Dr. Howard Platnick

The applicant sought statutory accident benefits for medical cannabis and chiropractic treatment following a 2017 motor vehicle accident.

The respondent denied the benefits, relying on insurer examination reports indicating the applicant had reached maximal medical improvement and did not suffer from chronic pain or a sleep disorder as a result of the accident.

The adjudicator dismissed the application, finding the applicant failed to provide objective medical evidence to prove the treatment plans were reasonable and necessary.

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 sought removal from the MIG on the basis of psychological impairment and chronic pain.

The Tribunal found insufficient objective medical evidence to support a psychological impairment or chronic pain with functional impairment caused by the accident.

As the applicant remained within the MIG and the $3,500 limit was exhausted, the claims for further medical benefits, an award, and interest were dismissed.

The applicant sought entitlement to statutory accident benefits for a chronic pain assessment and various physiotherapy treatment plans following a 2016 motor vehicle accident.

The Licence Appeal Tribunal dismissed the application, finding that the chronic pain assessment was a duplication of previous assessments and therefore not reasonable and necessary.

The Tribunal also denied the physiotherapy claims, noting discrepancies in the treatment times invoiced versus the sign-in sheets, and finding the applicant failed to meet her burden of proof for the remaining treatment plan.

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's physical injuries were minor soft-tissue strains and that he failed to establish any accident-related psychological impairments warranting removal from the MIG.

Because the $3,500 MIG limit was exhausted, the disputed treatment plans were not payable.

The Tribunal also dismissed the claim for non-earner benefits, finding the applicant failed to prove a complete inability to carry on a normal life, and denied the request for a special award.

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

The respondent insurer denied certain treatment plans, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant contended that pre-existing chronic neck pain, psychological impairments, and accident-related chronic pain removed him from the MIG.

The Tribunal found that the applicant's physical injuries were soft tissue in nature and predominantly minor.

The Tribunal also rejected the psychological and chronic pain claims, noting inconsistencies in self-reporting, lack of objective medical evidence, and the applicant's continued high level of functioning, including working and attending the gym.

As the applicant failed to prove his injuries fell outside the MIG and the $3,500 limit was exhausted, the application was dismissed.

The plaintiff, Denis Roy, was seriously injured in a 2004 motorcycle accident, suffering physical and psychological impairments.

His insurer, Primmum Insurance Co. (referred to as TD), initially paid attendant care benefits (ACBs) and housekeeping benefits (HKBs) but later reduced and terminated them.

Roy applied for a catastrophic impairment (CAT) determination in 2010, which TD contested for over three years before conceding in 2014.

Roy then sought retroactive ACBs and HKBs, plus statutory interest, from the date of the accident.

The court found that Roy was catastrophically impaired from the date of the accident, that the claimed retroactive ACBs were reasonable and necessary, and that TD was obligated to pay statutory interest due to its failure to comply with SABS obligations and its duty of good faith.

The applicant was injured in a motor vehicle accident and sought Income Replacement Benefits (IRBs) and medical benefits for chiropractic services.

The insurer terminated IRBs and denied further treatment on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and he was able to return to work.

The Tribunal found the applicant's self-reporting to be unreliable, noting he had returned to work multiple times without disclosing it to the insurer or medical assessors.

Relying on independent medical examinations and surveillance evidence, the Tribunal concluded the applicant did not suffer a substantial inability to perform the essential tasks of his employment and his injuries were treatable within the MIG.

The application was dismissed.

The Applicant was injured in a rear-end motor vehicle accident and sought accident benefits from the Insurer.

The Insurer denied various treatment plans on the basis that the Applicant's injuries fell within the Minor Injury Guideline (MIG).

The Arbitrator found that the Applicant's injuries fell outside the MIG due to chronic pain, psychological impairments, and radicular symptoms.

The Arbitrator approved several treatment plans for chronic pain assessment, psychological assessment and treatment, active treatment, and a home assessment, while denying others as duplicative or unnecessary.

The Applicant was also awarded interest on overdue payments.

The Applicant sought a determination that he sustained a catastrophic impairment due to a mental or behavioural disorder following a motor vehicle accident.

The Insurer argued his impairment was only moderate (Class 3).

The Arbitrator preferred the evidence of the Applicant's expert, who conducted a robust 14-hour assessment including collateral interviews and cognitive testing, over the Insurer's experts whose assessments were brief and lacked collateral information.

The Arbitrator found that the Applicant's chronic pain and psychological conditions significantly impeded his useful functioning, meeting the criteria for a Class 4 Marked Impairment.

The Applicant was deemed catastrophically impaired.

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

The Insurer denied several treatment plans and assessments, arguing the Applicant's injuries fell within the Minor Injury Guideline (MIG).

The arbitrator found that the Applicant's psychological and orthopaedic expert reports were tainted by a conflict of interest, as the primary psychologist had a close personal and financial relationship with the Applicant, and other experts relied on her clinic's flawed assessments.

The arbitrator excluded or gave no weight to the Applicant's expert evidence and accepted the Insurer's independent medical examinations.

The arbitrator concluded the injuries were predominantly minor and dismissed the claims for further benefits.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits, claiming he sustained a catastrophic impairment due to a mental disorder.

The insurer argued the mental disorder was genetically based and not caused by the accident.

The Arbitrator found that the accident caused the applicant's mental disorders, which resulted in a marked impairment of his ability to function, meeting the definition of catastrophic impairment.

The applicant was awarded attendant care benefits at a reduced rate, as he did not require round-the-clock care.

Claims for Botox injections and a special award were dismissed.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including non-earner benefits and medical/rehabilitation benefits for prescription medication (primarily Oxycontin).

The arbitrator found that the applicant did not suffer a complete inability to carry on a normal life within 104 weeks of the accident, dismissing the claim for non-earner benefits.

However, preferring the evidence of the applicant's treating physician over the insurer's paper-review assessor, the arbitrator found the ongoing prescription of narcotics to be reasonable and necessary for chronic pain management, awarding $25,546.02 for medication expenses.

Claims for the cost of medical reports and a special award were dismissed.