Dr. Howard Platnick

The applicant sought a determination that she sustained a catastrophic impairment as a result of a 2016 motor vehicle accident under Criteria 6, 7, and 8 of the Statutory Accident Benefits Schedule.

The Tribunal reviewed multidisciplinary assessments from both parties.

For Criterion 6 (physical), the Tribunal found a 36% whole person impairment, preferring the respondent's assessors on headaches and neurocognitive issues but the applicant's assessor on extremity impairments.

For Criterion 7 (combined physical and mental), the Tribunal added a 10% mental impairment rating based on the respondent's psychiatrist, resulting in a 42% combined impairment, falling short of the 55% threshold.

For Criterion 8 (mental/behavioural domains), the Tribunal found moderate impairments across all domains, rejecting the applicant's claims of marked or extreme impairments.

The application was dismissed.

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

The Tribunal found the applicant entitled to outstanding amounts for psychological and psychotherapy services, accepting that a registered psychotherapist could reasonably bill at a rate comparable to a psychologist when providing structured cognitive behavioural therapy under clinical supervision.

The Tribunal also approved a chiropractic treatment plan and assessments for neurology and chronic pain, finding them reasonable and necessary based on ongoing symptoms.

However, a comprehensive chronic pain program was denied due to insufficient evidence of severity and functional decline.

The applicant's claim for a special award was dismissed.

The applicant sought payment for three treatment plans for chiropractic services following a motor vehicle accident.

The Tribunal found that the first treatment plan, directed at the applicant's neck and back injuries, was reasonable and necessary as the contemporaneous medical evidence supported causation.

However, the Tribunal denied the remaining two treatment plans, which were directed at the applicant's right knee condition.

The Tribunal found insufficient evidence to establish that the knee injury was caused by the accident, noting a seven-month delay in reporting knee pain and MRI findings indicating degenerative changes rather than acute trauma.

The applicant was awarded the first treatment plan with interest.

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

The Tribunal found that the Applicant's injuries were predominantly minor and subject to the $3,500 Minor Injury Guideline (MIG) limit, as he failed to establish chronic pain with functional impairment or a psychological impairment warranting removal.

Although subject to the MIG, the Tribunal ordered the Respondent to pay for a $4,959.75 psychological treatment plan because the Respondent failed to comply with the notice requirements under s. 38(8) of the Schedule.

Claims for other treatment plans and a special award were dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, including a non-earner benefit, catastrophic impairment assessments, and physiotherapy treatment plans.

The Licence Appeal Tribunal dismissed the claims.

The non-earner benefit claim was statute-barred due to the late submission of the disability certificate and the applicant failed to prove a complete inability to carry on a normal life.

The catastrophic impairment assessments were denied as the applicant provided insufficient medical evidence to justify the need for further investigation.

The physiotherapy claims were dismissed because the applicant failed to address the specific provider rates in dispute.

Claims for interest and a section 10 award were consequently dismissed.

The applicant sought payment for a psychological assessment and a functional abilities evaluation following a motor vehicle accident.

The applicant argued that the insurer's denials were procedurally defective under s. 38(8) of the Schedule, triggering the 'shall pay' provision of s. 38(11).

The Tribunal found that the insurer's denials provided a principled rationale based fairly on the applicant's file, relying on insurer examination reports that concluded the applicant had no accident-related psychological impairment and that his physical injuries had resolved.

The application was dismissed, and claims for an award and interest were denied.

The applicant sought statutory accident benefits following a motor vehicle accident, specifically claiming entitlement to four physical therapy treatment plans and one supervised exercise program.

The Licence Appeal Tribunal found the physical therapy treatment plans reasonable and necessary based on the applicant's ongoing complaints and treating physician's recommendations, giving little weight to the insurer's examination reports.

However, the Tribunal denied the exercise program as the applicant provided insufficient evidence to establish its reasonableness and necessity.

The applicant was awarded the physical therapy plans with interest.

The applicant sought a determination of catastrophic impairment following a motor vehicle accident, claiming entitlement under Criteria 6, 7, and 8 of the Statutory Accident Benefits Schedule.

The Tribunal found that the applicant did not meet the threshold for catastrophic impairment, preferring the respondent's multidisciplinary assessments which were supported by objective evidence, including surveillance footage and employment records showing the applicant had returned to full-time work.

The Tribunal also dismissed the applicant's claims for the outstanding balance of a catastrophic impairment assessment plan, finding that clinical file reviews were subject to the $2,000 cap per assessment and that transportation expenses were not proven to exceed the 50-kilometre deductible.

Claims for interest and an award for unreasonable withholding of benefits were consequently dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, disputing the insurer's determination that her injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant failed to provide compelling medical evidence of a pre-existing condition, chronic pain, or psychological impairment that would warrant removal from the MIG.

Relying on the respondent's section 44 assessment, the Tribunal concluded the injuries were predominantly minor.

As the MIG limit was exhausted, the claims for chiropractic services, an award, and interest were dismissed.

The applicant sought a determination that he sustained a catastrophic impairment as a result of a motor vehicle accident, along with entitlement to various attendant care benefits and treatment plans.

The Licence Appeal Tribunal evaluated the applicant's impairments under Criterion 7 (Whole Person Impairment) and Criterion 8 (mental and behavioural disorders).

The Tribunal rejected several of the applicant's physical impairment ratings due to a lack of causal evidence and methodological flaws, concluding the applicant did not meet the 55% WPI threshold.

Under Criterion 8, the Tribunal found the applicant had only mild impairments in activities of daily living and social functioning, failing to meet the threshold of three marked or one extreme impairment.

