Dr. Pankaj Bansal

The applicant sought statutory accident benefits for physiotherapy and chiropractic treatments following a motor vehicle accident.

The insurer denied the treatment plans.

The Tribunal found that the applicant failed to prove the treatments were reasonable and necessary, noting a lack of contemporaneous medical evidence and the fact that the applicant had already received concurrent physical therapies.

The Tribunal also found the insurer's denial notices complied with s. 38(8) of the Schedule.

The application was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, disputing her placement in the Minor Injury Guideline (MIG) and claiming entitlement to income replacement benefits (IRBs), attendant care benefits (ACBs), and specific treatment plans.

The Tribunal found that the applicant's injuries were predominantly minor, rejecting claims of an accident-related concussion and chronic pain syndrome due to a lack of contemporaneous and consistent medical evidence.

The Tribunal also dismissed the claims for IRBs and ACBs, finding the applicant did not demonstrate a substantial inability to perform her pre-accident employment tasks or a functional need for attendant care.

The application was dismissed in its entirety.

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

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

The Tribunal found that the applicant suffered a concussion, removing her from the MIG, and approved a treatment plan for physiotherapy services.

However, a claim for an outstanding balance on chiropractic services was denied due to insufficient evidence.

The Tribunal also dismissed the applicant's claim for an award for unreasonable delay, finding the respondent reasonably relied on its medical assessor's reports, but granted interest on overdue benefits.

An adverse inference was drawn against the respondent for failing to provide reasons for redactions in adjuster log notes as previously ordered.

The applicant sought medical and rehabilitation benefits following a motor vehicle accident, including osteopathic, chiropractic, and occupational therapy services.

The Tribunal found the applicant was entitled to osteopathic services at a rate of $80.00 per hour, as osteopaths are not relegated to the lowest rate under the Professional Services Guideline.

However, the claims for chiropractic services and an occupational therapy assessment were dismissed, as the insurer's section 44 assessments demonstrated the applicant had reached maximum medical improvement and did not suffer from functional impairments warranting further treatment.

The claim for a section 10 award was dismissed, but interest was awarded on the overdue osteopathic benefits.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that denied several treatment plans and a claim for an award under the Statutory Accident Benefits Schedule.

The Tribunal dismissed the reconsideration request regarding the award, the psychological assessment, and a chiropractic treatment plan, finding no errors of law or fact that would have changed the outcome.

However, the Tribunal granted the reconsideration in part, finding it had erred by failing to explicitly address a physiotherapy treatment plan dated August 14, 2023.

The Tribunal varied its original decision to approve the physiotherapy plan, noting it was supported by a contemporaneous chronic pain assessment.

The applicant sought statutory accident benefits following a motor vehicle accident, specifically claiming entitlement to a chiropractic treatment plan and an occupational therapy in-home assessment.

The respondent denied the benefits.

The adjudicator found that the applicant failed to prove the treatments were reasonable and necessary.

The applicant's medical records did not support consistent complaints of ongoing pain, and he failed to produce updated clinical notes and records as ordered.

The adjudicator accepted the respondent's independent medical examination, which concluded the applicant had reached maximum medical improvement with no objective signs of injury.

The application was dismissed, and claims for interest and an award for unreasonable delay were denied.

The applicant sought statutory accident benefits following a motor vehicle accident, including non-earner benefits, attendant care benefits, and various treatment plans.

The Licence Appeal Tribunal dismissed the application in its entirety.

The Tribunal found the applicant did not meet the test for a complete inability to carry on a normal life, preferring the respondent's section 44 assessments which attributed her functional decline to pre-existing conditions and age rather than the accident.

Furthermore, the Tribunal held that the applicant's claims for attendant care and treatment plans were barred because the non-catastrophic policy limit of $65,000 had been fully exhausted and there was no catastrophic impairment designation.

Claims for interest and a special award were also dismissed.

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

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

The applicant argued he should be removed from the MIG due to a pre-existing back condition from 1988.

The Tribunal found that the applicant failed to provide compelling medical evidence that his pre-existing condition would prevent maximal medical recovery if kept within the MIG limits.

Consequently, the applicant's injuries were deemed predominantly minor, and his claims for a treatment plan and interest were dismissed.

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

The respondent insurer denied two physiotherapy treatment plans, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant suffered a concussion, supported by emergency room records and a family physician's diagnosis, which warranted removal from the MIG.

The Tribunal ordered the respondent to pay the disputed treatment plans and awarded a 50% penalty under s. 10 of Regulation 664, finding the insurer's refusal to accept the concussion diagnosis and reliance on a flawed independent medical examination constituted stubborn and unreasonable conduct.

The applicant requested a reconsideration of a previous Tribunal decision that held him to the Minor Injury Guideline (MIG) and denied his treatment plans.

The Vice-Chair found that the original decision contained a factual error regarding the interpretation of a CT scan report, which did not rule out a concussion as previously concluded.

Upon re-hearing the matter, the Vice-Chair determined that the applicant's consistent neurological symptoms supported a concussion diagnosis, removing him from the MIG.

The applicant was awarded funding for physiotherapy, massage, and occupational therapy (excluding travel time), plus interest.

The claim for a special award was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, including a non-earner benefit and several treatment plans for physiotherapy, psychological services, and assessments.

The Licence Appeal Tribunal denied the non-earner benefit, finding the applicant did not suffer a complete inability to carry on a normal life, as he continued to engage in most pre-accident activities with only reduced frequency.

The Tribunal approved a physiotherapy treatment plan for $3,651.22, finding it reasonable and necessary for the applicant's soft-tissue injuries.

