Dr. Jennifer Gordon

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 on the basis of chronic pain and functional impairment.

The Tribunal applied the AMA Guides criteria for chronic pain and found the applicant only met one of the required three criteria.

Relying on the respondent's section 44 assessments, the Tribunal concluded the applicant failed to prove his injuries warranted removal from the MIG.

The application for physiotherapy benefits and interest was dismissed.

The applicant sought entitlement to statutory accident benefits for psychological, orthopaedic, neurological, and chronic pain assessments following a 2018 motor vehicle accident.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to prove the treatment plans were reasonable and necessary.

The Tribunal noted significant, unexplained gaps of over four years between the accident, the cessation of initial treatments, and the submission of the disputed assessment plans.

As no benefits were payable, claims for interest and a special award were also dismissed.

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

The applicant also claimed entitlement to non-earner benefits, various treatment plans, and a special award for unreasonable delay.

The Licence Appeal Tribunal dismissed the application in its entirety, finding that the applicant failed to provide sufficient medical evidence to establish that his injuries warranted removal from the MIG or that he suffered a complete inability to carry on a normal life.

Consequently, the disputed treatment plans were not payable, and the claims for interest and a special award were denied.

The applicant was involved in a motor vehicle accident and sought various statutory accident benefits, including income replacement benefits (IRBs), attendant care services, and medical/rehabilitation benefits.

The respondent insurer denied the benefits.

The Licence Appeal Tribunal found that the applicant failed to meet his burden of proving entitlement to any of the claimed benefits.

Specifically, the applicant did not provide compelling medical evidence to establish a substantial or complete inability to perform the essential tasks of his pre-accident employment.

The Tribunal also dismissed the claims for attendant care and treatment plans due to a lack of supporting evidence.

The respondent's request for costs was denied, as the applicant's conduct was not found to be unreasonable, frivolous, vexatious, or in bad faith.

The application was dismissed in its entirety.

The applicant sought a non-earner benefit, medication expenses, and a special award following a motor vehicle accident.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to establish a complete inability to carry on a normal life.

The Tribunal relied on the respondent's section 44 assessments and surveillance evidence, which showed the applicant engaging in various physical activities, over the applicant's medical evidence.

The claims for medication expenses, interest, and a special award were also dismissed.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision regarding her entitlement to statutory accident benefits following a motor vehicle accident.

The adjudicator granted the request in part, finding a factual error in the original decision which had limited income replacement benefits to date rather than ongoing, as the issue of entitlement was not in dispute.

The adjudicator varied the decision to award income replacement benefits to date and ongoing.

However, the adjudicator dismissed the reconsideration request regarding three disputed treatment plans, finding that the applicant was attempting to re-litigate the issue and had failed to demonstrate any error of law or fact.

The applicant sought statutory accident benefits following a motor vehicle accident, specifically claiming entitlement to two physiotherapy treatment plans, three psychological services treatment plans, interest, and an award for unreasonable delay.

The adjudicator found that the applicant failed to prove the physiotherapy plans were reasonable and necessary, placing significant weight on the respondent's physiatry report which was corroborated by the applicant's own family doctors' clinical notes.

The adjudicator also found the respondent complied with the notice requirements under s. 38(8) of the Schedule.

The psychological services plans were no longer in dispute as they had already been paid in full.

As no benefits were overdue or unreasonably withheld, the claims for interest and an award were dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, including income replacement benefits (IRBs) and three treatment plans.

The respondent denied the benefits.

The Tribunal found the applicant was entitled to IRBs from February 4, 2023, onward, calculating the quantum based on the applicant's pre-accident bi-weekly income and deducting Long-Term Disability and Canada Pension Plan benefits.

However, the Tribunal denied the three treatment plans for an orthopedic assessment, physical rehabilitation, and a general practitioner assessment, finding the applicant failed to prove they were reasonable and necessary.

The Tribunal preferred the respondent's insurer's examination reports, which concluded the applicant's injuries were minor soft tissue injuries.

Interest was awarded on overdue IRBs.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for physiotherapy and a chronic pain assessment.

The respondent insurer denied the treatment plans.

The Tribunal found that the applicant met her onus of proving the physiotherapy plans were reasonable and necessary, relying on her family doctor's records showing ongoing pain and benefit from treatment.

The Tribunal also approved the chronic pain assessment, noting the respondent's own medical examiner acknowledged the applicant's ongoing pain, but reduced the assessment cost to the $2,000 maximum under s. 25(5) of the Schedule.

The applicant was awarded the treatment plans and interest.

The applicant sought statutory accident benefits following a motor vehicle accident, specifically a treatment plan for chiropractic services.

The respondent insurer denied the treatment plan on the basis that the impairments were not caused by the accident and the treatment was not reasonable and necessary.

The Tribunal found that the applicant failed to prove causation, noting extensive pre-existing medical conditions and prior physical trauma.

The Tribunal also accepted the respondent's medical examination report, which concluded that the applicant had reached maximum benefit from facility-based treatment.

The application was dismissed, along with claims for interest and a special award.

The applicant was injured in a rear-end motor vehicle collision and sought statutory accident benefits for a chronic pain assessment and physiotherapy.

The insurer denied the treatment plans.

The Tribunal found the chronic pain assessment was reasonable and necessary, relying on the applicant's family physician and the AMA Guide criteria for chronic pain syndrome.

However, the Tribunal dismissed the claim for physiotherapy, accepting the insurer's physiatry expert opinion that the applicant had already benefitted from facility-based treatment and would benefit more from home-based exercise.

Interest was awarded on the overdue payment for the chronic pain assessment.

The applicant was involved in a motor vehicle accident and sought medical and rehabilitation benefits.

The respondent denied the benefits on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant argued for removal from the MIG due to psychological impairments, chronic pain, and headaches.

The Tribunal found that the applicant's psychological symptoms were subclinical, there was no evidence of functional impairment from chronic pain, and the headaches did not warrant removal from the MIG.

The application was dismissed, and the disputed treatment plans and interest were denied.