Dr. Justin Guy

The applicant sought statutory accident benefits, including a non-earner benefit and medical benefits, following a motor vehicle accident.

The respondent denied the benefits on the basis that the applicant's impairments were caused by pre-existing spinal degeneration rather than the accident.

The Tribunal found that the applicant failed to establish on a balance of probabilities that the accident caused her current impairments, noting that her medical records showed extensive pre-existing spinal issues and that her post-accident complaints were inconsistent with her self-reports to expert assessors.

The appeal was dismissed.

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

The central issue was whether the applicant's injuries fell within the Minor Injury Guideline (MIG), which caps treatment at $3,500.

The applicant argued that psychological impairments, chronic pain, and pre-existing conditions removed him from the MIG.

The Tribunal found that the applicant failed to provide compelling medical evidence from appropriately qualified practitioners to substantiate these claims, preferring the respondent's psychiatric and physiatry evidence.

The Tribunal also excluded the applicant's late challenge to the respondent's expert reports due to non-compliance with the Tribunal's rules on notice.

The application was dismissed, and the claimed medical benefits and assessment costs were denied.

The insurer requested a reconsideration of a Licence Appeal Tribunal decision that awarded the insured $1,160.50 for a Treatment and Assessment Plan.

The insurer argued that the insured filed hearing materials late in breach of Rule 9.2, and that the Tribunal erred in its assessment of the evidence regarding the insured's physical limitations, work capacity, and causation.

The Executive Chair denied the reconsideration request, finding that the insured complied with the disclosure timeline set in a case conference order, rendering the Rule 9.2 argument moot.

Furthermore, the Chair held that the Tribunal's factual findings regarding the insured's limitations and need for the recommended assistive devices were reasonably supported by the evidentiary record, including reports from the insurer's own examiners.

The insured's request for costs was also denied, as the insurer's conduct was not unreasonable, frivolous, or in bad faith.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits from the insurer.

The insurer denied several treatment plans and assessments, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) limit of $3,500.

The applicant argued his injuries had developed into chronic pain, taking him outside the MIG.

The arbitrator found the applicant provided compelling evidence of chronic pain, removing him from the MIG.

The arbitrator granted the claims for a functional abilities evaluation, chiropractic treatment, and certain assistive devices, finding them reasonable and necessary.

Claims for a social-emotional assessment and additional assistive devices were denied.

The arbitrator awarded interest on the overdue benefits but denied the applicant's request for a special award, finding the insurer's conduct was not unreasonable.

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

The respondent denied several treatment plans and assessments on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and the $3,500 limit had been exhausted.

The Tribunal found that the applicant sustained predominately minor injuries and failed to provide compelling evidence of a pre-existing condition or psychological impairment that would prevent maximal recovery within the MIG.

The application for benefits was dismissed, and the respondent's request for costs was also denied.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for physiotherapy and chiropractic services.

The respondent denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) and were subject to the $3,500 cap.

The Tribunal found that the applicant's soft tissue injuries fell within the definition of minor injuries under the Schedule.

The applicant failed to provide objective medical evidence of chronic pain or a pre-existing condition that would prevent maximal recovery under the MIG.

Consequently, the Tribunal held the applicant was not entitled to treatment beyond the MIG cap, and dismissed the claims for the disputed treatment plans and interest.

The respondent's request for costs was also denied.

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

The insurer denied treatment plans for physiotherapy and a functional abilities evaluation, arguing the injuries fell within the Minor Injury Guideline.

Just prior to the arbitration hearing, the insurer approved the treatment plans with interest.

The applicant sought a special award under s. 282(10) of the Insurance Act for unreasonable delay.

The arbitrator found that the insurer unreasonably withheld benefits by failing to provide complete medical information to its assessors and selectively relying on reports that supported termination.

A special award of $2,510.98, representing 25% of the entitled amount, was ordered.

Following a successful arbitration for statutory accident benefits, the applicant sought expenses of $22,076.18.

The insurer disputed the quantum.

The arbitrator reviewed the claimed legal fees and disbursements, reducing the hourly rate to the Legal Aid rate and disallowing administrative tasks.

The arbitrator also disallowed expert witness fees for a chiropractor and a social emotional assessor, finding their evidence unnecessary or irrelevant, but allowed the fees for the applicant's family doctor.

The applicant was awarded $7,704.47 in total expenses.

The applicant was injured in a motor vehicle accident and sought medical benefits from her insurer.

The insurer denied the benefits on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) limit of $3,500.

The arbitrator found that the applicant had a documented pre-existing back injury and psychological issues that prevented her from achieving maximal recovery within the MIG limits.

The arbitrator ordered the insurer to pay the disputed treatment plans and interest, but dismissed the applicant's claim for a special award, finding the insurer's conduct was not sufficiently unreasonable to warrant punitive measures.

The applicant was injured in a motor vehicle accident and sought accident benefits, including an attendant care assessment and a psychological assessment.

The insurer initially denied the assessments on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and there was insufficient medical documentation.

The arbitrator found that the applicant had compelling pre-existing conditions, including a prior brain injury and psychiatric diagnoses, which took him outside the MIG.

The arbitrator held that the requested assessments were reasonable and necessary to determine the applicant's entitlement to benefits.

Furthermore, the arbitrator ordered the insurer to pay a special award of $1,083.42, finding that the insurer had unreasonably delayed and withheld payments despite having sufficient information about the pre-existing conditions early on.