Dr. Konstantine Zakzanis

The applicant sought statutory accident benefits following a 2015 motor vehicle accident, claiming catastrophic impairment due to mental and behavioural disorders and entitlement to income replacement benefits (IRB).

The Licence Appeal Tribunal found that the applicant did not meet the threshold for catastrophic impairment under Criterion 8, as he sustained only moderate, rather than marked, impairments in activities of daily living and adaptation.

The Tribunal preferred the respondent's psychiatric assessment, noting the applicant maintained useful functioning such as driving, going to the gym, and caring for his parents.

The Tribunal also dismissed the claim for IRB, finding insufficient objective medical evidence that the applicant suffered a substantial inability to perform the essential tasks of his pre-accident employment as an IT technician.

Claims for an award and interest were consequently dismissed.

The applicant was injured in a motor vehicle accident and sought various statutory accident benefits, including income replacement benefits, treatment plans for physiotherapy and psychological services, assessments, and assistive devices.

The Licence Appeal Tribunal found that the applicant failed to prove entitlement to income replacement benefits, psychological services, and most assessments.

However, the Tribunal approved several physiotherapy plans and a portion of the requested assistive devices, finding them reasonable and necessary to manage the applicant's chronic pain.

The applicant's claim for a special award under s. 10 of O. Reg. 664 was dismissed, as the insurer's reliance on its assessors' reports was not unreasonable.

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

The applicant argued that her pre-existing psychological conditions, chronic pain, and accident-related psychological impairments warranted removal from the MIG.

The Tribunal found the medical evidence insufficient to establish that her pre-existing conditions precluded recovery within the MIG, or that she suffered from chronic pain or accident-related psychological impairments.

The Tribunal also dismissed the claim for non-earner benefits, finding the applicant failed to demonstrate a complete inability to carry on a normal life.

The application was dismissed in its entirety.

The applicant, a law student who was struck by a vehicle while riding a bicycle, sought a determination of catastrophic impairment under Criterion 8 (mental and behavioural disorders) and entitlement to various treatment plans.

The Tribunal found that the applicant did not meet the threshold for catastrophic impairment, as he did not demonstrate a marked impairment in three of four functional domains.

Despite accident-related challenges, the applicant successfully completed law school, passed the bar, and maintained employment as a lawyer.

The Tribunal also dismissed the claims for the disputed treatment plans, finding that the applicant failed to prove they were reasonable and necessary.

The applicant sought entitlement to 13 treatment plans for chiropractic, psychological, and assessment services following a 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 preferred the evidence of the respondent's insurer's examinations, which indicated the applicant's soft tissue injuries had healed and his psychological condition had improved, over the applicant's evidence.

The applicant sought statutory accident benefits following a 2017 motor vehicle accident, claiming entitlement to a chronic pain treatment program, a neurological examination, and a psychological examination.

The respondent denied the treatment plans, arguing the applicant had reached maximum medical recovery and had no ongoing impairments.

The Tribunal found that the applicant's functional abilities, normal gait, and lack of reliance on pain medication undermined the need for the chronic pain program.

Furthermore, previous assessments had already concluded the applicant suffered no neurological or psychological impairments.

The application was dismissed in its entirety.

The applicant sought statutory accident benefits following a 2017 motor vehicle accident, claiming catastrophic impairment due to psychological disorders.

The Licence Appeal Tribunal found that while the applicant suffered from accident-related post-traumatic stress disorder and major depressive disorder, these resulted in only moderate impairments in the activities of daily living and social functioning.

Consequently, the applicant did not meet the threshold for catastrophic impairment under Criterion 8.

The Tribunal also dismissed claims for attendant care benefits, finding them not reasonable and necessary based on orthopedic evidence of normal range of motion.

Claims for an attendant care assessment and various treatment plans were dismissed because the applicant had exhausted the $65,000 non-catastrophic funding limit.

The applicant was involved in a motor vehicle accident and sought statutory accident benefits, including a determination of catastrophic impairment due to a mental or behavioural disorder.

The respondent denied the benefits, arguing the applicant's psychological impairments pre-dated the accident.

The Tribunal found that the accident exacerbated the applicant's pre-existing condition, resulting in a marked class 4 impairment in her adaption to the workplace.

The Tribunal concluded the applicant was catastrophically impaired and awarded attendant care benefits of $931.57 per month, along with partial entitlement to claimed medical, rehabilitation, and examination expenses.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for a chronic pain assessment and a functional assessment, as well as a special award for unreasonable delay.

The Licence Appeal Tribunal found the chronic pain assessment to be reasonable and necessary, preferring the evidence of the applicant's assessors over the respondent's assessors.

However, the Tribunal denied the functional assessment because it was based solely on a telephone consultation.

The claim for a special award was also dismissed as the respondent's denial did not constitute unreasonable conduct.

The applicant was injured in a motor vehicle accident and sought various medical and rehabilitation benefits from the respondent insurer.

The insurer denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) and the $3,500 limit had been exhausted.

The applicant argued she should be removed from the MIG due to pre-existing injuries and psychological impairments.

The Tribunal found insufficient evidence of pre-existing conditions preventing recovery or clinically significant psychological impairments, preferring the respondent's psychological assessment over the applicant's.

