Dr. Pankaj Bansal

The applicant sought entitlement to various statutory accident benefits following a 2019 motor vehicle accident, including physiotherapy services, a lift chair, a massage chair, and other assistive devices.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to prove the physiotherapy and lift chair were reasonable and necessary, relying on an insurer's examination that concluded the applicant's soft tissue injuries had resolved.

The Tribunal also denied the claims for the massage chair and other assistive devices because the expenses were incurred before submitting a compliant treatment plan, contrary to section 38(2) of the Schedule.

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

The respondent denied treatment plans for physiotherapy and a psychological assessment, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant's physical and psychological injuries were predominantly minor and did not warrant removal from the MIG.

However, because the respondent's initial denial letter for the physiotherapy treatment plan failed to provide proper medical reasons as required by s. 38(8) of the Schedule, the Tribunal ordered the respondent to pay for any physiotherapy services incurred during the period of non-compliance.

The claims for the psychological assessment and a special award were dismissed.

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

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

The Tribunal found the applicant had a documented pre-existing chronic back condition that prevented maximal medical recovery under the MIG, removing him from its limits.

The Tribunal approved a 2021 treatment plan for physiotherapy and chiropractic services as reasonable and necessary, but denied a 2024 treatment plan due to a lack of contemporaneous medical evidence.

Claims for a non-earner benefit and a special award for unreasonable delay were dismissed.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that denied her entitlement to post-104 income replacement benefits and certain treatment plans.

The applicant argued that the Tribunal committed a material breach of procedural fairness by allowing the respondent's experts to testify without producing clinical notes and records, and by denying her the opportunity to cross-examine an adjuster.

The applicant also alleged errors of law and fact regarding the weighing of medical and vocational evidence.

The Tribunal dismissed the request, finding no breach of procedural fairness as the adjuster was not summoned or listed as a witness, and concluding that the applicant was attempting to re-litigate the weighing of evidence without demonstrating any actual errors of law or fact.

The applicant sought medical and rehabilitation benefits following a motor vehicle accident, arguing that chronic pain and psychological impairments warranted removal from the Minor Injury Guideline (MIG).

The adjudicator found that the applicant failed to prove on a balance of probabilities that his injuries fell outside the MIG.

The medical evidence indicated large gaps in treatment and an intervening fall that caused significant injuries, breaking the causal link to the accident.

Furthermore, the adjudicator preferred the respondent's psychological assessment, which found no accident-related psychological disorder.

As the applicant remained within the MIG, the disputed treatment plans and claim for interest were dismissed.

The applicant sought entitlement to statutory accident benefits for a neuro-optometric assessment and occupational therapy services following a motor vehicle accident.

The respondent denied the treatment plans, relying on insurer's examinations which concluded the applicant's ongoing symptoms were related to pre-existing conditions rather than the accident.

The Tribunal found the applicant failed to meet her burden of proving the treatment plans were reasonable and necessary, noting a lack of corroborating medical evidence and significant pre-existing health issues.

The application was dismissed.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for physiotherapy, an attendant care assessment, and a chronic pain assessment.

The respondent insurer denied the benefits.

The Tribunal found the applicant was entitled to a reduced amount for physiotherapy, as the clinical records supported the need for treatment to reduce pain and improve functionality.

However, the Tribunal denied the requests for the attendant care and chronic pain assessments, finding insufficient medical evidence to demonstrate they were reasonable and necessary.

The application was granted in part.

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

The respondent denied several treatment plans, leading to a dispute before the Licence Appeal Tribunal.

As a preliminary issue, the Tribunal struck portions of the applicant's reply submissions for improperly introducing new evidence and arguments, violating the rule against splitting a case.

On the merits, the Tribunal found the applicant was not entitled to the remaining balance for psychological treatment, as the respondent's partial approval at the rate of $99.75 per hour for a psychotherapist was reasonable.

The Tribunal also denied a chronic pain assessment as a duplication of services.

However, the Tribunal granted the treatment plans for chiropractic, massage, physical therapy, and physiotherapy services, finding them reasonable and necessary based on the applicant's ongoing chronic pain and the recommendations of his treating physicians.

Claims for a special award and costs were dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming her psychological impairments and pre-existing conditions warranted removal from the Minor Injury Guideline (MIG).

The Licence Appeal Tribunal found that the applicant failed to provide compelling evidence of a psychological impairment caused by the accident or a documented pre-existing condition that would prevent maximal recovery within the MIG.