As the applicant was not catastrophically impaired and had exhausted his non-CAT limits, the claims for attendant care and treatment plans were dismissed.

The applicant sought accident benefits following a motor vehicle accident, arguing she should be removed from the Minor Injury Guideline (MIG) due to chronic pain and psychological injuries.

The Licence Appeal Tribunal found the applicant failed to meet her burden of proof, noting inconsistencies in the medical evidence and a lack of formal psychological diagnosis.

The Tribunal held the applicant to the MIG, rendering the disputed treatment plan for chiropractic services moot, and denied claims for interest and a special award.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to removal from the Minor Injury Guideline (MIG) due to a left knee injury, chronic pain, and psychological impairments.

The adjudicator found that the applicant failed to prove her injuries warranted removal from the MIG, noting pre-existing osteoarthritis and a lack of contemporaneous reporting of knee pain.

The adjudicator also determined that the respondent provided proper medical reasons for denying the disputed treatment plans under s. 38(8) of the Schedule.

The claim for non-earner benefits was dismissed as the applicant did not establish a complete inability to carry on a normal life, having returned to her pre-accident activities.

The application was dismissed in its entirety.

The applicant sought statutory accident benefits following a motor vehicle accident, including a non-earner benefit, funding for a functional cognitive assessment, and psychological services.

The Tribunal dismissed the application.

Applying the Heath test, the adjudicator found the applicant did not suffer a complete inability to carry on a normal life, as medical evidence showed she remained independent in self-care and could perform light housekeeping, with her knee pain likely stemming from pre-existing arthritis.

The treatment plans were deemed not reasonable and necessary based on respondent medical examinations indicating her neurological and psychological issues had largely resolved or did not require the proposed assessments.

A claim for an award under s. 10 of Regulation 664 was also dismissed as the insurer's denials were reasonably based on medical evidence.

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

The Tribunal found the applicant was barred from claiming a non-earner benefit because she ought reasonably to have known her vehicle was uninsured at the time of the accident.

Claims for attendant care benefits and most treatment plans were denied, as medical and surveillance evidence demonstrated her injuries had healed and her presentation was exaggerated.

The Tribunal ordered the applicant to repay $3,000 in attendant care benefits, finding she wilfully misrepresented the extent of services received from personal support workers.

The applicant was awarded $80 for the outstanding balance of an assistive devices treatment plan.

The applicant sought statutory accident benefits following a motor vehicle accident, including attendant care benefits and various treatment plans for occupational therapy, physiotherapy, social work, and a psychological assessment.

The Licence Appeal Tribunal denied the claim for attendant care, finding the applicant failed to prove an ongoing need.

However, the Tribunal approved several of the treatment plans, either in whole or in part, finding them reasonable and necessary.

The Tribunal also granted an award under s. 10 of O. Reg. 664, ordering the respondent to pay $600 (15% of the denied occupational therapy benefits) because it unreasonably maintained its denial despite its own assessor recommending the treatment.

Preliminary motions regarding page limits and striking portions of the applicant's reply submissions were also addressed.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming his injuries warranted removal from the Minor Injury Guideline (MIG) due to chronic pain and psychological impairments.

The adjudicator found that the applicant failed to prove on a balance of probabilities that his ongoing back pain, including spondylolisthesis, was caused by the accident.

Furthermore, the adjudicator rejected the applicant's psychological assessment due to a lack of corroborating medical evidence, preferring the respondent's insurer examination.

As the applicant's injuries were deemed predominantly minor and the MIG limits had been exhausted, the application for disputed treatment plans and interest was dismissed.

The applicant sought statutory accident benefits for chiropractic services and platelet-rich plasma injections following a motor vehicle accident.

The respondent denied the treatment plans.

The Tribunal found that the applicant failed to prove the treatments were reasonable and necessary, and that the respondent's denials complied with s. 38(8) of the Schedule.

The application was dismissed.

The applicant was involved in a motor vehicle accident and sought accident benefits, which were denied by the respondent insurer.

The applicant applied to the Tribunal, arguing his injuries warranted removal from the Minor Injury Guideline (MIG) due to pre-existing conditions and a psychological impairment, and claiming entitlement to an income replacement benefit (IRB) and specific treatment plans.

The Tribunal found the applicant failed to provide compelling medical evidence that his pre-existing conditions prevented maximal recovery within the MIG, nor did he establish a psychological impairment caused by the accident.

The Tribunal also dismissed the IRB claim, finding the applicant did not suffer a substantial inability to perform the essential tasks of his pre-accident employment as a security guard, noting his post-accident return to work.

As the applicant remained in the MIG and the limit was exhausted, the treatment plans were denied.

The application was dismissed.

The applicant sought a catastrophic impairment designation and attendant care benefits following a motor vehicle accident.

The Tribunal evaluated the competing multidisciplinary assessments to determine if the applicant met the 55% whole person impairment threshold under Criterion 7.

The Tribunal rejected several of the applicant's proposed impairment ratings, including those for the lumbar spine, headaches, mental status, and medication, finding them inconsistent with the AMA Guides and medical evidence.

The Tribunal concluded the applicant's combined whole person impairment was 45%, falling short of the catastrophic impairment threshold.

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

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 Tribunal found that the applicant failed to prove she sustained a concussion, chronic pain, or a psychological condition that would warrant removal from the MIG.

Furthermore, the Tribunal held that the applicant was not entitled to a non-earner benefit, as she retained the ability to perform self-care and light housekeeping, and therefore did not suffer a complete inability to carry on a normal life.

The application was dismissed.