Dr. Naumetz

The applicant sought medical benefits for physiotherapy, a TMJ assessment, and an orthopedic assessment following a motor vehicle accident.

The Licence Appeal Tribunal found that the applicant failed to prove the proposed treatments and assessments were reasonable and necessary.

The evidence showed physiotherapy had not been helpful, there was no indication of a jaw injury from the accident, and the orthopedic assessment would be duplicative of previous assessments.

The application was dismissed.

The applicant sought entitlement to statutory accident benefits for physiotherapy and chiropractic treatment plans following a 2017 motor vehicle accident.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to prove the treatments were reasonable and necessary.

The Tribunal preferred the evidence of the respondent's orthopaedic surgeon, who found no physical abnormalities and concluded the applicant had recovered from her minor soft tissue injuries, over the applicant's clinical notes and records which showed significant gaps in treatment and a failure to undergo recommended diagnostic imaging.

The applicant sought reconsideration of a decision denying income replacement benefits and various treatment plans on the basis that his injuries fell within the Minor Injury Guideline (MIG).

The applicant argued the adjudicator made significant errors of law and fact in weighing the medical evidence regarding his physical limitations, psychological impairment, and chronic pain.

The adjudicator dismissed the reconsideration request, finding no errors of law or fact in the original decision.

The adjudicator reaffirmed that the applicant failed to meet the burden of proving his injuries fell outside the MIG or that he suffered a substantial inability to perform the essential tasks of his employment.

The applicant insurer sought judicial review of a Director's Delegate's appeal decision regarding a catastrophic impairment determination under the Statutory Accident Benefits Schedule.

The Delegate had overturned an arbitrator's finding that combining impairment ratings for a physical brain injury and a separate psychological disorder constituted impermissible 'double counting'.

The Delegate also remitted the issue of medication impairment back to arbitration and upheld a 4% rating for scarring.

The Divisional Court applied the reasonableness standard of review and dismissed the application, finding the Delegate's interpretation of the AMA Guides and the Schedule fell within the range of acceptable outcomes.