The Tribunal preferred the respondent's psychological and musculoskeletal assessments, which concluded the applicant suffered only minor soft tissue injuries and no diagnosable psychological condition.

As the MIG limit was already exhausted, the disputed treatment plans for chiropractic services and the claim for interest were 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 applicant argued she should be removed from the MIG due to pre-existing osteoarthritis, psychological injuries, and chronic pain.

The Tribunal found the applicant failed to provide compelling medical evidence that her pre-existing conditions prevented recovery within the MIG, or that she suffered from a psychological injury or chronic pain as a result of the accident.

The applicant's injuries were found to be minor, and her claims for occupational therapy, physiotherapy, and interest were dismissed.

The applicant sought statutory accident benefits following a rear-end motor vehicle collision.

The respondent denied several treatment plans on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant argued that he should be removed from the MIG due to accident-related psychological impairments and a pre-existing psychological condition.

The Tribunal found that the applicant's pre-accident medical records showed severe anxiety and depression, contradicting his expert's report that symptoms began after the accident.

The Tribunal concluded the applicant failed to prove that his pre-existing condition would prevent maximal recovery from his minor injuries if kept within the MIG.

The application was dismissed, with the applicant remaining subject to the $3,500 MIG limit.

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

The applicant argued that pre-existing shoulder and back conditions, as well as chronic pain with functional impairment, warranted removal from the MIG.

The Licence Appeal Tribunal found that the applicant failed to provide compelling medical evidence that his pre-existing conditions precluded maximal recovery within the MIG.

Furthermore, relying on independent medical examinations, the Tribunal concluded there was insufficient evidence of chronic pain causing functional impairment.

As the applicant remained within the MIG, the disputed treatment plans were not assessed, and claims for an award and interest were dismissed.

The respondent's request for costs was also denied due to procedural non-compliance.

The applicant sought entitlement to statutory accident benefits for chiropractic services, assistive devices, a chronic pain assessment, and a neurological assessment following a 2019 motor vehicle accident.

The respondent insurer denied the benefits and requested the exclusion of late-filed medical records, which the Tribunal allowed into evidence as the delay was minimal and non-prejudicial.

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

The Tribunal preferred the objective medical evidence from the respondent's multiple insurer's examinations, which consistently found normal ranges of motion and no objective signs of accident-related impairments warranting the disputed treatments.

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

The respondent denied various treatment plans and assessments on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and the $3,500 limit had been exhausted.

The Tribunal found that while the accident was a necessary cause of the applicant's neck, right forearm, and left shoulder impairments (excluding a partial thickness tear), the applicant failed to prove that her injuries warranted removal from the MIG.

The Tribunal rejected the applicant's claims of chronic pain syndrome and psychological impairment, finding that she did not meet the AMA Guides criteria for chronic pain and that her self-reported limitations were inconsistent with her return to work and medical records.

As the MIG limits were exhausted, the disputed benefits, interest, and award were denied.

The applicant sought statutory accident benefits following a motor vehicle accident, including attendant care benefits, a lawn tractor, a snow blower, an iPhone, an iMac computer, and an optometry assessment.

The Licence Appeal Tribunal dismissed the application in its entirety.

The adjudicator found that the attendant care benefits were not incurred as required by the Schedule.

The request for a lawn tractor and snow blower was denied because they fell under the housekeeping exception for rehabilitation benefits.

The requests for an iPhone and iMac were denied as the applicant failed to prove they were essential for rehabilitation rather than normal household upgrades.

Finally, the optometry assessment was deemed not reasonable and necessary given previous normal assessments by specialists.

The applicant sought medical benefits for physiotherapy, an orthopedic assessment, and a psychological assessment 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 funding limit had been exhausted.

The Tribunal found that the applicant failed to prove her injuries, including headaches, chronic pain, and psychological issues, warranted removal from the MIG.

The Tribunal also found insufficient evidence that pre-existing conditions prevented her from achieving maximal recovery within the MIG limit.

The application was dismissed.

The applicant sought medical benefits for chiropractic, physiotherapy, and occupational therapy services following a motor vehicle accident.

The respondent denied the benefits, initially arguing the injuries fell within the Minor Injury Guideline (MIG), though it later removed the applicant from the MIG.

The Tribunal found that the applicant failed to establish on a balance of probabilities that the disputed treatment plans were reasonable and necessary.

The evidence showed the applicant had returned to work and regular activities shortly after the accident, and there was insufficient current medical evidence to support the need for the proposed passive therapies and assessments months or years post-accident.

The application was dismissed.