The Tribunal concluded the applicant's injuries were predominantly minor, and since the MIG limits were exhausted, the claims for treatment plans and interest were dismissed.

The applicant, a pedestrian struck by a vehicle, sought a determination that she sustained a catastrophic impairment due to psychological and emotional damage.

The Tribunal reviewed extensive medical and occupational therapy evidence, finding that the applicant's pre-accident active lifestyle had been replaced by severe avoidant behaviours, fatigue, and an inability to cope with stress.

Preferring the evidence of the applicant's psychiatric assessor over the respondent's, the Tribunal concluded the applicant suffered a marked impairment in the domain of adaptation.

The claims for interest and a special award were dismissed as there were no specific monetary benefits in dispute.

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

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

The Licence Appeal Tribunal found that the applicant sustained a psychological injury and chronic pain syndrome, removing her from the MIG.

The Tribunal awarded medical benefits for a chronic pain program and one chiropractic/massage treatment plan, as well as the costs of psychological and orthopaedic assessments.

The applicant was also awarded pre-104 week income replacement benefits (IRBs) due to her inability to perform her heavy pre-accident work as a machine operator, but her claim for post-104 week IRBs was dismissed for lack of evidence regarding alternative suitable employment.

A claim for a special award for unreasonable delay was dismissed.

The applicant was injured in a rear-end motor vehicle accident and subsequently developed complete hearing loss in his left ear and partial hearing loss in his right ear due to a labyrinthine concussion.

He applied for non-earner benefits, housekeeping benefits, and a determination of catastrophic impairment.

The arbitrator found that the applicant's hearing loss and resulting psychological impairments continuously prevented him from engaging in substantially all of his pre-accident activities, entitling him to non-earner benefits.

The arbitrator also concluded that the applicant sustained a catastrophic impairment under criterion (g) of the Schedule, as his psychological impairments resulted in a Class 4 marked impairment in the sphere of social functioning.

The claim for housekeeping benefits was dismissed.

The insurer was ordered to pay the applicant's arbitration expenses.

The applicant sought payment for several treatment plans and assessments following a motor vehicle accident, which the respondent insurer denied.

The Licence Appeal Tribunal found that the applicant failed to provide sufficient medical evidence to prove the treatment plans were reasonable and necessary.

The Tribunal preferred the evidence of the insurer's assessors, who concluded the physical injuries were minor and had largely resolved, and that there was no objective evidence linking the applicant's psychological issues to chronic physical pain.

The application was dismissed.

The applicant was injured in a motor vehicle accident and sought a non-earner benefit after the respondent insurer stopped payments.

The adjudicator found that the applicant failed to provide sufficient evidence regarding the time commitments of his pre-accident activities.

Without this information, it was impossible to determine whether the applicant was continuously prevented from engaging in substantially all of the activities in which he ordinarily engaged before the accident.

The application for the non-earner benefit and interest was dismissed.

The appellant was injured in a motorcycle accident and sought a determination of catastrophic impairment.

The arbitrator found the appellant had a 49% Whole Person Impairment (WPI) by only considering physical neurological impairments and excluding psychological impairments to avoid double counting.

On appeal, the Director's Delegate held that the arbitrator erred in law by failing to combine the physical and psychological impairments.

When combined, the WPI totaled 59%, exceeding the 55% threshold.

The appeal was allowed in part, declaring the appellant catastrophically impaired, while upholding the denial of attendant care benefits and a special award.

The applicant sought statutory accident benefits following a motor vehicle accident, disputing the insurer's determination that her injuries fell within the $3,500 Minor Injury Guideline (MIG) limit.

The adjudicator found that while the applicant's physical injuries were predominantly soft-tissue and she did not suffer a diagnosable psychological impairment, she was nevertheless removed from the MIG limit because the insurer's notice failed to explicitly state its belief that the MIG applied, breaching section 38(9) of the Schedule.

Consequently, the applicant was awarded the outstanding balance of an incurred chiropractic plan and reimbursement for prescription expenses.

However, claims for a psychological assessment and a further chiropractic plan were dismissed as not reasonable and necessary.

The applicant was injured in a motorcycle accident and sought a determination that he sustained a catastrophic impairment, along with claims for attendant care benefits and a special award.

The arbitrator evaluated competing medical assessments and preferred the insurer's experts, finding the applicant's combined physical and psychological impairments amounted to 49% Whole Person Impairment, falling short of the 55% threshold.

The claim for attendant care benefits was dismissed as the applicant failed to demonstrate an economic loss incurred by his wife and medical assessments indicated he was independent in self-care.

The request for a special award was denied because the insurer had not unreasonably withheld benefits.

The applicant was ordered to pay the insurer's hearing expenses.

The applicant sought statutory accident benefits following two motor vehicle accidents in 2007.

The arbitrator found the applicant's evidence to be unreliable due to poor recall and contradictions with documentary evidence, including Ontario Works records showing he had returned to work.

Relying on the medical evidence, particularly the applicant's orthopaedic surgeon, the arbitrator concluded the applicant suffered a complete inability to engage in suitable employment for a limited period.

The applicant was awarded income replacement benefits from July 7, 2009, to August 1, 2010, but his claims for various assessment costs and a special award were dismissed.