Dr. Joseph Wong

The applicant sought entitlement to three multidisciplinary treatment plans and interest following a motor vehicle accident.

The respondent denied the plans, arguing the applicant had not established chronic pain syndrome and had already received extensive treatment.

The Tribunal found the treatment plans were reasonable and necessary, noting the applicant had been diagnosed with chronic myofascial pain and psychological conditions linked to his ongoing pain.

The Tribunal also found the applicant had not received extensive treatment due to financial constraints and pandemic-related gaps in care, and that the limited treatment received was beneficial.

The applicant was awarded the treatment plans and interest.

The applicant, who was deemed catastrophically impaired following a 2015 motor vehicle accident, sought payment for several treatment plans denied by the respondent insurer.

The Licence Appeal Tribunal found that the proposed physiotherapy services were not reasonable and necessary, as the applicant had reached maximum medical recovery and previous treatment yielded no functional gains.

The Tribunal partially approved the psychological services plan for the OCF-18 completion fee but denied administrative and planning costs.

The Tribunal approved the occupational therapy and case management plans, finding the requested hours for documentation and planning to be reasonable.

The applicant's claim for a special award was dismissed, as the insurer's conduct was not found to be unreasonable.

The applicant sought statutory accident benefits following a motor vehicle accident, including psychological services, a catastrophic impairment assessment, and a special award.

The Tribunal found the applicant was entitled to the higher psychologist rate for services provided by a supervised psychotherapist, awarding $598.32.

However, further psychological services were denied as the applicant had reached maximal improvement and was independent in daily living.

The catastrophic impairment assessment was also denied due to insufficient evidence of impairment.

The claim for a special award was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, including post-104 week income replacement benefits (IRBs) and various treatment plans.

The Tribunal found that the applicant suffered a complete inability to engage in any employment for which he was reasonably suited due to a severe shoulder injury requiring surgery, exacerbated by the accident, and awarded IRBs at the optional rate of $1,000 per week.

The Tribunal denied most of the disputed treatment plans for lack of supporting medical evidence, but approved a vocational assessment relevant to the IRB claim.

The request for a special award was dismissed as the insurer's denial was not found to be unreasonable, though interest was awarded on overdue benefits.

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

The respondent denied various treatment plans, 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 a psychological impairment.

The Tribunal found that the applicant failed to prove on a balance of probabilities that he suffered from chronic pain with functional impairment or a psychological condition, noting significant gaps in medical treatment and a lack of corroborating evidence in the family physician's records.

The Tribunal concluded the injuries were predominantly minor, dismissing the application for the disputed treatment plans and an award.

The applicant sought statutory accident benefits following a motor vehicle accident, including a non-earner benefit, various treatment plans for physiotherapy and psychological services, and a chronic pain assessment.

The Tribunal found the applicant failed to prove a complete inability to carry on a normal life, noting inconsistencies between self-reported limitations and employer records.

The Tribunal also dismissed the claims for treatment plans, relying on the respondent's section 44 assessments which found no ongoing accident-related impairments warranting the disputed treatments.

Claims for interest, an award, and costs from both parties were also dismissed.

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

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

The Licence Appeal Tribunal found that the applicant demonstrated chronic pain with functional impairment, warranting removal from the MIG.

However, the Tribunal dismissed the claims for a physiotherapy treatment plan and a psychological assessment, finding the applicant failed to prove they were reasonable and necessary due to a lack of contemporaneous supporting medical evidence.

No interest was payable as no benefits were overdue.

The applicant requested a reconsideration of a Tribunal decision that found he was not removed from the Minor Injury Guideline (MIG) and was not entitled to disputed treatment plans.

The applicant argued the adjudicator made errors of law and fact in evaluating his chronic pain syndrome claim.

The Tribunal dismissed the request, finding the applicant was attempting to re-litigate the case and reweigh evidence, specifically regarding the expert report of a physiatrist and the application of the AMA Guidelines for diagnosing chronic pain.

The applicant sought statutory accident benefits following a motor vehicle accident, including income replacement benefits (IRBs) and funding for physiotherapy and a physiatry assessment.

The insurer had suspended IRBs due to the applicant's failure to attend section 44 examinations.

The Tribunal found that the applicant did not suffer a substantial inability to perform the essential tasks of her pre-accident employment, relying on functional abilities evaluations and the applicant's return to work as a cashier.

The Tribunal also dismissed the claim for physiotherapy as not reasonable and necessary, and declined to order a special award, finding the insurer did not unreasonably withhold benefits.

The insurer agreed to fund the physiatry assessment, and the Tribunal ordered interest on that overdue payment.

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

The Licence Appeal Tribunal considered whether the applicant was entitled to psychological and physiotherapy services, interest, and an award under s. 10 of Reg. 664.

The Tribunal denied the claim for psychological services, finding the proposed treatment was not reasonable and necessary given the lack of lasting improvement.

However, the Tribunal granted the claim for physiotherapy services, noting corroborating evidence of chronic pain from treating specialists.

