Dr. James Fung

The applicant requested reconsideration of a Licence Appeal Tribunal decision that denied certain physiotherapy and chiropractic treatment plans following a motor vehicle accident.

The applicant argued that his post-hearing decision to undergo shoulder surgery constituted new evidence that would have affected the outcome.

The Tribunal found that while the decision to have surgery was new evidence, it would not have changed the original decision.

The original denial was based on the lack of clinical justification for extended passive treatment and a factual finding that the applicant did not sustain a concussion, neither of which were altered by the subsequent surgery.

The request for reconsideration was dismissed.

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

The Licence Appeal Tribunal considered entitlement to multiple treatment plans for psychological, optometric, dietary, and physical rehabilitation services.

The Tribunal granted the plans for optometric services and a dietary assessment, finding them reasonable and necessary based on the medical evidence and the applicant's positive response to vision therapy.

The Tribunal denied the remaining plans, including psychological and physical therapy, finding that the applicant either failed to prove they were reasonable and necessary, failed to exhaust collateral benefits, or incurred expenses prior to submitting a plan.

The claim for a special award was dismissed, but interest was awarded on overdue benefits.

The applicant sought various statutory accident benefits following a motor vehicle accident, including attendant care benefits, multiple treatment plans, and an award for unreasonable delay.

The Licence Appeal Tribunal found the applicant entitled to attendant care benefits of $1,372.21 and $1,297.46 per month, preferring the applicant's occupational therapy assessments over the insurer's examination.

The Tribunal also approved assessments for concussion and chronic pain.

However, claims for extended physiotherapy, chiropractic care, and other assessments were denied as not reasonable and necessary.

The Tribunal held that outstanding invoices were payable only after collateral benefits were exhausted, and declined to order a section 10 award, finding the insurer's conduct was not unreasonable.

The applicant sought statutory accident benefits following a motor vehicle accident, disputing the respondent's denial of multiple treatment and assessment plans, medication expenses, and parking costs.

The Tribunal found that the applicant failed to prove on a balance of probabilities that the proposed in-home, attendant care, neurological, concussion, chiropractic, physiotherapy, and psychological plans were reasonable and necessary, preferring the objective findings of the respondent's assessors over the subjective reporting relied upon by the applicant's assessors.

The Tribunal awarded the cost of one prescription medication and interest on overdue payments, but denied the remaining expenses and the claim for a special award under s. 10 of Reg. 664.

The applicant sought various statutory accident benefits after being struck by a detached tire while walking.

The Licence Appeal Tribunal dismissed the application in its entirety, finding that the applicant had fully recovered from his physical injuries and was engaging in 'learned helplessness'.

The Tribunal denied claims for attendant care, assistive devices, occupational therapy, and chiropractic treatments, noting inconsistencies in the applicant's expert evidence and exaggerated assessment fees.

The claim for non-earner benefits was dismissed as time-barred and substantively unproven.

Claims for a special award and interest were also dismissed.

The applicant sought a non-earner benefit following a motor vehicle accident, claiming physical and psychological impairments prevented him from engaging in his pre-accident activities.

The Tribunal applied the Heath test and found the applicant failed to prove a complete inability to carry on a normal life, as evidence showed he had resumed many activities, albeit with some modifications.

Claims for interest and a special award were consequently dismissed.

The applicant sought a medical benefit of $2,233.46 for chiropractic treatment and massage therapy following a motor vehicle accident.

The insurance company denied the treatment plan, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant contended they suffered from cervical radiculopathy, which falls outside the MIG.

The Tribunal found that the applicant failed to meet the burden of proving their injuries fell outside the MIG, as their medical evidence lacked sufficient objective testing and persuasive analysis to support a diagnosis of cervical radiculopathy.

The Tribunal preferred the insurance company's medical assessment, which diagnosed a whiplash injury.

The application for benefits and interest was dismissed.

The Applicant was injured in a motor vehicle accident and sought statutory accident benefits.

The Insurer terminated income replacement and housekeeping benefits based on insurer's examinations.

The arbitrator found the Applicant's evidence and her medical assessors' opinions credible, establishing that her physical and psychological impairments substantially prevented her from performing her pre-accident employment and housekeeping tasks.

The arbitrator rejected the Insurer's assessors' evidence as flawed and unpersuasive.

The Applicant was awarded income replacement and housekeeping benefits for the 104-week period, with interest.

Claims for post-104 week benefits were dismissed on a technical basis without prejudice.

The claim for a special award was dismissed as the Insurer's reliance on its assessors, though ultimately unsuccessful, was not unreasonable.