The defendants admitted liability but brought a threshold motion to declare the plaintiff's non-pecuniary loss claim barred under s. 267.5(5) of the Insurance Act, arguing the plaintiff did not sustain a permanent, serious impairment of an important physical, mental, or psychological function.

The court applied the three-part Meyer v. Bright test, finding the plaintiff suffered permanent chronic pain, anxiety, driving phobia, and depression, which constituted a permanent and serious impairment of important functions.

The defendants' motion was dismissed.

The defendant moved for leave to appeal an order dismissing his motion for summary judgment.

The underlying action arose from a motor vehicle accident, and the defendant argued the claim was statute-barred because the plaintiff ought to have discovered his chronic pain claim within two years of the accident.

The Divisional Court dismissed the motion for leave to appeal, finding no good reason to doubt the correctness of the motion judge's decision.

The court held that the plaintiff was entitled to rely on the discovery evidence filed by the defendant on the summary judgment motion, and that the motion judge correctly applied the discoverability principles to find the plaintiff had exercised reasonable diligence in investigating whether his injuries met the statutory threshold.

The appellant was injured in a motor vehicle accident and sought payment for a multidisciplinary assessment under s. 24 of the SABS-1996.

The arbitrator allowed the costs for the physiotherapy and functional abilities assessments but denied the cost of the orthopaedic assessment.

Both parties appealed.

The Director's Delegate dismissed the appeal and cross-appeal, finding that the arbitrator correctly applied a flexible, contemporaneous reasonableness test to determine whether the assessments were obtained for the purpose of the regulation.

The Delegate also declined to admit fresh evidence on appeal and dismissed a motion alleging institutional bias.

The applicant was injured in a motor vehicle accident and sought ongoing weekly caregiver benefits, as well as costs for medical devices, housekeeping services, and a case manager.

The insurer had terminated caregiver benefits.

The arbitrator found that the applicant suffered a psychological impairment resulting from the accident, including depression and a driving phobia, which caused a partial inability to carry on a normal life.

The arbitrator awarded ongoing caregiver benefits, the costs of a massager and an orthopaedic mattress, and partial housekeeping expenses, but denied the claim for a case manager.

The applicant, a taxi driver, was injured when pinned between two vehicles.

He claimed ongoing weekly income benefits, alleging chronic pain and depression prevented him from working.

The insurer terminated benefits after medical assessments indicated he could return to work.

The arbitrator dismissed the claim for ongoing benefits, finding the applicant lacked credibility, exaggerated his symptoms, and had been working covertly at his brother's store, as revealed by surveillance evidence.

The medical opinions supporting disability were rejected as they relied on the applicant's unreliable subjective reporting.

The applicant was awarded one-third of his expenses.