The claim for an award under s. 10 was dismissed as the insurer's conduct was not unreasonable.

The applicant sought $14,750.81 for a catastrophic impairment assessment following a 2019 motor vehicle accident.

The respondent denied the treatment plan and argued that the issue of the applicant's chronic pain was res judicata based on a prior Tribunal decision.

The Tribunal found that res judicata did not apply as the issues were different and the prior decision did not address the cost of a catastrophic assessment.

The Tribunal partially approved the treatment plan, finding the physiatry, psychological, and occupational therapy assessments reasonable and necessary, but denied the costs for clinic file reviews, transportation, and interpretation.

The applicant was awarded $8,400.00 plus interest, but the claim for a special award under s. 10 of Regulation 664 was dismissed.

The applicant sought entitlement to statutory accident benefits for a multi-disciplinary chronic pain program and psychological services following a 2014 motor vehicle accident.

The Tribunal drew an adverse inference against the applicant for failing to comply with a production order for clinical notes and records.

The Tribunal dismissed the application, finding the applicant failed to prove the treatment plans were reasonable and necessary, relying instead on the respondent's insurer examinations which concluded the applicant had reached maximum medical recovery and did not suffer from a psychological impairment.

The Applicant sought entitlement to a treatment plan for physiotherapy services in the amount of $4,115.12, along with an award and interest, following a motor vehicle accident.

The Respondent denied the benefits.

The Tribunal found that the Applicant failed to meet her burden of proving the treatment plan was reasonable and necessary, noting a lack of contemporaneous or compelling medical evidence supporting the need for physical therapy.

The Tribunal preferred the comprehensive assessment of the Respondent's section 44 assessor over the Applicant's medical reports.

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

The applicant sought statutory accident benefits following a motor vehicle accident, arguing her injuries warranted removal from the Minor Injury Guideline (MIG) due to chronic pain syndrome with functional impairment.

The Licence Appeal Tribunal found the applicant's medical records and a section 44 physiatry assessment did not support a finding of functional impairment, noting she had returned to work without restrictions.

The Tribunal concluded the applicant's injuries were predominantly minor, dismissing the claims for additional treatment plans and assessments beyond the $3,500 MIG limit.

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

The Licence Appeal Tribunal found that the applicant's injuries were predominantly minor.

The Tribunal preferred the evidence of the insurer's examiners, noting that the applicant's experts failed to explain how her pain improved over time and then worsened years later, and that her psychological assessment was conducted by a panel lacking a qualified psychologist or psychiatrist.

As the applicant had exhausted her $3,500 MIG limit, her claims for further medical benefits, an award, and interest were 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 his injuries were more than minor or that a pre-existing condition prevented his maximal medical recovery within the MIG limits.

Consequently, the claims for additional treatment plans, assessments, interest, and an award for unreasonable delay were dismissed.

The applicant sought reconsideration of a decision denying three treatment plans for chiropractic services and one for a physiatry assessment.

The applicant argued the Tribunal made errors of fact by ignoring a physiotherapy referral and a chronic pain diagnosis from a section 25 assessor.

The adjudicator dismissed the request, finding that a physiotherapy referral does not constitute objective evidence for chiropractic services, and that the insurer's physiatrist was properly preferred over the section 25 assessor because the applicant's minimal use of pain medication was inconsistent with a chronic pain diagnosis.

The applicant sought statutory accident benefits following a motor vehicle accident, including a non-earner benefit and several treatment plans for chiropractic and physiatry services.

The Licence Appeal Tribunal found that the applicant did not suffer a complete inability to carry on a normal life, preferring the evidence of the insurer's experts over the applicant's experts regarding her physical and psychological impairments.

The Tribunal also denied the treatment plans, finding insufficient objective evidence to demonstrate they were reasonable and necessary.

Claims for an award, interest, and costs were also dismissed.

The applicant sought various statutory accident benefits and a catastrophic impairment (CAT) designation following a 2016 motor vehicle accident.

The Licence Appeal Tribunal found that while the accident contributed to the applicant's psychological impairment, the applicant's self-reports were not credible due to significant inconsistencies regarding his pre-accident health and functional status.

The Tribunal concluded the applicant did not suffer a marked impairment in three spheres of functioning and therefore did not meet the CAT threshold.

All claims for income replacement benefits, attendant care, and medical benefits were dismissed as the applicant failed to prove they were reasonable, necessary, or incurred.

The applicant sought statutory accident benefits following a motor vehicle accident, specifically claiming costs for physiotherapy, a physiatry assessment, and a psychological assessment.

The adjudicator found the physiotherapy treatment plan reasonable and necessary as the applicant reported gradual improvement and pain relief.

The physiatry assessment was also approved, supported by medical opinions indicating the applicant suffered from chronic pain syndrome extending beyond the expected recovery period.

However, the claim for a psychological assessment was dismissed because there was insufficient documented evidence of psychological impairments in the family physician's records, and the respondent's psychological assessment finding no impairment was preferred.

Interest was awarded on the overdue payments for the approved benefits.