Dr. Mohamed Lamine

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

The applicant argued that he sustained psychological impairments and chronic pain that warranted removal from the MIG.

The Tribunal preferred the evidence of the respondent's clinical psychologist, who found no psychological condition removing the applicant from the MIG, over the applicant's evidence, which included a virtual assessment and procedurally excluded late-filed reports.

The Tribunal concluded the applicant's injuries were predominantly minor, dismissed the claims for treatment plans outside the MIG limit, and denied claims for interest and a special award.

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

The respondent denied benefits beyond the $3,500 Minor Injury Guideline (MIG) limit.

The Tribunal found that the applicant sustained a concussion, which falls outside the definition of a minor injury, and removed her from the MIG.

However, the Tribunal dismissed the claims for physical therapy, finding it not reasonable and necessary based on the insurer's examination.

The claim for a psychological assessment was dismissed because the applicant failed to attend requested insurer's examinations.

Claims for osteopathy, vision therapy, and eyeglasses were also dismissed because they were submitted on claim forms without the required treatment plans under s. 38(2) of the Schedule.

Claims for an award and interest were consequently denied.

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

The respondent denied several treatment plans and assessments, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant established a chronic pain condition with functional impairment, relying on the AMA Guides criteria and expert medical evidence, thereby warranting removal from the MIG.

The Tribunal ordered the respondent to pay for the disputed chiropractic treatment plans, a neurological assessment, and a chronic pain assessment, finding them reasonable and necessary.

The applicant was also awarded interest on overdue benefits, but her claim for a special award under s. 10 of O. Reg. 664 was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, including a non-earner benefit (NEB), various treatment plans, and an award for unreasonable delay.

The Tribunal found the applicant was not entitled to the NEB, as he failed to prove a complete inability to carry on a normal life, noting he returned to full-time work shortly after the accident.

Most treatment plans were denied for lack of objective evidence of impairment, relying on the respondent's insurer examinations.

However, a functional abilities evaluation was approved based on psychological reports indicating a need to investigate functional impairments.

The claim for an award was dismissed as the insurer adjusted the claim in good faith.

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

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

The Tribunal found the applicant sustained a psychological impairment as a result of the accident, warranting removal from the MIG.

The Tribunal preferred the evidence of the applicant's treating practitioners and section 25 assessor over the respondent's section 44 examiners.

The Tribunal ordered the respondent to pay for the disputed physiotherapy treatment plans, an orthopaedic assessment, a psychological assessment, and psychological services, finding them reasonable and necessary.

Interest was also awarded on overdue benefits.

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 with functional impairment.

The Tribunal found the applicant failed to provide sufficient objective medical evidence to establish chronic pain with a functional limitation, noting the applicant's own expert did not diagnose chronic pain.

As the applicant was held to the MIG and the disputed treatment plans exceeded the remaining limits, the application was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, disputing the respondent's denial of various treatment plans, an income replacement benefit (IRB) deficit, and seeking an award for unreasonable delay.

The Licence Appeal Tribunal found that the proposed treatment plans for physiotherapy, optometric services, concussion therapy, occupational therapy, and pharmacotherapy were reasonable and necessary, preferring the evidence of the applicant's treating specialists over the respondent's independent examiners.

However, the Tribunal dismissed the claims for the IRB deficit and the outstanding balance for psychological therapy due to insufficient evidence.

The request for an award under s. 10 of Regulation 664 was also dismissed, as the respondent's conduct did not meet the threshold of being unreasonable.

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

The respondent denied the benefits on the basis that 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 chronic pain and psychological impairments.

The Tribunal found that the applicant failed to prove on a balance of probabilities that she suffered from chronic pain with functional impairment or a psychological injury caused by the accident that would warrant removal from the MIG.

The Tribunal preferred the respondent's medical and psychological assessments.

As the MIG limit was exhausted, the claims for treatment plans and interest were dismissed.

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

The respondent insurer determined the applicant's injuries fell within the Minor Injury Guideline (MIG) and denied a treatment plan for chiropractic services.

The applicant applied to the Licence Appeal Tribunal, arguing he suffered from chronic pain warranting removal from the MIG.

The Tribunal found the applicant failed to provide compelling medical evidence, such as clinical notes or a chronic pain diagnosis, to challenge the MIG determination.

The Tribunal held the applicant remained within the MIG and was only entitled to the remaining balance of the $3,500 limit.

The respondent's request for costs was denied as the applicant's failure to meet his evidentiary burden did not amount to unreasonable or frivolous conduct.