Dr. Mohammad Nikkhou

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

The respondent denied the claims, arguing the injuries fell within the Minor Injury Guideline (MIG) and the applicant failed to attend scheduled insurer's examinations (IEs).

The Tribunal found the applicant was barred from proceeding with her claim for physiotherapy services due to her unexcused failure to attend two reasonably necessary IEs.

Furthermore, the Tribunal held the applicant failed to prove she sustained an accident-related psychological impairment warranting treatment outside the MIG.

The application for psychological benefits, an award, and interest was dismissed.

The applicant sought a non-earner benefit, various chiropractic treatment plans, an orthopaedic assessment, interest, and an award under the Statutory Accident Benefits Schedule following a motor vehicle accident.

The Licence Appeal Tribunal dismissed the application, finding the applicant failed to demonstrate a complete inability to carry on a normal life, as medical evidence indicated she continued to substantially engage in her pre-accident activities.

The Tribunal also found the applicant did not meet her burden to prove the disputed treatment plans were reasonable and necessary.

Claims for interest and an award were consequently 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 suffered from an accident-related psychological condition, warranting removal from the MIG.

The Tribunal approved treatment plans for a psychological assessment, a chronic pain assessment, and partially approved psychological services, but denied plans for a neurological assessment, driving rehabilitation, and physiotherapy.

The applicant's claim for an award for unreasonable delay was dismissed, but interest on overdue benefits was granted.

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 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 based on a scapular fracture, pre-existing conditions, psychological impairments, and a concussion.

The Tribunal found the applicant failed to prove any of these grounds on a balance of probabilities, noting inconsistencies in reporting and a lack of diagnoses from qualified medical practitioners.

The Tribunal held that diagnosing psychological impairments and concussions is outside the scope of practice for chiropractors and occupational therapists.

As the injuries were predominantly minor, the disputed treatment plans were not considered.

The Tribunal also dismissed the claims for income replacement benefits and attendant care benefits due to insufficient evidence.

The application was dismissed.

The applicant sought accident benefits following a motor vehicle accident, arguing she should be removed from the Minor Injury Guideline (MIG) due to chronic pain and psychological injuries.

The Licence Appeal Tribunal found the applicant failed to meet her burden of proof, noting inconsistencies in the medical evidence and a lack of formal psychological diagnosis.

The Tribunal held the applicant to the MIG, rendering the disputed treatment plan for chiropractic services moot, and denied claims for interest and a special award.

The applicant sought entitlement to a psychological assessment treatment plan and an award for unreasonable delay following a motor vehicle accident.

The adjudicator dismissed the application, finding the applicant failed to prove the assessment was reasonable and necessary.

The adjudicator preferred the objective testing and comprehensive assessments of the respondent's psychological experts over the applicant's pre-screening report and treating records, which lacked contemporaneous psychological complaints.

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

The applicant sought statutory accident benefits following a motor vehicle accident, disputing the respondent's denial of treatment plans for occupational therapy, assistive devices, physiotherapy, and a driving rehabilitation assessment.

The Licence Appeal Tribunal found the applicant partially entitled to the occupational therapy services and assistive devices, noting that the reasonableness of the benefits must be assessed at the time they were proposed.

However, the Tribunal denied the physiotherapy services as duplicative and exceeding guideline rates, and denied the driving rehabilitation assessment due to a lack of compelling evidence of ongoing psychological impairment.

Interest was awarded on the overdue benefits.

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

The Tribunal found that the applicant's injuries were predominantly minor and subject to the Minor Injury Guideline (MIG) limit of $3,500, which had been exhausted.

The applicant failed to establish chronic pain or a psychological condition warranting removal from the MIG.

The Tribunal denied the disputed physiotherapy treatment plan.

However, the Tribunal found the applicant was entitled to income replacement benefits from November 6, 2020, to May 16, 2021, as she suffered a substantial inability to perform the essential tasks of her pre-accident employment during that period.

Claims for an award under s. 10 of Reg. 664 were dismissed.

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 did not suffer from chronic pain or a psychological condition that would warrant removal from the MIG, relying on the AMA Guides and the respondent's psychological assessment.

The applicant was denied funding for a physiotherapy treatment plan as the MIG limit was exhausted.

However, the Tribunal found the applicant was entitled to income replacement benefits for a closed period from the date of the accident until she returned to full-time work.

Claims for an award under s. 10 of O. Reg. 664 were dismissed, but interest was awarded on the overdue income replacement benefits.

The applicant sought statutory accident benefits following a motor vehicle accident, arguing he should be removed from the Minor Injury Guideline (MIG) due to chronic pain and psychological impairment.

The Licence Appeal Tribunal found the applicant failed to establish functional impairment from chronic pain, noting that his own expert's examination produced normal results.

The Tribunal also rejected the claim of psychological impairment, finding the psychological diagnosis relied too heavily on self-reports and lacked corroboration from the applicant's family physician.

As the applicant remained within the MIG and the limits were exhausted, the claims for treatment plans and an award were dismissed.