However, the Tribunal denied the psychological treatment and assessment plans, preferring the respondent's expert evidence that the applicant suffered only psychological sequelae and did not require treatment.

A chronic pain assessment was also denied.

A claim for a section 10 award was dismissed for failure to provide particulars.

Interest was awarded on the overdue physiotherapy benefits.

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

The Licence Appeal Tribunal found that while the applicant was diagnosed with chronic pain, she failed to demonstrate the requisite functional impairment, as she continued to work full-time and remained independent in her activities of daily living.

The Tribunal also found insufficient medical evidence to support an accident-related psychological injury.

Consequently, the applicant remained subject to the MIG, and her claims for treatment plans outside the MIG limit, along with claims for interest and an award, were dismissed.

The respondent's request for costs was also denied due to a lack of supporting particulars.

The applicant sought statutory accident benefits following a motor vehicle accident, disputing the respondent's denial of several treatment plans for chiropractic and psychological services, travel expenses, and a claim for an award for unreasonable delay.

The Tribunal found the chiropractic and two psychological treatment plans to be reasonable and necessary, preferring the evidence of the applicant's treating physicians over the insurer's examiners.

The claim for travel expenses was denied as it did not meet the statutory criteria for emergency transportation, and one psychological treatment plan was denied because it was not submitted into evidence.

The Tribunal also denied the request for a special award, finding no unreasonable delay by the respondent, but awarded interest on the overdue benefits.

The applicant sought statutory accident benefits following a motor vehicle accident, arguing that his injuries fell outside the Minor Injury Guideline (MIG) due to chronic pain.

The Licence Appeal Tribunal found that the applicant failed to prove he suffered from chronic pain causing functional impairment as a result of the accident, noting a lack of persistent pain reports to his family doctor and a subsequent workplace injury.

The Tribunal concluded the applicant's injuries were predominantly minor and subject to the $3,500 MIG limit, dismissing his claims for disputed treatment plans and interest.

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

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

The Tribunal found the applicant was removed from the MIG due to pre-existing lupus and chronic pain that prevented maximal recovery.

The Tribunal approved treatment plans for a chronic pain assessment and a multidisciplinary chronic pain program, finding them reasonable and necessary given the applicant's clinical deterioration and diagnosis of chronic pain syndrome.

Claims for chiropractic services, a psychological assessment, prescription medications, and a non-earner benefit were dismissed due to lack of evidence.

The Tribunal declined to order an award against the insurer or costs against the applicant.

The applicant sought a determination of catastrophic impairment and entitlement to attendant care benefits and income replacement benefits following a motor vehicle accident.

The Licence Appeal Tribunal found that the applicant did not meet the criteria for catastrophic impairment under either Criterion 7 (55% whole person impairment) or Criterion 8 (mental and behavioural disorders).

The Tribunal preferred the evidence of the respondent's experts, noting significant validity concerns and sub-maximal effort during the applicant's assessments.

Consequently, the applicant was not entitled to enhanced attendant care benefits, having exhausted her non-catastrophic limits.

The Tribunal also dismissed the claim for income replacement benefits, finding the applicant failed to prove a substantial inability to perform the essential tasks of her pre-accident employment as a personal support worker.

The applicant sought entitlement to income replacement benefits (IRBs) and various treatment plans following a motor vehicle accident.

The Licence Appeal Tribunal dismissed the claim for IRBs, finding the applicant failed to provide sufficient medical evidence or required employment information to establish a substantial inability to perform the essential tasks of his employment.

The Tribunal also denied the enhanced hourly rates sought for a psychotherapist and social worker, as well as the costs for progress reports, but awarded $200 for the cost of completing one treatment plan.

The claim for a special award under s. 10 of Regulation 664 was dismissed as there was no evidence of unreasonable delay by the insurer.

The applicant sought statutory accident benefits following a motor vehicle accident, disputing the insurer's denial of treatment plans for physiotherapy and psychological services, as well as claiming an award for unreasonable delay.

The Tribunal dismissed the claim for physiotherapy, accepting the insurer's medical examination which found no ongoing physical injuries.

The Tribunal also dismissed two psychotherapy treatment plans because the applicant failed to justify rates exceeding the Professional Services Guideline and session lengths beyond one hour.

However, the Tribunal partially approved a third psychological treatment plan, preferring the treating clinic's recent progress report over the insurer's assessment, but reduced the quantum to align with Guideline rates and one-hour sessions.

The claim for a special award was dismissed due to lack of evidence of unreasonable delay.

The applicant sought payment for four treatment plans, arguing the respondent insurer failed to provide sufficient medical reasons in its denial notices as required by s. 38(8) of the Statutory Accident Benefits Schedule.

The Tribunal found that the respondent's denial letters were compliant, as they clearly relied on and excerpted independent medical examination reports that directly addressed the requested treatments.

Because the notices were compliant, the applicant was not entitled to the treatment plans under s. 38(11).

The application was dismissed, and claims for interest and an award were denied.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to income replacement benefits and medical benefits beyond the Minor Injury Guideline (MIG) due to psychological impairments.

The Tribunal found that the applicant failed to establish a psychological impairment warranting removal from the MIG, preferring the respondent's expert evidence which noted credibility issues and inconsistent effort during testing.

The Tribunal also dismissed the claim for income replacement benefits, finding insufficient medical evidence to prove a substantial inability to perform the essential tasks of the applicant's pre-accident employment as a window packer.

All claims, including those for disputed treatment plans and interest, were dismissed.