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

The Licence Appeal Tribunal found the applicant was entitled to funding for psychotherapy, a neuropsychological assessment, and a COGMED assessment/treatment, as these were reasonable and necessary given objective evidence of a traumatic brain injury and ongoing psychological symptoms.

Claims for chiropractic services and a driver evaluation were dismissed.

The Tribunal also held the applicant was barred from pursuing a neurological assessment due to his failure to attend scheduled insurer's examinations without a reasonable explanation.

A claim for a special award under s. 10 of O. Reg. 664 was dismissed, but interest was awarded on the approved treatment plans.

The applicant was involved in a motor vehicle accident and sought statutory accident benefits for psychological services, a chronic pain management program, and physical therapy.

The respondent partially denied the psychological services and fully denied the other treatment plans.

The Tribunal found that the psychological services, to be provided by a registered psychotherapist, were reasonable and necessary, and that the respondent unreasonably withheld payment by applying the unregulated professional rate.

The Tribunal awarded the disputed amount for psychological services, plus a 25% award under s. 10 of Reg. 664 and interest.

The claims for the chronic pain management program and physical therapy were dismissed, as the Tribunal preferred the respondent's medical evidence that the applicant had reached maximum medical recovery and did not meet the criteria for chronic pain.

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 applied to the Licence Appeal Tribunal for non-earner benefits, various physiotherapy treatment plans, and assessments for psychology and chronic pain.

The adjudicator found that the applicant failed to meet his evidentiary burden to prove his injuries fell outside the MIG, noting the lack of clinical records and the failure of his assessors to address the respondent's medical reports.

The adjudicator also dismissed the claim for non-earner benefits, applying the Heath test and finding the applicant had resumed substantially all of his pre-accident activities, including completing his education.

All disputed treatment plans were deemed not reasonable and necessary, and the application was dismissed in its entirety.

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

The adjudicator found the applicant was entitled to the disputed amount for a psychological services treatment plan, noting that psychotherapy is a regulated profession and the respondent failed to provide sufficient explanations for its partial denial.

The adjudicator dismissed the claims for a chronic pain management program and a physical therapy treatment plan, preferring the respondent's medical experts who opined the applicant had reached maximum medical recovery.

An award of 25% under s. 10 of Reg. 664 was granted for the respondent's unreasonable handling of the psychological services claim, along with interest.

The applicant sought statutory accident benefits for various treatment plans and assessments following a motor vehicle accident.

The respondent denied the benefits.

The Tribunal dismissed the application, finding that the applicant failed to meet her burden of proving the treatment plans were reasonable and necessary.

Crucially, the applicant failed to submit the actual treatment plans (OCF-18s) into evidence, making it impossible for the Tribunal to assess them.

Furthermore, the Tribunal preferred the respondent's medical evidence, including multiple insurer examinations, which concluded the applicant had reached maximum medical improvement and did not require the disputed treatments.

The applicant sought entitlement to various statutory accident benefits following a motor vehicle accident, including treatment plans for psychological, physiotherapy, and chiropractic services, as well as catastrophic assessments and medical expenses.

The Licence Appeal Tribunal found the psychological and physiotherapy treatment plans to be reasonable and necessary, supported by extensive medical evidence, and noted the insurer's failure to provide proper notice of denial for one plan.

However, the Tribunal denied the chiropractic plan as there was no proof it was submitted, denied the catastrophic assessments as the unapproved file reviews were not standalone assessments, and denied the medical expenses incurred in China as they were submitted late and not proven reasonable and necessary.

The applicant sought income replacement benefits (IRBs) and funding for various treatment plans and assessments following a motor vehicle accident.

The Tribunal found that the applicant failed to prove a substantial inability to perform the essential tasks of his employment, noting he returned to work post-accident and was laid off due to a shortage of work, not his impairments.

Furthermore, the applicant failed to submit the disputed OCF-18 treatment plans into evidence, depriving the Tribunal of the ability to assess their reasonableness and necessity.

The application was dismissed in its entirety.

The applicant sought statutory accident benefits following a motor vehicle accident, disputing the denial of income replacement benefits (IRBs), removal from the Minor Injury Guideline (MIG), and several treatment plans.

The Tribunal found the applicant was not entitled to IRBs, as she failed to prove a substantial inability to perform the essential tasks of her pre-accident employment.

However, the Tribunal concluded the applicant's injuries fell outside the MIG due to a psychological impairment, preferring the evidence of the applicant's psychologist over the respondent's assessor.

The Tribunal approved a psychological assessment but denied the chiropractic and physiotherapy treatment plans, noting the applicant had previously discontinued such treatments because they were unhelpful.

The applicant was injured in a rear-end motor vehicle accident and sought various medical and rehabilitation benefits under the Statutory Accident Benefits Schedule, including physiotherapy, a chronic pain program, psychological treatment, aqua therapy, and assessments.

The respondent insurer denied the treatment plans based on Insurer's Examination reports.

The Tribunal found that the applicant failed to provide compelling contemporaneous medical evidence to support the treatment plans.

The Tribunal preferred the respondent's expert evidence, noting the applicant's active work and family life and the lack of objective signs of accident-related impairment.

The application was dismissed in its entirety.